SCHOOL OF EDUCTION

Teacher Education Program

Teacher Work Sample

Performance Prompts and Scoring
Rubrics
Standards and Indicators

Fall 2015
Revised by Dr. Dolores Burton from a document created by the CSU Arts & Sciences Teacher Education
Faculty and Mentor Teachers (Ms. Joyce Blake, Dr. Marie Borim, Ms. Kathy Hill and Ms. Shonda Shaw)

The Renaissance Partnership for Improving Teacher Quality is a Title II federally funded project with offices
at Western Kentucky University. Director: Roger Pankratz roger.pankratz@wku.edu. Drafting Committee: Jeanie
Behrend, Pam Scortt, Georgea Langer, Nelson Maylone, Jo Anne Rainey, Al Hickey, Ed Smith, Betty Jo Simmons, Luther
Kirk, Bennett Berhow, Lillie West, Donna Topping, Suzanne Mccotter, Beverly PetchHogan, Rob Boody, Lynn Nielsen,
Fran Miller, Vicki Robinson, Toby Daniel, Alice Mikovch, Brenda Sabey and Tony Norman.

Notice: The materials in this document were developed by representatives of the Renaissance
Partnership Institutions, were adapted for use at Clayton State University using Georgia Performance
Standards (GPS) and Understanding by Design (Wiggins & McTighe , 2005) and may not be used or
reproduced without citing The Renaissance Partnership for Improving Teacher Quality Project
http://fp.uni.edu/itq
The Teacher Work Sample is a performance assessment to document the teacher candidates'
evidence of their ability to facilitate learning by meeting the following standards.
The teacher candidate:
Gathers information about the teaching and learning context and student individual differences to
set learning goals, enduring understandings, essential questions, and to plan assessment tasks and
learning activities.
• Develops significant, challenging, varied, and appropriate learning goals consistent with New
York Common Core Learning Standards.
• Identifies desired student results, and plans and uses multiple assessment modes and
approaches aligned with New York Common Core Learning Standards to assess student learning
before, during, and after instruction.
• Designs teaching and learning activities for specific New York Common Core Learning
Standards, enduring understandings, and essential questions given the student characteristics and
needs, and learning contexts.
• Uses ongoing analysis of student learning to make instructional decisions.
• Uses assessment data to profile student learning and communicate information about student
progress and achievement.
• Reflects on his or her instruction and student learning in order to improve teaching practice and
learning outcomes.

The Teacher Work Sample Assignment

Your keystone assignment is to design and teach a comprehensive two week unit of instruction
during your student teaching placement. Your goals and learning outcomes for your lesson
should be based on national and state/district content standards as appropriate to the subject
matter area. You will also need to create an assessment plan by identifying the desirable learning
outcomes from students, determining how you will measure these results (acceptable evidence),
and then planning teaching and learning activities for students. You should plan to assess student
performance before (pre-assessment), during (formative assessment), and after (post assessment)
your unit of instruction. Finally, you will need to analyze and reflect upon your instructional
design, the educational context in which you have taught, and the learning gains demonstrated by
your students.

THE FORMAT
Your Teacher Work Sample must include all of the elements listed above and must be word
processed and double spaced in 12 point font. The sample should include a narrative and graphs of
your student progress monitoring. Sections of the Teacher Work Sample are:
I. Contextual Factors
II. Learning Goals, Understandings, and Essential Questions
III. Assessment Plan
IV. Instructional Knowledge and Planning
V. Analysis of Learning Results
VI. Reflection and Self - Evaluation

In order to insure the anonymity of students in your class, do not include any student names or
identification in any part of this performance assessment.

