Pathwise Framework Observation Program Feedback Form

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Pathwise Framework Observation Program Feedback Form Powered By Docstoc
					               Richmond Community Schools Psychologist Support Program

Feedback Form

Psychologist                                    Observer

Time:                                          Date:




Directions
Step 1. Psychologist and Observer will examine all evidence from the lesson.
        (observer’s notes, etc.)
Step 2. Psychologist and Observer will highlight or circle the relevant parts of the statements
        from the Levels of Performance by component for each Domain.
Step 3. Psychologist and Observer will check all components where evidence was found and
        summarize evidence.
Step 4. Psychologist and Observer will review the Domain summaries and develop strategies
        for future practice.




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Psychologist:                       Observer:                                  Date:
                      Richmond Community Schools Psychologist Support Program: Feedback Form
Domain 1: Planning and Preparation
    Component                                              Level of Performance
                             UNSATISFACTORY                                       BASIC                              PROFICIENT                               DISTINGUISHED
1a:                       Displays little understanding of the       Psycho-education knowledge              Demonstrates solid understanding of       Knowledge of practice of school
                          subject, structure of the discipline, or   represents basic understanding, but     content, prerequisite relationships       psychology is extensive with evidence
Demonstrating             of content-related psycho-                 does not extend to connections with     and connections with other                of a continuing search for improved
Knowledge of School       educational principles.                    other disciplines.                      disciplines. Responsibilities reflect     practice.
Psychology                                                                                                   current psycho-educational
                                                                                                             knowledge.

1b:                       Makes little attempt to acquire or use     Uses appropriate instruments and        Psychologist gathers information          Demonstrates all proficient level criteria
                          knowledge of students’ backgrounds,        demonstrates culturally competent       from parents in a culturally              and also contacts relevant community
Demonstrating             skills, or interests.                      practices to gain knowledge of          competent manner as well as               resources. Promotes partnership with
Knowledge of Students                                                students’ backgrounds, skills and       previous teachers and caregivers to       family and school.
                                                                     interests.                              gain knowledge of students’
                                                                                                             backgrounds, skills, and interests.

1c:                       Assessment and consultation do not         Assessment and consultation address     Comprehensively addresses referral        Thoroughly response to referral problem
                          address referral question/problem.         referral question/problem as            question/problem and identifies           and related issues, facilitates problem
Addressing Referral       Fails to tailor choice of tools to         presented. Uses standard test battery   related issues. Selects instruments       solving, and provides appropriate
Questions                 individuals needs.                         with little variation to specific       based on individual needs and             resources and intervention techniques.
                                                                     student needs.                          problem. Has and uses a variety of        Creatively approaches referral question,
                                                                                                             test instruments.                         using a variety of standardized test and
                                                                                                                                                       developing curriculum-based measures.

1d:                       Displays little knowledge and              Has knowledge and understanding of      Has more detailed knowledge and           Participates in and accesses a network of
                          understanding of the available             the available resources within the      understanding of the resources            child serving agencies to provide
Demonstrating             resources.                                 immediate educational setting.          available within the immediate            seamless services to the child, family
Knowledge of School,                                                                                         education setting, school district, IU,   and school.
District, and Community                                                                                      and community.
Resources

1e:                       Repeatedly disregards timelines or         Attentive to timelines and adheres to   Works with school-based team and          Conducts training with school staff to
                          fails to adhere to procedural              procedural safeguards.                  parents to ensure that all procedural     ensure understanding, collaboration and
Complies with             safeguards.                                                                        safeguards are consistently followed.     compliance with timelines and
Procedural Guidelines                                                                                                                                  procedural safeguards.




                                                                                                                                                                                                2
Psychologist:                              Observer:                                 Date:
                             Richmond Community Schools Psychologist Support Program: Feedback Form
Planning and                      Demonstrating Knowledge of School Psychology   Demonstrating Knowledge of School
Preparation                       Demonstrating Knowledge of Students            District, & Community Resources
(Check all components             Addressing Referral Questions                  Complies with Procedural Guidelines
where evidence was found.)

