Revised 8/2015

UNI Principalship Program

INTERNSHIP SKILL FORMATIVE/SUMMATIVE
ASSESSMENT
Evaluation of Students Progress

Formative
Summative
Students Name: Charles Goetzinger
Cohort: UEN Purple
Date: 12/1/16
Options for submitting the assessment:
1) Complete electronically, Save, and Email as an attachment. To fill out electronically, check the appropriate option by double clicking on
the circle, then type x. The circle will change into an x.
OR
2) Print, Fill out with pen, Scan, and Email as an attachment to the Field Supervisor for your cohort.
If you are a member of the All-Iowa Cohort, email to jere.vyverberg@uni.edu. If you are a member of the UEN Cohort, email to:
lewis.finch@uni.edu.
Instructions:
Please complete the following evaluation and be prepared to discuss with UNI Field Supervisor at the end of each semester. Once this is
completed, upload the signed copy to the Ed Leadership Principalship System.
The following instrument is to be completed by the mentor to assess students knowledge and experience in each of the following 35 ISSL
criteria. If the student has not had the opportunity to demonstrate knowledge or experience in a particular skill area, please check (None) in the
appropriate circle.

Evaluation Scale:

HD (high degree)

SD (some degree)

LD (low degree)

None

HD

SD

LD

None

Standard 1: Visionary Leadership

The student has demonstrated knowledge or understanding of:
A. Uses Data for Establishment of Achievement Goals
B. Uses best practice in Program Improvement
C. Articulates/Promotes high Expectations for teaching/learning
D. Aligns educational programs w/ District Vision and Goals
E. Provides leadership for Major Initiatives & Change Efforts
F. Communicates effectively w/Various Stakeholders on progress

x
x
x
x
x
x

Standard 2: Instructional Leadership

The student has demonstrated knowledge or understanding of:
A. Provides leadership for Assessing/Developing/Improving Climate/Culture
B. Systematically/Fairly Recognizing/Celebrating Staff/St. Accomplishment
C. Encourages design of more effective learning experiences for students
D. Monitors/Evaluates Effective Curriculum/Instruction/Assessment
E. Evaluates Staff & Provides ongoing coaching for improvement
F. Ensures professional development that enhances teaching/learning
G. Uses research/theory to develop/revise professional growth plan
H. Promotes collaboration with all stakeholders
I. Accessible & approachable to all stakeholders
J. Visible & engaged in the community
K. Articulates & reinforces desired school culture, showing evidence

x
x
x
x
x
x
x
x
x

x
x

Standard 3: Organizational Leadership

The student has demonstrated knowledge or understanding of:
A. Complies with state & federal mandates & local board policies
B. Recruiting, selection, induction, & retention of staff for quality instruction
C. Addresses current & potential issues in a timely manner
x
D. Effectively/efficiently manages fiscal & physical resources
E. Protects instructional time
F. Uses effective communication w/internal & external audiences about
school operations

Standard 4: Collaborative Leadership

The student has demonstrated knowledge or understanding of:
A. Engages families & community and promotes shared
responsibility for student learning & education
B. Promotes/supports structure for family/community involvement
C. Facilitates connections of students/families to health/social services
that support focus on learning
D. Collaboratively establishes culture that welcomes & honors families &
community & seeks ways to engage them in student learning

HD

SD

LD

None

x
x

Standard 5: Ethical Leadership

The student has knowledge or understanding of the need to act with integrity, fairness and in an ethical manner as related to:
A. Demonstrates ethical & professional behavior
x

B. Demonstrates values, beliefs, & attitudes that will inspire others to

higher levels of performance
x

C. Fosters & maintains caring, professional relationships with staff

x

D. Demonstrates appreciation for and sensitivity to diversity in

the school community
x

E. Demonstrates respect for divergent opinions

x

Standard 6: Political Leadership

The student has knowledge and understanding of:
A. Collaborates with service providers/decision-makers to improve
teaching & learning
B. Advocates for the welfare of all members of the learning community
C. Designs & implements appropriate strategies to reach desired goals

x
x
x

UNI Educational Leadership Contextual Framework

To what degree this semester has the student engaged in leadership experiences allowing him/her to function as a:
Leader of Learning
x

Leader of Service

Leader of Change
x

Summary

A. What leadership experiences were especially successful for the student this semester?
Charlie has done a nice job of rounding out his experiences. Hes been especially successful with developing new teachers into their
innovative program and working to find ways around barriers and obstacles put in front of the program.
B. What leadership experiences failed to meet expectations for the student this semester?
None
C. What has been the main focus or topic of reflections and conversations with the student this semester?
Lots of discussion about how to engage the fence-sitters and the openly negative colleagues. Weve talked a lot about how to continue to
share stories and data in ways that bring alive both the changes in academic performance of the students but also the quality and joy of work
life for the teacher.
D. How many summaries & reflections has the student logged on the Student Management System this semester?
Two reflections, with at least 11 more to come
E. How many hours of field-based internship did your student complete this semester?
63 hours, some of those hours came at the completion of last school year and during the summer months.

Overall Evaluation:
Please rate the quality of your students internship performance for this semester using a scale of 1-10 (low to high)

Check this box to verify that the Mentor, Faculty Field Supervisor, and Student have discussed the completed assessment.

Date: ______12/15/2016______________
Options for Submitting this completed form:
1) Complete electronically and email to
2) Copy, scan, and email as attachment to