The following tasks must be included in your Teacher Work Sample. Each of the tasks will be
evaluated using the scoring rubric at the end of this document.
 TWS Requirement
Assignment I. Contextual Factors
The teacher candidate uses information about the
teaching/learning context and student individual
differences to set learning goals consistent with
appropriate standards. Context factors are used to plan
TWS Standard
assessment, teaching and learning activities, and to
analyze student learning. Collaborate with other tenured
teachers during your placement to plan lesson plans and
share instructional strategies.
Discuss relevant factors and how they may affect the teaching-
Task 1 learning process. Include any supports and challenges that affect
instruction and student learning.
I. Community, district and school factors. Address
geographic location, community and school
population, socio-economic profile and
race/ethnicity. You might also address such things as
stability of community, political climate, community
support for education, and other environmental
factors. Discuss the importance of establishing a
positive relationship with families, school colleagues,
and community agencies. Attend School Board
meetings, PTA and I.E.P. (if permitted)
II. Classroom factors. Address physical features,
availability of technology equipment and resources
and the extent of parental involvement. You might
also discuss other relevant factors such as classroom
rules and routines, grouping patterns, scheduling and
Prompt In your discussion, include:
classroom arrangement.
III. Student characteristics. Address student
characteristics you must consider as you design
instruction and assess learning. Include factors such
as age, gender, race/ethnicity, special needs,
achievement/developmental levels, culture,
language, interests, learning styles/modalities or
students’ skill levels. In your narrative, make sure you
address student’s skills and prior learning that may
influence the development of your learning goals,
instruction and assessment.
Instructional implications. Address how contextual
characteristics of the community, environment, classroom and
students have implications for instructional planning and
assessment. Include specific instructional implications for at least
two characteristics and any other factors that will influence how
you plan and implement your intervention
Suggested Page Length: 1-3 pages
Rubric: I. Contextual Factors: The Teaching and Learning
Connection.
 TWS Requirement
Assignment II. Learning Goals, Enduring Understandings, and Essential Questions
The teacher candidate sets meaningful, challenging,
varied, and appropriate learning goals,enduring
TWS Standard understandings, and essential questions for students that
are consistent appropriate standards.

Task 2 Provide and justify the learning goals for the unit.

• List the learning goals and student learning

outcomes (not activities) consistent with
appropriate standards that will guide the
planning, delivery and assessment of your
unit. These goals and student learning
outcomes should define how you expect
students to demonstrate their knowledge
Prompt:
during and upon completion of the unit.

• Provide justification for your choice of

learning goals and student learning
outcomes. Elements of your justification
should include at least nature and level of
learning,appropriateness, and alignment
with local, state, and national standards.

Suggested Page Length: 1-3 pages

II. Learning Goals, Understandings and Essential
Rubric:
Questions
 TWS Requirement
Assignment III. Assessment Plan
The teacher candidate understands the purpose of
using multiple assessment modes to measure learning.
The teacher candidate knows how to use and
administer a variety of assessment models and
TWS Standard
instruments that align with learning goals and student
learning outcomes to measure student learning
throughout the instructional process.

Design an assessment plan to monitor student progress

toward learning goals. Identify the desired student results,
and determine the assessment evidence for the results. Use
multiple assessment modes and approaches aligned with
learning goals to assess student learning before, during, and
after instruction. These assessments should authentically
Task 3 measure student learning and may include performance
based tasks, paper ­ and ­ pencil tasks, or personal
communication Describe why your assessments are
appropriate for measuring learning in the context of your
placement and the goals, understandings, and essential
questions for your unit.

Assignment 3.1- Pre and Post Assessment

Include a description of pre and post assessments. Provide
evidence that your assessments align with your learning goals
and student learning outcomes. Explain the assessment tasks
and how you will evaluate or score the pre and post
assessments. Include the assessment and the evaluation
instrument (rubric or checklist). State what criteria you will use
to determine if the students' performance meets the learning
goals. Include evidence of pre and post assessments (copies of
the assessments of prompts and student directions for prompts)
and criteria for judging student performance. Copies of all
assessments should be placed as attachments.
Prompt:
Assignment 3.2 – Formative Assessment
Discuss your plan for formative assessment that will help you
determine student progress during the unit. Describe the
indicators you will use to check on student progress and
comment on the importance of collecting that particular
evidence. Although formative assessment may change as you
are teaching the unit, your task here is to predict at what points
in your teaching it will be important to assess students' progress
toward learning goals and student learning outcomes.

Assignment 3.3 – Learning Goals and Assessment Used

Use the table below to list each learning goal, assessments used
to judge student performance relative to learning goals, and
adaptations of the assessments for the individual needs of
students. The primary purpose of this table is to depict the
 alignment between learning goals and assessments. The table
also provides opportunities to show where adaptations are going
to be implemented to meet the individual needs of students or
certain contextual factors.

This table should be included in the text:

Learning Goals Assessments Assessments Task Adaptations
Specify goals, Specify type (Pre – Specify format Specify method and
understanding and Formative, and Post – (Performance – based, purpose of each
essential questions assessment) Paper – pencil, Personal adaptation
Communication)
Learning goal #1
Learning goal #2
Learning goal #3
Please Note: You Not limited to 3 learning Goals.

