Form completed by _________________________________ on ___________________(date).

1. Which

Test _______________
Average Percent Score:
Percent passed:
Percent at the ___ passing standard:
# of Students with a score between __ &
__:

high passing rate? Include the TEK tested.

Areas of Strengths

Assessme
nt
Reflection
questions had a

Lessons that Have Helped

2. Which questions had a low passing rate? Include the TEK tested.

Areas to Improve

Ideas for Re-teaching the Topic

3. Which TEKS showed mixed results depending on the question?

4.
5.
6.
7.

What differences do you note?

What do you notice about the distractors that students chose?
What pleases you or makes you proud?
What questions does this raise?
Who will be responsible for the interventions?
Panther Period Intervention ___________________________________________
Tutorial Times and Activities _________________________________________

Re-teach lesson #1 _____________________________________________________

Re-teach lesson #2 _____________________________________________________

Re-teach lesson #3 _____________________________________________________
Pull-Outs_______________________________________________________________
Peer Tutorials __________________________________________________________

Form completed by _________________________________ on ___________________(date).

Resources/supplies needed _____________________________________________
Targeted Students ____________________________________________________