Summary




Strategies for Future Practice




                                                                                                                       3
Psychologist:                        Observer:                                 Date:
                      Richmond Community Schools Psychologist Support Program: Feedback Form
Domain 2: The Assessment Environment
    Component                                              Level of Performance
                              UNSATISFACTORY                                BASIC                           PROFICIENT                          DISTINGUISHED
2a:                        Interactions are negative,           Interactions are appropriate but     Interactions are characterized by    Contacts parents and teachers in
Interaction with Parents   demeaning, or inappropriate to       occasionally do not reflect equal    civility, mutual respect, give and   advance to discuss concerns and
                           the culture of the parent.           partnerships, mutual respect, or     take, and a sense of partnership,    goals for evaluation, what will be
and Teachers                                                    regard for differences in culture    questions are encouraged and         done and when, what to tell the
                                                                or values.                           answered.                            child, how to reduce child’s anxiety,
                                                                                                                                          and removal from class. Explains
                                                                                                                                          MDE and IEP procedures.
                                                                                                                                          Interviews and feedback are timely,
                                                                                                                                          respectful, empathetic and
                                                                                                                                          collaborative; respect time
                                                                                                                                          limitations; and are clear with a
                                                                                                                                          minimal use of technical terms.

2b:                        Interactions are negative,           Interactions are developmentally     Interactions are caring, friendly,   Interactions are warm, caring and
Interaction with           demeaning, or inappropriate to       and situationally appropriate.       respectful, and developmentally      respectful. Procedures are explained
                           the age or culture of the student.   Efforts to establish rapport and     and culturally appropriate.          and questions answered within
Students                                                        adequate to ensure validity of       Questions are answered in            limitation of instruments.
                                                                results.                             accordance with instrument           Psychologist ensures student is at
                                                                                                     limitations. Uncooperative           ease, cooperative, comfortable
                                                                                                     students are responded to with       asking and responding to questions,
                                                                                                     patience.                            and respectful. Uncooperative
                                                                                                                                          students are responded to
                                                                                                                                          therapeutically with patience,
                                                                                                                                          understanding, and empathy.

2c:                        Student is not prepared prior to     Time is spent preparing student      Efforts to put student at ease       Student is asked to test area in
Importance of Preparing    test administration. Anxious         for evaluation. Student anxiety is   begin at first meeting. Reasons      careful manner. Evaluation,
                           reactions to departure from          addressed periodically with          for activities are given in          activities and levels of difficulty are
the Student                classroom or to test procedures      encouragement and efforts to         developmentally appropriate          explained in developmentally
                           are not addressed.                   relax the student.                   language; questions are answered     appropriate language and within
                                                                                                     within instruments’ limitations      instrument limitations; questions are
                                                                                                     and in friendly manner. Feedback     encouraged. Psychologist conveys
                                                                                                     is given as permitted by the         that student is active participant and
                                                                                                     instruments.                         that responses are valued and creates
                                                                                                                                          atmosphere of cooperation.



                                                                                                                                                                                4
2d:                   Psychologist does not monitor or     Psychologist is alert to            Is alert and anticipates             Is sensitive to emerging fatigue and
Managing Student      address negative test behaviors      problematic behaviors and takes     problematic behaviors and            reduced motivation and attention
                                                           steps to intervene.                 proactively takes steps to           and takes steps to intervene.
Behavior during                                                                                intervene. Uses developmentally      Addresses uncooperative or
Evaluation                                                                                     appropriate encouragement or         disruptive behaviors with gentle but
                                                                                               incentives. Addresses                firm limit setting and a sense of
                                                                                               uncooperative or disruptive          humor.
                                                                                               behaviors with gentle but firm
                                                                                               limit settings.

2e:                   Psychologist is unfamiliar with      Demonstrates competency in          Psychologist is well versed in       Uses innovative strategies and
Managing Assessment   relevant procedures and fails to     procedures for each measure and     multiple procedures and              techniques to optimally assess the
                      administer or score according to     adheres to standardized             administers them according to        student’s needs. Procedures are
Procedures            acceptable practices. Test           administration.                     standardized specifications and      adapted to accommodate for special
                      administration is not modified as                                        special needs.                       needs and circumstances.
                      needed.
2f:                   Does not observe or modify           Observes and modifies testing       Inspects and modifies, to extent     Consults with building and district
Organizing Testing    testing room limitations. Does       room limitations. Reduces           possible, rooms in advance for       administration to promote the
                      not reduce distractible stimuli      distractible stimuli and ensures    distractions, lighting and           availability of optimal testing
Rooms                 when possible. Does not take         safety. Ensures appropriate         temperature. Arranges furniture      conditions.
                      steps to ensure safety.              conditions with building            to maximize efficiency of
                                                           administrator. Modifies test        administration, optimize
                                                           administration based on             attention/activity level, and
                                                           environmental conditions.           maximize safety. Discontinues
                                                                                               testing if conditions become
                                                                                               adverse or counterproductive.

