Trainee: School: Class:

Teacher: Date and time:

Total points / 100 0-5 pts. (Below standard) 6-7 pts.(Acceptable) 8-9 pts.(Proficient) 10 pts.(Exemplary)
Aims are not identified or not appropriate Aims are appropriately identified, but Aims are appropriately identified and Aims meet proficient criteria, are clearly
for the grade level, development level, or may not be aligned with state/national aligned with state/national standards; stated, and relate to meaningful skills or
Aims total /10
topic. standards, and may not be specific, objectives are specific, observable, and concepts essential to student learning.
observable, and/or measurable. measurable.
Assessment may be described, but the At least one formal assessment tool is Formal assessment tool(s) and Assessment meets the proficient criteria
assessment tool and/or evaluation included, but the evaluation instrument evaluation instrument(s) are both and reflects a variety of assessment
Assessment total /20
instrument are not included. may be missing. The assessment may included. The assessment reflects the types and/or methods.
not reflect the objectives or may not be objectives and is appropriate to the topic
appropriate to the topic or grade level. and grade level.
Plan of instruction is so vague or Plan of instruction may, at times, be too Plan of instruction is clear and designed Plan of instruction meets the proficient
generalized that it is unusable. vague or lacking elements or details to promote critical thinking, inquiry, criteria, utilizes multiple instructional
necessary for effective delivery of problem-solving strategies, or creativity; strategies, and includes guiding
Instructional Strategies total /20
information; instructional strategies may instructional strategies facilitate the questions appropriate for engaging
rely too heavily on lecture or worksheets, learning goals. students in higher-level thinking.
or may not facilitate the learning goals.
Learning activities to engage students Learning activities to engage students Learning activities engage and motivate Student learning activities meet the
are not included or are not appropriate are included but may not give students students with opportunities to proficient criteria and include
Structured Application total /20 for the grade level or topic. clear opportunities for guided and demonstrate skills or exhibit conceptual opportunities for remediation and
independent practice or inquiry. understanding of the learning goals enrichment.
through guided and independent
practice or inquiry.
Plans for accommodating learner Plans for accommodating learner Plans for accommodating learner Plans for accommodating learner
differences are not included or not differences show a limited understanding differences are appropriate and specific differences meet proficient criteria and
Differentiation total /10
appropriate for students’ needs. of students’ needs. for a variety of students’ needs and are are embedded throughout the wording of
designed to facilitate success for a the Instructional Strategies and Learning
variety of students. Tasks.
Materials and resources are not listed or Materials and resources are listed, but Materials and resources are listed with Materials and resources meet proficient
not appropriate. specific titles and/or citation information specific citation information; a range of criteria and are selected and/or designed
Material total /10 may not be identified; materials and resources and technological tools that to meet diverse learning needs.
resources may not be effectively effectively implemented by both teacher
implemented. and students.
Organization may lack clear movement Organization is generally clear, but may Organization is coherent and clear; Organization is coherent, clear, and
or focus, making the ideas difficult to be poorly formatted. Formal language formatting and graphic elements support highly logical, with formatting and
follow. Numerous grammar, usage, contains some grammar, usage, readability. Formal language contains graphic elements that strongly support
Writing Conventions total /10
spelling, and punctuation errors may spelling, or punctuation errors that may few grammar, usage, spelling, or readability. Language is professional,
significantly impede readability or impede readability or expected level of punctuation errors that do not impede concise, and precise, with no noticeable
expected level of professionalism professionalism. readability. grammar, usage, spelling, or punctuation
errors.