Elementary Inclusive Preservice Education ProgramDual Certification (ELEM-DUAL)

Department of Curriculum and Teaching

Teachers college, Columbia University
CSE Intern Fieldwork Evaluation1
Date: __ Completed by (circle):

Intern

Supervisor

Mentor Teacher

CSE Intern: ________________________________________

School: ___________________________________________________
Supervisor: ________________________________________________
Mentor Teacher: ___________________________________________

Objective: This evaluation guide is designed to identify the CSE interns strengths and capacities
demonstrated in the field as well as those aspects of professional practice that pose challenges.

Guidelines: The CSE intern, the university supervisor, and the mentor teacher will each fill out this
assessment instrument individually prior to meeting at mid-term and at the end of term. These
assessments will serve as a basis for substantive dialogue.
There are three sections: Pedagogical Decision-Making, Professional and Ethical Collaboration, and
Narrative Feedback. The first two sections have a rubric to mark the CSE interns progress regarding
specific goals. Use the narrative feedback section to share comments that provide evidence of areas of
strength or concern.
For the rubric sections, please place an X to indicate your assessment of the CSE interns development
and practice as an inclusive educator. You may mark more than one benchmark if appropriate.

Mentor Teachers:
This tool is not meant to restrict or to prescribe the nature of your comments. We welcome any and all
feedback you care to offer on the students learning, strengths, and challenges in his or her placement. We
thank you on behalf of the faculty and the interns for whatever descriptive evaluation you are able to
provide.

1 CSE interns are responsible for turning in all completed evaluations during C&T 4311.
1

I. Pedagogical Decision-Making and Practice for Increased Accessibility and Participation:

Learning Goals for CSE Intern

Problematic Opportunity not Expresses Emergent in Strong in

in practice yet afforded to knowledge of practice
practice
demonstrate

A. Demonstrate and model respectful, professional,

and ethical practice in interactions with all students
(e.g., presume student competence, foster and respect
student agency and autonomy, involve students in
decision-making).
B. Seeks to understand each student through:
conversations, assessments, observations
across settings, consultation with educators,
service providers, and caregivers.
C. Use knowledge of students to inform individual,
small group and whole class learning opportunities.
D. Initiates teaching/ learning interactions with
students throughout the day
E. Identify barriers to participation and accessibility
within the classroom and utilize supports and
strategies to minimize those barriers.
F. Designs instruction to address using supports and
strategies to minimize barriers.
G. Use various forms of assistive technology within
the classroom to support diverse learners. (Assistive
technology is here broadly defined to include low tech
and high tech options for modification, adaptation and
participation..eg. this can mean anything from post-its
to computers.)
H. Create safe and effective environments that
contribute to fulfillment of student needs that
facilitate student membership and participation in
the classroom.
I. Facilitate student membership and participation in
multiple learning environments (i.e., the larger school
community).

II. Professional and Ethical Collaboration:

Learning Goals for CSE Intern

Problematic Opportunity
Expresses Emergent in Strong in
in practice not yet afforded knowledge of practice
practice
to demonstrate

A. Demonstrate and model respectful,

professional, and ethical practice in interaction
with students, family members,
paraprofessionals, fellow educators,
administrators, and community members.
B. Understand the roles of students, families,
and school personnel in planning an
individualized education program (IEP).
C. Collaborate with students, families, school
personnel, and community members to promote
active participation in various settings.
D. Demonstrate development of professional
communication skills.

III. Narrative Comments:

Specific examples of strengths of demonstration in Specific challenges faced OR areas in which
practice:
intern has not yet had opportunity to demonstrate
skills:

Specific Goals for Learning and Growth: (based

upon assessment of strengths, challenges,
opportunities not yet afforded):

Signature

More Goals:

Date