2g:                   Protected test materials, scoring    Protected test materials, scoring   Consults with building               Consults with district administrator
Organizing Storage    forms, and notes are not stored in   forms, and notes and stored in a    administrator to store protected     to ensure policy that allows for
                      a secure area and access to          secure area when one is             test materials, scoring forms, and   storing protected materials, forms,
Space                 records is not monitored.            provided.                           notes in a secure, locked area.      and notes in a secure area. Keeps a
                                                                                               Keeps and review and access log.     log to monitor and record access to
                                                                                                                                    records by authorized personnel
                                                                                                                                    only.




                                                                                                                                                                           5
Psychologist:                              Observer:                                 Date:
                             Richmond Community Schools Psychologist Support Program: Feedback Form
The Classroom                     Interaction with Parents and Teachers             Managing Assessment Procedures
Environment                       Interaction with Students                         Organizing Testing Rooms
(Check all components             Importance of Preparing the Student               Organizing Storage Space
where evidence was found.)        Managing Student Behavior during Evaluation


Summary




Strategies for Future Practice




                                                                                                                     6
Psychologist:                             Observer:                                 Date:
                            Richmond Community Schools Psychologist Support Program: Feedback Form
Domain 3: Consultation
    Component                                                                    Level of Performance
                              UNSATISFACTORY                             BASIC                       PROFICIENT                        DISTINGUISHED
3a:                         Does not understand client        Demonstrates basic               Demonstrates thorough             Clients seek the involvement of
Providing Consultation      concerns. Does not provide        understanding of client needs.   understanding of client needs.    psychologist in solving
to Clients                  timely, useful or practical       Strategies are sound.            Facilitates the development of    problems. Strategies are
                            strategies.                                                        clear and concise strategies      consistently monitored and
                                                                                               that are timely and effective.    revised as necessary to promote
                                                                                               Follow up provided as             problem solving. Collaboration is
                                                                                               necessary.                        ongoing.
3b:                         Does not utilize process skills   Uses process skills when         Uses process skills effectively   Highly proficient use of process
Communicates                (i.e. empathy, genuineness,       communicating and                resulting in marked degree of     skills resulting in a degree of
Effectively                 and warmth) necessary for         collaborating to engender        client cooperation in             client cooperation in
                            establishing client               client cooperation.              communicating and                 communicating and collaborating
                            cooperation, trust, and                                            collaborating.                    that allows for exploration of
                            rapport.                                                                                             other concerns in greater depth.
3c:                         Lacks awareness of own            Stays appropriately within       Has expert knowledge and          Strives to expand knowledge and
Consults within             limits of knowledge and           boundaries of knowledge and      competency in addressing          expertise of self, colleagues, co-
Boundaries of               expertise. Consults outside the   expertise.                       referral problems. Maintains      workers and community.
Competence and              boundaries of knowledge.                                           professional boundaries.
Expertise
3d:                         Fails to evaluate                 Collects information about       Integrates evaluation with the    Psychologist facilitates data
Evaluates Effectiveness     implementation and                interventions in a timely        design of the consultation so     collection that permits client to
and Integrity of            effectiveness of consultation.    manner that allows program       that data collection and          make ongoing evaluation and
Consultation                                                  adjustment as needed.            program adjustment are            necessary modifications. Client
                                                                                               ongoing processes.                implements intervention
                                                                                                                                 strategies with integrity.
3e:                         Does not participate in or        Participates in team meetings.   Participates actively,            Facilitates team meetings.
Involvement on Building,    attend team meetings when         Needs supervision and            consistently, and                 Anticipates and plans for team
District, and Interagency   required. Participation in        direction about participation.   constructively in team            needs. Assists in developing
Teams                       meetings undermines team                                           meetings. Assists in              positive behavioral intervention
                            process/climate.                                                   developing positive               strategies.
                                                                                               behavioral intervention
                                                                                               strategies.



