STUDENT TEACHER EVALUATION FORM
Student:__________________________Date of evaluation:____________________
Site:_____________________________Supervisor:__________________________
Check one:
Check one:
□ First full-time placement
□ Midterm evaluation
□ Second full-time placement
□ Final evaluation
Caseload includes (check all that apply):
Age groups:
□ Early childhood (birth-grade 2)
□Middle Childhood (grades 5-9)
Disorder types/Areas Addressed:
□ Language
□ Childhood (grades 1-6)
□ Adolescence □ Adult
□ Phonology/Articulation
□Fluency
□ Cognitive aspects of Communication
□Voice
□AAC/AT
□ Social communication
□ Aural Rehab
□Hearing screenings
□ Feeding/swallowing
□ High-risk population (specify) ______________________________________
***** □ Culturally/linguistically diverse population: specify in detail the backgrounds
of those students with whom the intern worked:
_______________________________________________________________________
Knowledge and Skills Demonstrated by the TSSLD Student
0
Skill Not
Apparent
1
Emerging
2
Adequate
Demonstrates a rich, thorough understanding of the content and skill
knowledge compromising their discipline (b) Content Core(c) (1) (v)*
plans and implements effective, developmentally appropriate lessons (c) (1) (ii,
v)*
creates safe and motivational learning environments (c) (1) (I & ii, iv, x-xii)*
Understands and celebrates the unique nature, abilities, cultures and
characteristics of all learners, unclosing literacy and second language
acquisition, and is able to modify instruction so everyone can be successful. (c)
(1) (i, ii, iv)* (diversity)
Effectively utilizes technology to enhance students learning and professional
growth when appropriate (c) (1) (vi)*
Develops and utilizes a variety of assessment approaches designed to evaluate
student learning and performance, positive feedback, and shape future lesson
planning and curricula. (c) (1) (vii)*
Fosters positive relationships and collaborates with a variety of target groups
(eg: students, local community members, etc) as appropriate (c) (1) (viii)*
(collaboration and outreach)
Seeks to improve her/his knowledge base and effectiveness as a teacher and
makes positive contributions to that environment (c) (1) (ix)* (professional
development)
Demonstrates an understanding of the organizational structure of site
Documents client performance in an efficient and accurate manner, daily SOAP
notes if appropriate (c) (1) (vii)*
Evidences appropriate professional behaviors including: dress, timeliness,
conflict resolution, problem solving
Adheres to the Code of Ethics and other practice guidelines
*Part 52.21 (b) (2) (ii) of NYS Ed. Dept. Commissioner’s Regulations: Register of curricula in teacher education
3
Strong
SUMMARY
Please use the reverse or additional pages as needed for comments.
1. Student’s Growth:
□ Substantial
□ Moderate
□ Minimal
□ Adequate
□ In need of continued supervision
Comments:
2. Level of independence:
□ Exceptional
Comments:
3. Ability to handle documentation demands:
□ Accurate and efficient
□ Adequate (feedback helpful) □ Guidance needed
Comments:
4. The student showed a firm theoretical foundation for the placement:
5. The student was able to apply treatment procedures appropriately:
6. The student demonstrated critical thinking and problem-solving skills:
7. The student maintained professional and ethical behaviors:
Please comment on any “No” responses:
□ Yes
□ Yes
□ Yes
□ Yes
□ No
□ No
□ No
□ No
Additional comments (use reverse or attach as needed):
Recommended grade:__________
_____________________________________
Supervisor
________________________________
Student