Instruction: Design, Delivery, Assessment
Worksheet
Sponsoring Organization
Program/Group of Programs
Instruction Worksheet for:
X
Professional
Required Documents in this Domain:


Program of Study
All associated course descriptions
As applicable (see your Submission Requirements Chart for program specific requirements):
 Subject Matter Knowledge (SMK) Matrix
 Professional Standards for Teachers (PST) matrix
 Associated course syllabi
ESE names and approves programs according to the licensure role (e.g., Elementary 1-6, Initial, PostBaccalaureate) for which candidates are endorsed. Sponsoring Organizations may have one or more
“program variations” that result in that endorsement (e.g., MAT in Elementary Ed, MEd in Elementary
Ed, licensure-only, etc.). To ensure that ESE has a record and has approved all of the pathways to
endorsements, we ask that you include a full list of the program variations below. Each variation should
have its own program of study.
If your organization has only a single route to obtaining the licensure endorsement, you do not have to
complete this portion of the worksheet. If you are unclear, ask your Ed Prep Specialist for more details.
Program Variation: List each program variation below.
Variation Title
Variation Title
Variation Title
Variation Title
Educator Preparation Review
Resources: http://www.doe.mass.edu/edprep/resources.html
Review Toolkit: http://www.doe.mass.edu/edprep/toolkit/
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Instruction: Design, Delivery, Assessment
Worksheet
Program Delivery: Indicate the ways in which the program(s) are delivered. Check all that apply.
On Campus Program
Online/Hybrid Program
Satellite Program
Statements of Assurances: There are several regulatory expectations for preparing candidates for
licensure in Massachusetts. By checking the boxes below, you are affirming that the program was
developed in a way that fully addresses these requirements. It is the expectation that programs be
built on strong inputs and produce positive outcomes for candidates.
Practicum hours meet regulatory requirements as per 603 CMR 7.04 (4)
Program of Study meets regulatory requirements for applicable licenses set forth
in 603 CMR 7.03 (3) (a) and (b) and 7.04 (2) (c) 5. b. i. or c. i.
Program of Study addresses all SMK requirements set forth in 603 CMR 7.06,
7.07, 7.09, and 7.11at the appropriate licensure level (if applicable).
Program of Study addresses all Professional Standards set forth in 603 CMR 7.08
or 7.10 at the appropriate licensure level (if applicable).
If you also offer this subject/grade level license at the initial level: Coursework and
experiences used by candidates to satisfy the requirements for an Initial license
may not be used to satisfy the requirements for the Professional license in the
same field.
Outcome Criteria:
Prompt 1: Describe the evidence your organization will use to demonstrate that
completers have deeper content knowledge (SMK) that makes them more
effective in their specific licensure role.
200 words
Educator Preparation Review
Resources: http://www.doe.mass.edu/edprep/resources.html
Review Toolkit: http://www.doe.mass.edu/edprep/toolkit/
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Instruction: Design, Delivery, Assessment
Worksheet
Prompt 2: Describe the evidence your organization will use to demonstrate that
completers have increased pedagogical skills (PSTs) that make them more
effective in the licensure role.
200 words
Prompt 3: Describe the evidence your organization will use to demonstrate that
completers have an increased positive impact on PK-12 students as a result of
the program.
250 words
Supporting Criteria:
Prompt 4: Explain how the program(s) of study are sequenced to support the
increased depth of skills and knowledge over time.
200 words
Prompt 5: Explain how the program of study is coherent such that connections
among courses are evident.
200 words
Prompt 6: Explain how content is differentiated by subject area and grade levels
(i.e., 5-8, 9-12).
200 words
Educator Preparation Review
Resources: http://www.doe.mass.edu/edprep/resources.html
Review Toolkit: http://www.doe.mass.edu/edprep/toolkit/
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Instruction: Design, Delivery, Assessment
Worksheet
Prompt 7: Describe how your organization ensures that content delivery is
consistent within the program (e.g. across different instructors, in satellites, via
online, etc.).
200 words
Prompt 8: Describe the evidence your organization will use to demonstrate that
faculty/instructors model effective pedagogical and content practices of the
discipline (including strategies to meet the diverse needs of learners).
200 words
Prompt 9: Explain how faculty/instructors use formative and summative data to
target areas of candidate need.
200 words
Prompt 10: Describe the evidence your organization will use to demonstrate that
candidates receive targeted feedback from faculty/instructors that improves
their practice.
300 words
Educator Preparation Review
Resources: http://www.doe.mass.edu/edprep/resources.html
Review Toolkit: http://www.doe.mass.edu/edprep/toolkit/
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Instruction: Design, Delivery, Assessment
Worksheet
Optional: Provide additional context pertaining to the design, delivery or
assessment of instruction within this program/group of programs.
250 words
Supplemental Documents
Optional: Provide additional documents pertaining to partnerships.
Title of Document
50 words each
Rationale for Including
Educator Preparation Review
Resources: http://www.doe.mass.edu/edprep/resources.html
Review Toolkit: http://www.doe.mass.edu/edprep/toolkit/
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