CLINICAL SUPERVISION TEMPLATE
| Observation #: | Date | Observer: | |
| First Name of Teacher Observed: XXXXXXXXXXXXX | Subject: | Grade Level: | |
| #1 Context for Observation |
| #2 Pre-Conference | |||||
| 2a. Focus of pre-conference
Which criteria may be evident during the observation?
How can the instructional framework be used to support this teacher? |
Focus
Criterion :
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| Standard | |||||
| Learning Target | |||||
| Students’ work samples that show current skill level and teacher explanation of progress to be made towards target. | |||||
| Evidence that will show if students met learning target. | |||||
| 2b. Supervisory Behaviors during pre-conference (Indicate number of times used) | Listening | Clarifying | Encouraging | Reflecting | Presenting |
| Problem Solving | Negotiating | Directing | Standardizing | Reinforcing | |
| 2c. Insights from Pre-conference | |||||
| #3 Environment for Observation | ||||
| 3a. Tools selected for use during observation
(attach observation tool) |
Qualitative | Quantitative | ||
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| 3b. Evidence of students learning (or not learning): | Student work shows evidence of understanding, not just recall. Evidence? | |||
| Students are engaged in activities to develop understanding and create personal meaning through reflection. Evidence? | ||||
| Students apply knowledge in real-world contexts. Evidence? | ||||
| Students are engaged in active participation, exploration, and research. Evidence? | ||||
| Teachers utilize the diverse experiences of students to build effective learning experiences. Evidence? | ||||
| Assessment tasks allow students to exhibit higher-order thinking. Evidence? | ||||
| Students are presented with a challenging curriculum designed to develop depth of understanding. Evidence? | ||||
| 3c. Describe the learning environment of the classroom | Diverse learners were accommodated? Evidence: | |||
| Students worked independently or collaboratively? Evidence: | ||||
| Classroom was positive, “warm”, safe, and conducive to learning? Evidence: | ||||
| Teacher used variety of questioning strategies?
Evidence |
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| Teacher expected high performance from all students? Evidence: | ||||
| 3d. Insights from Observation |
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| Did the lesson align with the Standard and support state goals (skills, knowledge, thinking, and applications)? Yes/No, Comments? | ||||
| #4 Analysis of Data and Preparing for Post Conference: (must have data to support conference) | ||||
| Data Analysis and Plan for Post Conference |
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| 4a. Type of Conference | Directive | Directive Informational | Collaborative | Nondirective |
| 4b. “Pluses” | ||||
| 4b. “Areas of Focus” | ||||
| 4c. Plan for Post Conference
What are possible entry questions to a growth conversation? |
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| #5 Post Conference | |||||
| 5a. Focus | |||||
| Was target met? What evidence was there of student learning? | |||||
| 5b. Supervisory Behaviors used during Post Conference | Listening | Clarifying | Encouraging | Reflecting | Presenting |
| Problem Solving | Negotiating | Directing | Standardizing | Reinforcing | |
| 5c. Highlights of Post Conference | |||||
| 5d. Follow-up Plan (next steps) | |||||
| Additional resources teacher will access: | |||||
| #6 Reflection | |
| 6a. What did you learn? Reference the intent of TPEP, the essential beliefs that drive the process, relationships and roles, critically important elements of the process | |
| 6b. What will you do differently in the future? | |
| 6c. How did the instructional framework support growth conversations? | |
| Discuss rater agreement between you and your mentor principal | |
| Discuss the self-assessment of this teacher | |
| Discuss the goal setting of this teacher | |
| List types of artifacts/evidence used in this teacher’s evaluation | |
| Reflect on the final evaluation conference with this teacher | |