Assignment 3.4 Analysis of Student Performance

After administering the pre-assessment, analyze student
performance relative to the learning goals and student learning
outcomes. Depict the results of the pre – assessment in a graph
or chart, indicating students' progress toward each learning
goal. This graph or chart should be included in the body of text.
Discuss how this analysis will guide your instruction or
modification of the learning goals. You may use Chart to
display your assessment results for your class.

Suggested Page Length: Page number should be determine by the activities / lesson goals
Rubric: III. Assessment Plan
 TWS Requirement
Assignment IV. Demonstration of Instructional Knowledge and Planning
The teacher candidates designs and aligns curriculum plans and
instructional strategies according to specific learning goals,
TWS Standard
student learning outcomes and developmentally appropriate
learning needs/styles of students..
Describe how you will implement your unit of teaching and
learning around unit goals, and student learning outcomes,
Task 4
students’ characteristics and needs, and the specific learning
context.

Assignment # 4.1 Academic Calendar of Learning Unit

Use the block plan format attached to provide an academic

calendar of your entire learning unit. Include the topic or
activity you are planning for each day. Also indicate the goal or
goals, understandings, and essential questions (coded from your
Learning Goals section) that you are addressing in each activity.
Make sure that every goal is addressed by at least one activity
and that every activity relates to at least one goal and student
learning outcomes. Include academic calendar as an attachment.

Week Monday Tuesday Wednesday Thursday Friday

1
Prompt: 2

Assignment # 4.2 Lesson Plans

Choose four lesson plans created in the format distributed by
your college supervisor that reflect a variety of instructional
strategies/ techniques and explain why you are planning to use
or have used those specific activities. In your explanation for
each activity, include:
(a) how the content of the lesson relates to your instructional
goal(s) and student outcome(s),
(b) how the activity stems from your pre-assessment
information and instructional context, what
materials/technology you will need to implement the activity ,
(d) how you plan to assess student learning during and/ or
following the activity (i.e., formative assessment), and a copy of
these four lesson plans included as an attachment.

Suggested Page Length: Page number should be determine by the activities / lesson goals
Rubric: IV. Design of Instructional Knowledge and Planning
 TWS Requirement
Assignment V. Analysis of Learning Results
The teacher candidate uses assessment data to profile student
TWS Standard learning and communicate information about student progress
and achievement.
Analyze your post – assessment data to report the performance
of the whole class, subgroups, and two individual students. Use
Task 5
visual representations (charts or graphs) and narrative to profile
student performance.

Assignment # 5.1 Whole Class

Use aggregated data to draw conclusions about the extent to

which the whole class attained all learning goals. Provide a
graphic representation to compare pre and
Post assessment results for each goal. Explain what the graph
illustrates and why you think students performed this way.

Prompt: Assignment # 5.2 Subgroup

Select two students who represent different levels of

performance. Explain why it is important to understand the
learning of these particular students in relation to one
significant learning goal. Draw conclusions about the extent to
which these students attained the learning goal and provide
examples of student work to support your response.

(Include student work samples in attachments)

Suggested Page Length: Page number should be determine by the activities / lesson goals
V. Teaching Process: Analysis of Student Learning
Rubric:
Results
 TWS Requirement
Assignment VI. Reflection and Self – Evaluation
The teacher candidate reflects upon the relationship between his
TWS Standard or her instruction and student learning in order to improve
teaching practice.
Reflect on your performance as a teacher in guiding the
instructional process of this unit and link your performance to
Task 6 student learning results. Evaluate your performance relative to
the six standards of the work sample to identify future actions
for improved practice and professional growth.

Assignment # 6.1 Narrative Student Learning

Write a narrative reflecting on instruction and student learning

in which you
(a) describe the instructional strategies or activities that
contributed most to student learning and which were most
effective.
(b) explain the greatest barriers to achieving learning results,
specifically considering which of these were under your control
as a teacher.
(c) discuss what you would do differently to improve student
learning,

Assignment # 6.2 Narrative – Instructor Effectiveness

Prompt:
Write a narrative evaluating your effectiveness as an instructor
in which you:

(a) assess the extent to which you met the work sample
standards, focusing specifically on your key areas of strength
and weakness. Analyze how your performance on these
standards impacted the learning of your students.
(b) reflect on your own abilities and identify the professional
knowledge, skills, or dispositions (e.g., attitudes, values, and
beliefs) that would improve your performance on these
standards.
(c) review your management plan discuss its effectiveness in
relation to teaching and learning.
(d) select and discuss your most significant learning insight
from teaching this unit.