                                                                                                                                                                     7
Psychologist:                              Observer:                                 Date:
                             Richmond Community Schools Psychologist Support Program: Feedback Form
Consultation                      Providing Consultation to Clients                 Evaluates Effectiveness & Integrity of
(Check all components             Communicates Effectively                          Consultation
where evidence was found.)        Consults within Boundaries of Competence          Involvement on Building, District,
                                  & Expertise                                       & Interagency Teams
Summary




Strategies for Future Practice




                                                                                                                             8
Psychologist:                           Observer:                               Date:
                       Richmond Community Schools Psychologist Support Program: Feedback Form
Domain 4: Professional Responsibilities
    Component                                               Level of Performance
                                UNSATISFACTORY                                 BASIC                         PROFICIENT                          DISTINGUISHED
4a:                          Uses methodology that is             Uses methodology that is            Generates and communicates an        Generates and communicates and
Validity of Assessment       unreliable or invalid relative to    appropriate to the presenting       integrated profile of the student    integrated profile of the student in
                             the presenting problem.              problem. Follows standardized       in their learning environment.       their learning environment. Works
                                                                  procedures and ensures accuracy.                                         with the MDT to design
                                                                                                                                           interventions based on assessment
                                                                                                                                           results.
4b:                          Records are not fount, not legible   Keeps systematic and accurate       Records are complete, accurate,      Records are complete, secure,
Accuracy of Contact          or not secure. Important data may    records.                            legible and organized.               legible, and understandable to
                             be missing.                                                                                                   another qualified professional in the
Notes, Reports, and                                                                                                                        event of psychologist’s absence.
Protocols
4c:                          Provides meager or inaccurate        Offers basic information to         Provides extensive information       Provides extensive information
Quality and Timeliness       information about student            teachers and parents about          and considers parents’               designed to meet parents’
                             performance, interventions,          student performance,                communication needs. Involves        communication needs and encourage
of Feedback                  programs or other relevant issues.   interventions, programs, or other   teachers and parent in the           parental involvement. Maintains
                                                                  relevant issues.                    intervention process.                contact to ensure continuing
                                                                                                                                           cooperation and involvement.
4d:                          Engages in few or no                 Participates in professional        Seeks out opportunities for          Makes a systematic effort to
Enhancement of               professional development             activities as required.             development to enhance               enhance professional skills; applies
                             activities to enhance knowledge                                          professional knowledge and           and shares new knowledge.
Professional Knowledge       or skill.                                                                practice.

4e:                          Makes little or no effort to         Supports professional               Offers staff training and makes      Initiates important activities to
Service to the Profession;   promote professional                 improvement in others. Is           ongoing effort to promote            contribute to profession, such as
                             improvement through sharing          available to staff when needed.     professional improvement;            needs assessments, staff
Staff Development            knowledge; fails to assume                                               actively participates in assisting   presentations, interventions, articles,
                             professional responsibilities.                                           colleagues.                          and mentoring.
4f:                          Participates in school practices     Works within the context of         Works within the context of          Challenge negative attitudes and
Advocacy                     that are indifferent needs of some   teams, committees, and groups to    teams, committees, and groups to     practices and helps ensure all
                             students; sensitive to cultural      ensure all students a fair          ensure all students a fair           students are treated fairly; promotes
                             and/or ethnic issues.                opportunity to succeed.             opportunity to succeed. Sensitive    awareness of and sensitivity to
                                                                                                      to social and cultural issues.       cultural diversity.
4g.                          Makes decisions that are biased,     Decisions are data driven and       Decision-making is guided by         Takes a leadership role in team
Decision Making              unethical or unsupported by data.    reflect the needs of the client.    best practice and interest of        decision-making and helps ensure
                                                                                                      client; participates in team         decisions are based on highest
                                                                                                      decision-making.                     professional standards.


                                                                                                                                                                                 9
Psychologist:                               Observer:                                  Date:
                              Richmond Community Schools Psychologists Support Program: Feedback Form
Professional                          Validity of Assessment                                   Enhancement of Professional Knowledge
Responsibility                        Accuracy of Contact Notes, Reports                       Service to the Profession; Staff Development
(Check all components                 & Protocols                                              Advocacy
where evidence was found.)            Quality & Timeliness of Feedback                         Decision Making
Summary




Strategies for Future Practice




Psychologist                                                 Principal


Date                                                         Date

Signature does not mean acceptance or rejection of evaluation-only that the teacher has examined this evaluation and has a copy of same. The
teacher may include a response or rebuttal to the evaluation.

This document is retained at the building by the building principal.




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