Cooperating Teacher Lesson Feedback Form

Note: A complete lesson plan should be provided by the teacher candidate prior to observation.

To be completed by the teacher candidate prior to observation

Preservice Teacher: Shelby Boshuizen Observer: Jade Jackson

Date: 03/13/18 School: First Ward Creative Arts Academy
Time: 12:00 Grade: 2nd Grade

1. What are your goals and objectives for this lesson?

I hope to conduct lessons that I can engage the students and to practice my self confidence while
teaching. I want my lessons to be enjoyable and to benefit the students.
2. What are some specific things you would like observed?
One of the hardest things for me is making the lesson flow well and being confident in my teaching.
Sometimes it is hard for me to remain confident throughout lessons without students thinking
I’m nervous to teach them. I’d like for this to be observed so I can get some ideas on how to feel
good while teaching and about the lessons I conduct.
To be completed by the Observer:

3. Strengths to continue to build on:

As far as content goes, your lesson was engaging for the students and aligned nicely to our topic of
study. Use of technology and connection to US History was really creative and fun.
Delivery of content was overall, great. You paced it well, paused to let students consider and asked
good questions along the way. I especially appreciate you moving around the room and checking in
with each student while they worked.

4. Suggestions for future lessons:

For future lessons, I would suggest having students repeat instructions back to you after you've
given them. Some students were unclear as far as what you wanted them to do and a couple just
copied the example you gave them. After each set of instructions you give, pause and have
students repeat them back to you. Ask for questions and see if they need clarification. Having the
instructions posted in a visual way is also very helpful.
Consider stopping students as they work and check in whole class. A few kids were drawing a
blank in terms of what they wanted to sketch for their comic, I would suggest asking students to
share their ideas if you notice a few kids needing some inspiration.

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Cooperating Teachers: please fill out the Clinical Evaluation (as seen on these two pages)
electronically. A link to this survey will be delivered to your clinical educator/cooperating teacher
via email.

Assessment of Professional Education Dispositions

Shelby Boshuizen
Candidate ____________________________________

Jade Jackson
Evaluator ____________________________________ 03/13/18
Date of assessment ________________

1. This form is to be used by any faculty member or P-12 school partner at any time during a candidate’s program of study. Please
circle or highlight one number for each disposition using the descriptors listed below the disposition as the basis for your rating.
Highlight/mark individual bullets as needed. Add comments in the blank space under the disposition or on a separate page if more
space is necessary.
2. The faculty member who initiates the assessment should schedule a conference with the student to discuss and document the
concern (see p. 2 below).

Needs Meets Exceeds

The candidate demonstrates: Not Observed
Improvement Expectations Expectations

I. Impact 0 1 2 3

• Demonstrate the belief that all individuals can succeed

• Provide encouraging feedback to all individuals
• Respect and respond to individual needs
• Provide equitable learning and development opportunities for all
• Promote positive outcomes based on assessment results
Comment: Shelby was supportive and respectful to all students. She provided feedback to students as they worked and supported those
that were struggling.
II. Professional Identity and Continuous Growth 0 1 2 3

• Maintain positive attitudes in academic and professional settings

• Demonstrate professional appearance
• Act on constructive feedback from others
• Conduct self-assessments through reflection to overcome limitations and enhance strengths
• Demonstrate self-initiated learning
• Communicate effectively and appropriately
• Show punctuality in meeting academic and professional obligations
Comment: Shelby created a schedule and stuck to it. She was punctual and professional.

III. Leadership 0 1 2 3

• Create opportunities for the mutual benefit of all involved

• Promote positive change through personal interactions, organizations, communities, and the profession
• Initiate, suggest, and contribute in appropriate ways
• Maintain knowledge of and disseminate information about current research and best practices
Comment: NA - Not enough time to observe this.

IV. Advocacy 0 1 2 3

• Support and empower individuals from diverse backgrounds

• Include families and other stakeholders in planning for individual success
• Advocate for the social, emotional, physical, educational, behavioral, and basic needs of others
• Demonstrate empathy, professional self-confidence, fairness, persistence, problem-solving, and appropriate risk-taking on behalf of
others
Comment:

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V. Collaboration 0 1 2 3

• Respond respectfully to individual perspectives and differences of others

• Engage in culturally responsive practices in interactions with learners, families, communities, and colleagues
• Share information and ideas with others
• Cooperate with university, school, and community personnel
• Collaborate to resolve differences and solve problems respectfully and reflectively
Comment:

VI. Ethics 0 1 2 3

• Demonstrate honesty, integrity, fairness, respect for others and confidentiality

• Comply with laws, policies, and procedures
• Accept responsibility for personal actions and behaviors
• Follow professional codes of ethics and the UNC Charlotte Code of Academic Integrity and Student Responsibility
• Disclose any unlawful activity upon application to and throughout the program
• Pass criminal background checks and drug screening, as required
• Create and maintain appropriate interpersonal relationships in all settings
Comment:

NOTE: Students who receive negative scores (0 or 1) will meet with the Interventions Committee to discuss their
performance.

Candidate self-assessments as well as assessments by faculty members are also documented in TaskStream at the
program-designated entry, midpoint, and exit dispositions decisions point courses. See the full dispositions plan on the
College of Education website for additional information on this process.

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