Suggested Page Length: Page number should be determine by the activities / lesson goals
VI. Teaching Process: Self – Evaluation
Rubric:
VII. Teaching Process: Literacy Component
Please Note:
• The teacher candidate will complete and submit the Teacher Work Sample as specified at the due date
predetermined by the director of student teaching.

• If any teacher candidate falls below the composite score of 80% or attains a "1" in any indicator, the
teacher candidate will have two weeks to resubmit that section of the Teacher Work Sample for the
purpose of reevaluation.
 TWS

Scoring Rubrics
 Rubrics for Assessing Teacher Work   Sample
I. Contextual Factors: The Teaching and Learning Connection
The teacher candidate uses information about the learning/teaching context and student  individual 
differences  to set learning goals and objectives, plan  instruction,  and assess   learning.

Minimum score:  12 out of  15 points
1 2 3
Indicator  Not Met Indicator  Partially Met Indicator  Met Score
Knowledge of Teacher candidate Teacher candidate Teacher candidate displays
Community, School, displays minimal or displays some knowledge a  comprehensive
and Classroom,  and irrelevant knowledge of of the characteristics of understanding of the
Collaboration with the characteristics of the the community and characteristics of the
families, community community, and school; school, and collaboration community and  school,
agencies, and school and collaboration with with school colleagues, And collaboration with
colleagues school, colleagues and and community agencies school colleagues, and
agencies . that are relevant to the community agencies that
ACEI  5.2: learning goals. are relevant to the learning
Collaboration with goals.
families, colleagues,
and community
agencies
Knowledge of Teacher candidate Teacher candidate Teacher candidate displays
Characteristics of displays minimal, displays some knowledge a  comprehensive
Students stereotypical , or of student differences knowledge  of student
irrelevant knowledge of (e.g., development  , differences (e.g.,
ACEI 1.0: student differences (e.g., interests, culture, development, interests,
Development, development, interests, abilities/disabilities)   that culture,   abilities/disabilities)
Learning, and culture, are relevant to the that  are relevant to  the
Motivation abilities/disabilities) learning goals. learning goals.
Knowledge of Teacher candidate Teacher candidate Teacher candidate displays
Students'  Varied displays  minimal, displays  a general comprehensive knowledge
Approaches to stereotypical,  or knowledge  about  the about the different ways
Learning irrelevant knowledge different ways students students learn (e.g.,
about the different ways learn (e.g., learning styles, learning styles, learning
ACEI 3.1: Integrating students learn (e.g., learning modalities, modalities, special needs
and applying learning styles, learning special needs students) students) relevant to the
knowledge for modalities, special that are relevant to the learning goals .
instruction needs students). learning goals.
Knowledge of Teacher candidate Teacher candidate Teacher candidate displays
Students' Skills  and displays little or displays some knowledge comprehensive knowledge
Prior Learning irrelevant knowledge of of students' skills and prior of students'  skills  and prior
students' skills and prior learning that are relevant knowledge relevant to the
ACEI 4.0:  Assessment learning. to learning goals. learning goals.
for instruction
Implications for Teacher candidate does Teacher candidate Teacher candidate
Instructional  Planning not provide implications provides some provides comprehensive
and Assessment for instruction and implications for instruction implications  for  instruction
assessment based on and assessment based on and assessment based on
student individual student individual student individual
differences and differences and differences and community,
community , school, and community , school,  and school, and classroom
classroom classroom characteristics . characteristics .
ACEI 4.0:  Assessment characteristics   OR
for  instruction provides inappropriate
implications.
COMMENTS:

11 
II. Learning Goals, Understandings, and Essential  Questions
The teacher candidate sets meaningful, challenging, varied, and appropriate learning goals  and 
understandings.
M1. n.rmum score: 10 out of 12 points
1 2 3
Indicator Not Met Indicator Partially Met Indicator Met Score
Significance, Goals reflect only one Goals reflect several types Goals reflect several types
Challenge.  and type or level of learning. of learning. of learning and reflect high
Variety expectations for student
understanding and
ACEl 3.1: application of knowledge.
Integrating and
applying
knowledge for
instruction
Clarity Goals are not stated Some of the goals are Most of the goals are
clearly and are activities clearly stated as learning clearly stated as learning
ACEl3. 1: rather than learning outcomes. outcomes.
Integrating and outcomes.
applying
knowledge for
instruction
Appropriateness Goals are not Some goals are Goals are developmentally
for Students developmentally developmentally appropriate and meet the
appropriate and do not appropriate; many goals needs of most students.
ACEI 1.0: reflect the needs of do not meet the needs of
Development, students. students.
Learning and
Motivation

