Instructor Annual Feedback Form
ADMINISTRATION OF JUSTICE/FIRE SCIENCE TECHNOLOGY
Please review the following questions and answer them as best you can. Submit this form to the Department Chair by the end of the Fall
2012 term of this year. The completion of this form is part of the departmental program review process. This form is reviewed by the
department chair and then placed on file for future reference. The college has asked us to document our evaluation methods by class,
course, program, and department. We will not pass your form onto any college officials without your permission. We will, however, review
them for ideas to help complete the yearly department program review AND the biyearly evaluations that the institution requires of every
instructor.
____________________________________________________
INSTRUCTOR NAME
____________________________________
SUBMISSION DATE
1.
Courses taught
Please indicate below the names and sections of classes you taught during Fall and Spring of this school year.
SUMMER
FALL
SPRING
2.
Course Level Learning Objectives (Ex. – ADMJ 52 is a course. Each section is considered a class.)
3.
Student Experience
Please indicate below the methods that you have used in the past year to evaluate the experience of the students in
your classes
4.
Student Learning Outcomes – Assessment Methods
Please indicate below the methods that you have used in the past year to evaluate the learning outcomes achieved by your
students in your classes
5.
Student Learning Outcomes – Instructional Methodology
Please indicate below the methods that you have used in the past year to help your students achieve the objectives you’ve
set.
6.
Student Learning Outcomes – Assessment Results
Please summarize key results/data you’ve collected through the above-described assessment methods for this this year?
7.
Student Learning Outcomes – Instructor Response
Based on previous and current assessment results, during this school year what changes have you made to your teaching,
class structure, assignments, etc. to improve students learning? (Be sure to indicate which courses these changes are for.)
Effects you have noticed in the students as a result
Changes made (and course name)
(supporting data)
8.
Student Learning Outcomes – Future Plans
Based on assessment results from this year and in the past, what future changes would you like to make to your teaching,
class structure, assignments, etc. to improve students learning? (Be sure to indicate which courses these changes are for.)
Future changes
Effects you hope to see (and how you’ll know)
9.
Program and Course Review – Textbook Affordability
Do you know the price students are paying for the textbook you’re using? (Go to class schedule for your class, click on the BOOK
link to see the price.) What efforts are you making to improve the affordability of textbooks for your students? (*Find strategies at
this website and reference: http://www.ccsf.edu/Services/Textbook_Affordability_Task_Force/)
10. Departmental Review – Needed resources
Are there any additional ways that the department or your fellow instructors could support your efforts? If so, please discuss
below: (include here if you are in need or would simply like some additional equipment or materials or if there are issues with
classrooms, labs, or offices)
Desired equipment or support
What for?
11. Departmental Review – Past and present contributions
What contributions have you made to the department or college in the past year? If you have made none, you can leave this
section blank. But if you have made some, please document them here.)
12. Departmental Evaluations – Future contributions
In future years, what contributions would you like to make to the department or college? Include projects you would like to
start and other ideas.
13. Any suggestions for the Department for the future? (website upgrades, new programs, curriculum, etc.)
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