Internship Evaluation of Clinical Educator
Please complete this evaluation. The form will be sent to the Office of Field Experience and yourself. Note that the University Supervisor does not receive a copy of it through this online form.
Current Status:
Intern Name:
Intern Email:

Clinical Educator Data
Clinical Educator Name:
Today's Date: 11/24/2014 11:01:36 AM
Content Area/Grade Level:

Please rate your clinical educator member on the following statements. Select either Satisfactory or Unsatisfactory on the rating scale below.

Responsibility 1: Building Positive Relationships
A. Creates a positive, professional relationship with the intern:
B. Is familiar with the intern's university requirements:
C. Encourages varied opportunities for the intern's professional learning:
D. Introduces the intern to essential school personnel (e.g. principal, secretary, custodian, counselor, etc.):

Responsibility 2: Planning and Teaching
A. Demonstrates and discusses effective, standards-based planning, instructional, and assessment skills and strategies to meet all P-12 learners' needs:
B. Models effective use of appropriate instructional technology:
C. Reviews intern's lesson plans before they are implemented, expecting appropriate thoroughness:
D. Provides the intern with the school policy handbook and other relevant and appropriate P-12 student information:

Responsibility 3: Conferencing and Assessment Skills
A. Gives effective constructive, formative feedback that is specific, frequent, timely, and relevant:
B. Sets and leads summative assessment discussion points with the intern at both the midpoint and end of the placement:
C. Formally observes and evaluates the intern the minimum number of times and bases rankings on the rubric descriptors:
D. Maintains a dialogue with the university supervisor and intern regarding P-12 learning and revision of strategies to meet all learners' needs:

Responsibility 4: Diversity
A. Promotes equitable teaching practices and makes appropriate accommodations for diverse learners:
B. Engages the intern in determining alternative strategies to ensure all P-12 students are learning:
C. Models effective work with diverse students and families: