Impact on Student Learning Assignment
Name of Intern Teacher:
Semester Taught:
Name of Class or Grade Level:
Topic of Unit/Lesson:
Name of Person Providing Feedback:
Feedback Rubric-Revised December 2013
Criteria
Clear Learning
Expectations
Assessing Prior
Knowledge
Proficient
Emerging
Undeveloped

Learning expectations are based on a thoughtful
analysis of relevant standards, curriculum guides,
student needs, previous learning, and overall
trajectory of intended learning.

Learning expectations
are based solely on
state or district
standards.

Lesson/unit does not
seem to be developed to
address any relevant
learning expectations.

There is a clear plan for sharing explicit learning
expectations with students using understandable
language.



Success criteria or expectations for performance
on specific assignments are aligned with overall
learning expectations.
There is a plan for
presenting learning
expectations to
students.
There is no plan for
presenting learning
expectations to
students.

There is a plan for
presenting success
criteria to students.

There is no plan for
presenting success
criteria to students.

There is an plan for
administering a preassessment

There is no plan for
administering a preassessment.

There is a plan for sharing rubrics and exemplars
with students to illustrate performance
expectations and ensure that students have a
shared understanding of quality.

The plan includes pre-assessments to determine
prior student knowledge of the learning
expectations.

There is a plan for how to use the results of preassessments to inform the instructional design to
meet student needs.
Comments
Criteria
Monitoring
Student
Progress
Quality
Feedback
Proficient

There is an explicit plan for using assessments
throughout the lesson/unit to monitor individual
student progress toward meeting learning
expectations.

Students are provided with multiple opportunities
to demonstrate learning progress through a variety
of assessments that allow for student choice and
continued revision.
There is a plan for providing corrective feedback to each
student throughout the lesson/unit.
Students are provided with the time, opportunity, and
structure for using feedback to revise work.
Self- and Peer
Assessment
Students are provided with opportunities to assess their
own progress toward meeting the learning expectations
and there is a plan for guiding students through this
process. There are opportunities for students to
provide feedback to their peers during the learning
process.
Additional comments to help improve the plans:
Emerging

There is an
explicit plan for
using
assessments to
monitor student
progress.
Undeveloped

There is no explicit
plan for using
assessments to
monitor student
progress.
There is a plan for
providing feedback
to students.
There is a plan for
providing feedback to
students.
Students are given an
opportunity for selfassessment or peerassessment.
Students are not given
the opportunity for
self-assessment or peer
assessment.
Comments