Alignment with Goals are not aligned with Some goals are aligned Most of the goals are

National,State,or national, state, or local with national, state, or explicitly aligned with
Local Standards standards. local standards. national, state, or local
standards .
ACEI 3.1:
Integrating and
applying
knowledge for
instruction
COMMENTS:

11 
Ill. Assessment  Plan

The teacher candidate designs and administers a multiplicity of assessment models  and instruments 
that align with learning  goals  to measure pupil  learning  throughout  the instructional  process.
Minimum score: 12 out of 15 poi·nts
1 2 3
Indicator Not Met Indicator Partially Met Indicator Met Score
Alignment with Content and methods of Some of the learning Most of the learning goals
Learning Goals and assessment  lack goals are assessed are assessed through the
Instruction congruence with through the assessment assessment plan;
learning goals or lack plan, but many are not assessments are congruent
ACEI 4.0: cognitive complexity . congruent with learning with the learning goals  in
Assessment for goals in content and content and cognitive
instruction cocinitive  complexity. complexity.
Clarity of Criteria The assessments Assessment criteria  and Assessment criteria and
and Standards  for contain no clear criteria standards have been standards are clear and are
Performance or standards for developed, but they are explicitly linked to the
measuring student not clear or are not learning goals.
ACEI 4.0 : performance relative to explicitly linked to the
Assessment for the learning goals. learning goals.
instruction
Multiple Modes and The assessment  plan The assessment  plan The assessment  plan
Approaches includes only one includes multiple modes includes multiple
assessment mode  and but all are either assessment modes
does not assess pencil/paper based  (i.e. (including performance
students before, during, they are not performance assessments, lab reports,
ACEI 4.0: and after  instruction. assessments) and/or do research projects, etc.) and
Assessment for not require the integration assesses student
instruction of knowledge, skills and performance throughout
reasoning  ability. the  instructional  sequence .
Technical Assessments are  not Assessments appear  to Information regarding the
Soundness valid; scoring be valid for measuring the validity of the assessments
procedures are absent learning goals; scoring for measuring the learning
or inaccurate; items or procedures are  explained; goals is provided; scoring
prompts are poorly most items or prompts are procedures are clearly
written; directions  and clearly written ; directions explained and reliable;
ACEI 4.0: procedures are and procedures are clear items or prompts are
Assessment for confusing to students. to students. clearly written; directions
instruction and procedures are clear to
students.
Adaptations  based Teacher candidate  does Teacher candidate  makes Teacher candidate makes
on the Individual not adapt assessments adaptations to adaptations to
Needs of Students to meet the individual assessments that are assessments that are
needs of students or appropriate to meet the appropriate to meet the
ACEI 4.0: these assessments  are individual needs of some individual needs of most
Assessment  for inappropriate. students. students.
instruction
COMMENTS:

11 
 IV. Design of Instructional Knowledge and  Planning
The teacher candidate designs and aligns curriculum plans and instructional strategies according  to 
specific learning goals,  developmentally  appropriate  learning  needs  and styles  of students.

