FACULTY ANNUAL (SELF ASSESSMENT) REPORT (School/ Department/Program) __Nursing___________________________________ Academic Year: __________________ Faculty Name: ___________________ TEACHING Courses: Number Student New Title Students Evaluation Prep Fall Semester: ______ ________________ ______ ________________ ______ ________________ ______ ________________ ______ ________________ ________ ________ ________ ________ ________ __________ __________ __________ __________ __________ ____ ____ ____ ____ ____ ________ ________ ________ ________ ________ __________ __________ __________ __________ __________ ____ ____ ____ ____ ____ ________ ________ ________ ________ __________ __________ __________ __________ ____ ____ ____ ____ Number # Fall Advisees _________________ Spring Semester: ______ ________________ ______ ________________ _____ ________________ ______ ________________ ______ ________________ # Spring Advisees _____________ Summer Sessions: ______ ________________ ______ ________________ ______ ________________ ______ ________________ Independent Studies: _______________________________________________________________________ Thesis/Dissertation: TEACHING 1.1 Currency of Course Content: 1.2 Instructional Design, Delivery, & Improvement: 1.3 Course Management: 1.4 Faculty Pedagogical Development/Collaboration: 1.5 Contributions to Learning and Outcome Assessments: 1.6 Student Advising: 1.7 Other: SCHOLARLY: Research /Creative Activities Publications: [Publications is an unusual activity of a practicing artist, but this may occur in any of the following categories: books, articles, journals, chapters, proceedings, other (list coauthors and publication date). Group Exhibitions (Invited, Curated, Juried, and Open): Solo Exhibitions (Invited, Curated): Commissions, free lance activities: Work added to a Collection, Acquisition, and Gallery Affiliations: Publication: Publications of graphic designs, illustrations, creative works, and/or reviews of creative work by the faculty member in newspaper, magazines, books, periodicals, and online of publications of high quality. (If applicable, include copy of publication, and dates printed.) Other: Scholarly Presentations: [Indicate: 1) Conference; 2) National, Regional, State, Local; 3) Refereed or Invited; 4) Co-presenters; 5) Date]; Grants [Indicate: 1) Title; 2) Agency; 3) Submitted, Under Consideration, Received; 4) Dates of Grant]; etc. Research/Creative works in Process: [Indicate: 1) Title or Nature of Creative Work or Research; 2) Stage of Development; 3) Anticipated Completion Date; 4) Anticipated Dissemination] SERVICE For Committees: [Indicate: Standing or Special, Chair or Member, dates of service and contribution Department Service: School/College Service: University Service: Community & State Service: Service to Profession or Discipline: Other: _____________________________________________ ____________________ Faculty Signature _________________________________________________ Print Signature _________________________________________________ Department of Nursing Date