LSU SCHOOL OF MEDICINE - SHREVEPORT
Teaching Portfolio
Your Name
This packet is for creating your Teaching Portfolio. For
examples and explanations, see the Example packet .
I. Teaching Responsibilities and Skills
I. Teaching Responsibilities
A. List teaching activities to date grouped chronologically using the following format :
Repetitive Ongoing Teaching Responsibilities at LSUHSC
Dates
Activity Title
Contact
Hours
Method
Contact
Hours
Method
Non-LSUHSC and Nonrepetitive Teaching
Dates
Activity Title
B. List teaching materials development activities to date grouped chronologically by using the
following format:
Date
Title of Activity
SECTION I A
LSUMC Teaching Activity Summary Report by Academic Year
List conference contact hours (not including hospital rounds) for each category of teaching activity
(Hospital attending activities are credited in the service portion of the CV packet.)
Activity
Type
Prior
Years
Lay Media
H.S./
College
Medical
Student
Teaching
Rounds
House Staff
/ Graduates
Faculty
State
Meeting
Regional
Meeting
National
Meeting
<<Use table below for additional dates>>
Activity
Type
Lay Media
H.S./
College
Medical
Student
Teaching
Rounds
House Staff
/ Graduates
Faculty
State
Meeting
Regional
Meeting
National
Meeting
* Year to date as of submission.
SECTION I A
LSUMC Teaching Method Summary Report by
Academic Year
List contact hours for each category.
Only include actual time in direct teaching - not assigned or preparation hours.
Activity
Type
Prior
years
Lecture
~ slides/OH
~ video
~demonstration
Small
Group
~ Problem/
Case Based
~ Discussion
~ Lab
~ Hospital
Rounds
One-onOne
~ Clinical
Precepting
~ Guided
Instruction
OTHER:
OTHER:
OTHER:
* Year
to date as of submission.
SECTION I B
LSUMC Teaching Materials Development Summary Report
by Academic Year
Place an 'X' for each category.
Activity
Prior
Type
years
Course
Handout
Co-author
Syllabus
Edit
Syllabus
Author
Syllabus
Educational
Software
Educational
Video
Activity
Type
Course
Handout
Co-author
Syllabus
Edit
Syllabus
Author
Syllabus
Educational
Software
Educational
Video
* Year
to date as of submission.
II. ASSESSMENT -HOW TO EVALUATE YOUR SUCCESS AS AN
INSTRUCTOR
I. Please submit an example of an evaluation form for any or all of the activities listed in
Section I. A., complete with a synopsis of all the learner evaluations received for that particular
activity.
II. Please list written examinations you have had a substantial role in creating and
administering in chronological order. Please submit an example of an evaluation form for one
of the exams listed below, complete with a synopsis of all the learner evaluations received for
that particular exam.
Date
Type
# Contributors
Learner
III. Please list any oral examinations you have had a substantial role in creating and
administering in chronological order. Please submit an example of an exam plus an evaluation
form for that exam, complete with a synopsis of all the learner evaluations received for that
particular exam.
Date
Type
Learner
IV. Please list any computer based testing you have created and administered in chronological
order. Please submit an evaluation form for that test, complete with a synopsis of all the learner
evaluations received for that particular test.
Date
Type
Learner
V. Please list any written/oral examination questions submitted for regional/national testing
in chronological order.
Date
Type
Learner
VI. Please list any CME lectures/programs you have given in chronological order. Please
provide a sample evaluation form, completed as a synopsis of the evaluations received for one
of the referenced CMEs.
III. Advisor
A. In chronological order (academic year) within the following format, list any person(s) that
you formally advise.
Dates
Name
Status
Your Role
Position of
Advisee
B. List publications, posters, projects, or other materials prepared by students that you mentored
in a research setting. If appropriate, provide a representative publication(s).
Section III
LSUMC Advisor by Academic Year
Indicate the number of students of each type you formally advise.