1 2 3
Indicator Not Met Indicator Partially Met Indicator Met Score
Alignment with Few lessons are explicitly Most lessons are explicitly All lessons are explicitly
Learning Goals linked to learning goals. linked to learning goals. linked to learning goals.
Few learning activities, Most learning activities  , All learning activities,
assignments, and assignments, and assignments, and
resources are aligned resources are aligned resources are aligned with
ACEl  3.1: with learning goals.  Not with learning goals.  Most learning goals.  All learning
Integrating and all learning goals are learning goals are goals  are covered  in the
applying covered in the design. covered in the design. design.
knowledge for
instruction
Accurate Teacher candidate's use Teacher candidate's use Teacher candidate's use of
Representation   of of content appears to of content appears to be content appears to be
Content contain numerous mainly accurate.  Shows accurate.   Focus of  the
inaccuracies.  Content awareness of the big content is congruent with
seems to be viewed more ideas or structure  of  the the big ideas or structure of
as isolated skills and discipline . the discipline.  Where
facts rather than as part appropriate, teacher
ACEI 3.1: of a  larger  conceptual candidate makes
Integrating and structure. connections from the
applying  content to other parts of 
knowledge for  the content or to other 
instruction content areas.
Lesson and Unit  The unit and individual  The unit and lessons  The unit and individual 
Structure lessons within the unit within the unit have lessons have a clearly
have little recognizable structure.  Most lessons, defined structure.  All
structure. activities, and lessons, activities, and
assignments are coherent assignments are coherent
parts of this structure and  parts of this structure and 
ACEI  3.1: appear to be useful in appear to be useful in
Integrating and moving the students moving the students
applying towards  achieving  the towards achieving the
knowledge  for learning goals. learning  goals .
instruction
Use of a Variety of  There is little focus on  Some variety in  Design includes variety 
Instruction, variety of instruction, instruction, activities , across instruction,
Activities, activities, assignments, assignments, or  activities, assignments, 
Assignments, and and resources.  Heavy resources. and resources used.
Resources. reliance on textbook or
single resource.
ACEI 4.0:
Assessment for
instruction
Use of Contextual  Instruction has not been  Some instruction has  Most instruction has been 
Information and designed with reference been designed with designed with reference to
Data to Select to contextual factors and reference  to  contextual contextual factors and pre­
Appropriate and pre­assessment data. factors and pre­ assessment data.  Most
Relevant Activities and assessment data.  Some activities and assignments
Activities, assignments  do  not activities and appear  productive  and
Assignments, and appear productive and assignments appear appropriate for each
Resources. appropriate for each productive and student.
student. appropriate for each
ACEI 4.0: student.
Assessment   for
instruction

11 
Use of Technology Teacher candidate does  Teacher candidate  uses  Teacher candidate 
not use technology  in  technology appropriately  integrates appropriate 
instructional delivery and  in instructional delivery  technology for teaching 
does not provide  but does not integrate  and learning.
opportunities for students  technology into student 
to use technology  OR  learning activities.
technology  is  Technology does  not 
inappropriately used. make a significant 
contribution to teaching 
and learninq.
Management Teacher candidate Teacher candidate Teacher candidate
Assessment demonstrates minimal demonstrates some consistently  manages  the
control.  Ineffective use of appropriate management classroom appropriately,
time; communicates techniques; few instances uses time  effectively , and
inappropriately with of ineffective use of time; communicates
ACEI 4.0: students. communicates with appropriately with
Assessment  for students appropriately students .
instruction most of the time.
Sound Many instructional Instructional decisions are Most instructional
Professional decisions are mostly appropriate, but decisions are
Practice inappropriate and not some decisions are not pedagogically  sound  (i.e.
pedagogically sound. pedagogically   sound. they are likely to lead to
ACEI 3.4: Active student learning).
engagement in
learning
Adjustments Teacher candidate uses Some adjustments of the Appropriate  adjustments  of
Based on Analysis one plan of instruction for instructional plan are the instructional plan are
of Student entire class. made to address made to address individual
Learning individual student needs student needs.  These
within the class, but these adjustments are informed
are not based on the by the analysis  of  student
analysis of student learning/performance.
ACEI  3.2: learning and obvious
Adaptation to learning opportunities are
diverse students missed.
Congruence Modifications in Modifications in Modifications in instruction
Between instruction lack instruction are somewhat are congruent with learning
Modifications and congruence with learning congruent with learning goals.
Learning Goals goals. goals.

ACEI  3.2:
Adaptation to
diverse students

COMMENTS:

11 
11 
V. Teaching Process: Analysis of Student Learning Results
The teacher candidate uses assessment data to profile student learning and to communicate 
information  about student progress  and  achievement.
1n1mum score: 12 out of 15 points
1 2 3
Indicator Not Met Indicator Partially Met Indicator Met Score
Clarity and Presentation  is not  clear Presentation is Presentation is easy to
Accuracy  of and accurate  (does  not understandable and understand and contains
Presentation accurately reflect data) . contains few errors. no errors  of  representation.

