Outcomes Assessment Individual Faculty/Staff Notes/Record
This action form is intended to help focus individual faculty and staff efforts in regards to outcomes assessment at CCSF. We encourage
faculty and staff to document the assessment they are completing – the results – and the changes they plan or would like to make. It might
be helpful to provide this information to the Department Chair or Program Manager or Dean to facilitate program review and planning. Feel
free to use this form and modify it to suit your needs. Benefits:
 Conveniently store information that will be later asked for in forms (and thus make the entry of those forms easier).
 Share information easily amongst your fellow faculty and department and program chairs.
FACULTY/STAFF NAME: ________________________________DEPARTMENT/PROGRAM:___________________________________
DOCUMENTING THE DETAILS
1.
Courses taught/Services offered
Please indicate below the names and sections of classes you taught or services you offered during Fall and Spring of this school year.
SUMMER
FALL
SPRING
SAMPLE CLASS/SERVICE
SAMPLE CLASS/SERVICE
SAMPLE CLASS/SERVICE
2.
Assessing Experience
Indicate below the methods that you have used in the past year to evaluate the experience of the students in your
classes, students partaking of your services, or faculty/staff/vendors/community partaking of your service (Examples
include midsemester evaluations, end-of-semester evaluations, in-class or in-service participation, individual consultations, group
consultations, peer-review consultations (another person talking with your students/staff/faculty officially), anecdotal (feedback
other are hearing), etc.
3.
Outcomes – Assessment Methods
Indicate below the methods that you have used in the past year to evaluate the outcomes achieved by your students in your
classes or anyone partaking of your services (these include learning outcomes and service outcomes). Assessment examples
include surveys, quizzes, exams, homework assignments, writing assignments, in-class discussions, projects, etc.
4.
Outcomes – Assessment Results
Summarize key results/data you’ve collected through the above-described assessment methods for this this year? (A
combination of qualitative and quantitative data and observations is best.)
5.
Outcomes – Your Response
Based on previous and current assessment results, during this academic year what changes have you made to your courses
or services to improve student learning and/or institutional effectiveness? (Be sure to indicate which courses or services these
changes are for.)
Changes made (and course or service name)
Effects you hope to see (and how you’ll know it’s working)
6.
Outcomes – Future Plans
Based on assessment results from this year and in the past, what future changes would you like to make to your courses or
services to improve student learning and/or institutional effectiveness? (Be sure to indicate which courses these changes are for.)
Future changes (and course or service name)
Effects you hope to see (and how you’ll know it’s working)
7.
Planning for needed resources
Are there any additional ways that the college, department, or fellow faculty and staff could support your efforts? (include here
if you are in need or would simply like some additional equipment or materials or if there are issues with facilities, services, etc.)
Desired equipment or support
What for?
Strategies for getting these resources
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