Activity
Type
Prior
years
Premedical
-
Medical
-
Resident
-
Medical
Fellow
-
Graduate
-
Postdoc.
Fellow
Junior
Faculty
-
Activity
Type
Premedical
Medical
Resident
Medical
Fellow
Graduate
Postdoc.
Fellow
Junior
Faculty
* Year
to date as of submission.
IV. EDUCATIONAL ADMINISTRATION
A. List in chronological order by academic year, any position you have held on educational
committees, your involvement with courses/programs, and the role you played.
DATE(S)
TITLE OF COMMITTEE/COURSE OR PROGRAM
ROLE
Section IV
LSUMC Educational Administration Activity Report
(Please summarize the information provided in section IVA above)
Activity
Prior
Type
years
Committee
Member:
Department
Committee
Member:
LSUHSC-S
Coordinator
Co-Director
Director
Activity
Type
Committee
Member:
Department
Committee
Member:
LSUHSC-S
Coordinator
Co-Director
Director
* Year
to date as of submission.
V. Demonstration of Scholarly Activity in
Teaching and Educational Techniques
A. In chronological order by academic year within the following format, list any publications
on teaching and educational techniques or other topics related to education that you have
published. Indicate peer-reviewed articles, invited articles, and book chapters. (Note: only
publications on educational topics, not other publications.)
Journal
Date
Publication Title
Peer reviewed
(Yes/No)
Invited
(Yes/No)
Book /
Chapter
B. List in chronological order by academic year, presentations at meetings such as posters,
lectures and invited plenary lectures that you have presented in the area of teaching techniques
or educational approaches. Indicate specifically if the meeting was an international, national, or
regional meeting and indicate the focus of the meeting. (Note: only presentations on
educational topics, not other publications.)
Dates
Presentation Title
Meeting Type
Meeting Focus
C. List in chronological order by academic year any funding such as grants, contracts,
scholarships, etc. you have received that involved education.
D. List in chronological order by academic year any meetings, conferences, symposia, or other
related activities you have organized or chaired at the international, national, or regional level.
Indicate your specific role in each.
Dates
Event
Level
Role
E. List the education-related professional organizations or societies of which you are a
member. Indicate the dates of membership/service. Indicate if you hold an appointed or elected
office/position in these organizations.
Dates
Organization / Society
Appointed /
Elected
Section V
LSUMC-S Educational Scholarship Activity Report
# = Please provide total NUMBER per year across row.
X = Please indicate YES or NO across row.
Prior
years
Activity Type
Presentations #
Poster
Sessions
#
Publications
#
Grants
X
Education
Related Org.
Committee
Member
Committee
Chair
Elected
Position
X
X
X
X
# = Please provide total NUMBER per year across row.
Activity Type
Presentations #
Poster
Sessions
#
Publications
#
Grants
X
Education
Related Org.
Committee
Member
Committee
Chair
Elected
Position
* Year
X
X
X
X
to date as of submission.
X = Please indicate YES or NO across row.
VI. Continuing Education to Improve Your Teaching
A. In chronological order by academic year, list all activities that you have participated in that
were to improve your teaching skills or educational administrative activities. Indicate if these
activities are seminars, courses, workshops, or other activities. Also, in the activity column,
indicate the educational role(s) (lecturer, small group mentor, clinical teaching, graduate student
/ resident mentor, etc.) to which this activity best relates.
Date(s)
Activity
Seminar / Workshop
/ Course / Other
Role CME
Relates To
VII. Honors and Awards
A. In chronological order by academic year, list any recognition of excellence in teaching that
you have received. Indicate the specific aspect of your teaching responsibilities that was
recognized, such as clinical teaching, classroom teaching, etc. Indicate the source of the
recognition, such as the professional organization, university committee, etc. Also indicate if
the award is local, regional, national, or international.
Dates
Recognized
Aspect of Teaching & Source
Recognition Type