ACEI  3.1:
Integrating and
applying
knowledge  for
instruction
Alignment with Analysis  of  student Analysis of student Analysis  is aligned  with
Learning Goals learning lacks learning is partially aligned learning goals and provides
congruence with learning with learning goals and a comprehensive profile of
goals. fails to  provide  a student learning relative to
ACEI 4.0: comprehensive profile of the goals.
Assessment for student learning relative to
instruction the Qoals.
Presents Presentation  fails  to Presentation includes Presentation includes both
Aggregated and include aggregated either aggregated (whole aggregated (whole group)
Disaggregated (whole group) and group) or disaggregated and disaggregated
Data disaggregated (subgroup (subgroup and individual (subgroup and individual
and individual student) student)  data . student)  data.
ACEI  4.0: data.
Assessment for
instruction
Accuracy of Analysis is technically Analysis is technically Analysis  is  technically
Analysis of Data inaccurate and accurate but conclusions accurate and conclusions
conclusions are missing are missing or  not  fully are appropriate for the
ACEI  4.0: or  unsupported  by data. supported by data. data.
Assessment for
instruction
Provides Evidence Analysis of student Analysis of student Analysis of student learning
of Impact on learning fails to include learning includes evidence includes evidence of the
Student Learning evidence of impact on of the impact on student impact on student learning
student learning. learning for the entire for the entire   class,
ACEI 4.0: class but fails to include subgroups, and at least two
Assessment for subgroup and individual individual students.
instruction student  learninQ.
COMMENTS:

11 
VI. Teaching Process: Self­Evaluation and Reflection
The teacher candidate reflects upon the relationship between his or her instruction and  student 
learning  in order to improve  teaching practice .
M,.n.imum  score:  12 out of  15 points
1 2 3
Indicator Not Met Indicator Partially Met Indicator Met Score
Interpretation of No evidence  or Provides evidence but no Uses evidence  to  support
Student Learning reasons provided to reasons  (or gives conclusions drawn in
support conclusions simplistic, superficial Analysis  of  Student
drawn in Analysis of reasons)  or  hypotheses Learning section.
ACEI  5.1: Student Learning to  support  conclusions Explores multiple
Professional section. drawn in Analysis of hypotheses for why some
growth, reflection, Student Learning students did not meet
and evaluation section. learninq qoals.
Insights on Provides no rationale Identifies successful and Identifies successful and
Effective for why some activities unsuccessful activities or unsuccessful activities
Instruction and or  assessments  were assessments and and assessments and
Assessment more successful than superficially explores provides plausible
others. reasons for their success reasons (based on theory
ACEI 5.1: or lack thereof (no use of or research)  for  their
Professional theory  or  research). success or lack thereof.
growth, reflection,
and evaluation
Alignment Among Discussion shows no Discussion displays Logically connects
Goals, Instruction, alignment  among some  sense  of alignment learning goals, instruction,
and Assessment goals, instruction, and but misunderstandings or and assessment results in
assessment results. conceptual gaps are the discussion of student
ACEI 5.1: present. learning and effective
Professional instruction.
growth, reflection,
and evaluation
Implications  for Provides no ideas or Provides ideas for Provides ideas for
Future Teaching inappropriate ideas for redesigning instruction redesigning instruction
redesigning instruction. but offers no rationale for and explains  why  these
ACEI 5.1: why these changes modifications would
Professional would improve student improve student learning.
growth, reflection, learning.
and evaluation
Implications  for Provides no Presents professional Presents  a  small number
Professional professional learning learning goals, which are of professional learning
Development goals or inappropriate either vague  or  not goals that clearly emerge
learning goals. strongly related to the from the insights and
ACEI 5.1: insights and experiences experiences described in
Professional described in this section . this section . Describes
growth, reflection, plans for meeting these
and evaluation goals.
COMMENTS

11 
VII. Teaching Process: Literacy Component
The teacher candidate uses strategies to provide students with effective literacy skills.

M.in1.mum score: 12 OU  Of 18 points
1 2 3
Indicator Not Met Indicator Partially  Met Indicator Met Score
Content Area  The content area of the  The content area  has  The content area  has 
Literacy lesson has been  been identified and is  been identified and is 
identified but is not  well integrated with  richly integrated with 
connected to reading  reading and literacy.  In  reading and literacy 
and  literacy. cases where  instruction. In cases 
connections have been  where connections  have 
made to other content  been made to other 
ACEI 2.1: Reading,  areas, these links are  content areas,  these links 
Writing, and Oral  described in broad,  are well articulated and 
language general terms. detailed.
Goals and The candidate  has The candidate has The candidate  has
Objectives described what the described what the clearly explained what
students will learn  from students will learn from the students will  learn
the lesson by the lesson by describing from the lesson  by
articulating its goals and its goals and objectives, describing its goals  and
objectives, and why they and why they are objectives, and why they
are important. These important. Other areas are important. These
goals are not articulated of study have been goals have also been
in relation to other areas briefly mentioned and articulated in relation
of study, or these there is a brief other areas of study.  The
connections are articulation of their candidate has given a
unclear/confusing. The relationship to the goals detailed description  of
candidate has not of the lesson. The how the student's
described how the candidate has specific literacy strengths
student's specific described how the and needs will be met  in
ACEI 2.1: Reading, literacy strengths and student's specific this lesson.
Writing, and Oral needs will be met in this literacy strengths and
language lesson. needs will be met in this
lesson.
IRA and/or NYS The IRA and/or NYS The specific IRA and/or The specific IRA and/or
Common Core  ELA Common Core ELA NYS Common Core NYS Common Core ELA
Standards standards or ELA standards or standards or
performance  indicators performance indicators performance indicators to
to be addressed in  the to be addressed in the be addressed in the
lesson are not lesson are  mentioned, lesson are clearly
ACEI 2.1: Reading, mentioned at all. but the explanation of identified, and their
Writing, and Oral their relationship to the relationship to the
language objectives does not objectives has  been
have a narrative  quality. written as a  narrative.
Reading and Candidate has not Candidate has Candidate has
Literacy  Strategies developed any developed a  range developed a range  of
strategies to support appropriate strategy to appropriate and
students who need extra support students who authentic strategies  to
ACEI 2.1: Reading, help with  reading and need extra help with support students who
Writing, and Oral literacy. reading and literacy. need extra help with
lanquage reading and  literacy.
Assessment The methods  and The methods  and The methods  and
strategies to be used  to strategies for  measuring strategies for measuring
measure  student's student's literacy student's literacy learning
literacy learning are  only learning throughout the throughout the  lesson
provided for the lesson and at its and at its conclusion  are
conclusion of the lesson. conclusion are clearly clearly articulated. The
ACEI 4.0: The candidate  has articulated.  The candidate has  explained
Assessment for made poor choices of candidate has provided what they will  consider
instruction examples of "evidence" several examples of as "evidence" of literacy

11 
 of student's literacy  what they will consider  learning. The
learning.  The  as "evidence" of  connections between  the 
connections between  student's  literacy  assessment in the lesson 
the assessment in the  learning. The  and more summative 
lesson and more connections  between  assessments are clearly 
summative assessments  the assessment in  the  articulated. The
are absent or unclear. lesson and more  candidate has  provided 
The candidate has  not  summative ideas to the classroom 
provided ideas to the  assessments are vague  teacher about how  the 
classroom teacher about  or underdeveloped, but it  assessment in the  lesson 
how the assessment  in  is clear that the  will inform  literacy 
the lesson will  inform  candidate is able  to  instruction on an ongoing 
literacy instruction on an  make these connections.  basis.
ongoing basis. The candidate has 
provided a few ideas to 
the classroom teacher 
about how the 
assessment in the lesson 
will inform
literacy instruction on an 
ongoing basis.

Personal The candidate  has The candidate  has In cases where the

Reflection demonstrated her/his
(AC EI 5.1) ability to reflect on the
lesson with literacy
components, but did not
address connections to
literacy instruction and
the efforts to construct  a
meaningful learning
community. The
candidate has not
identified the strengths
and limitations of the
lesson in the future.
ACEI 5.1:
Professional
growth, reflection,
and evaluation
COMMENTS :
demonstrated her/his
ability to reflect on  the
lesson with literacy
components, including
their efforts to construct
a meaningful learning
community . The
candidate has  identified
the strengths and
limitations of the  lesson,
and has some  general
ideas about how it could
be revised in the  future.
The candidate  has
identified insights they
have learned about their
students and
themselves .
lesson with literacy
components has  been
taught, the candidate has
demonstrated her/his
ability to reflect on the
lesson, including their
efforts to make  meaning
connections to  literacy
and construct a
meaningful learning
community . The
candidate has  identified
the strengths  and
limitations of the  lesson,
and has made
suggestions for how  it
could be revised in the
future . The candidate
has identified insights
they have learned  about
their students and
themselves , and these
demonstrate
considerable thought  and
reflection.

• The teacher candidate will complete and submit the Teacher Work Sample as specified at the due 
date predetermined by the director of student teaching  .

11