Name Student ID # 3 Course EDU223AA Section Course Instructor ALL PAGES MUST BE ATTACHED Hours must add up to the total required in each section for this course. Incomplete documents or those with errors will be returned to the student. Failure to complete this form correctly may result in failure of the course or a delay in posting a final grade. Field Experience Verification and Mentor Teacher Evaluation Form Rio Salado College has adopted a Practitioner s Model for the preparation of students wanting to become teachers. The Practitioner s Model is where students receive hands-on experience in the classroom learning from master teachers during the students teacher preparation coursework. Every student must complete the field experience process in some form; modifications are made for Rio Salado students who are employed in a classroom. Contact the Field Experience Office for more information. The mentor teacher and/or administrator: must verify the dates and times that the Rio Salado student was present in the classroom by initialing the boxes on the Field Experience Verification Form. complete the Performance-Based Field Experience Mentor Teacher Assessment Tool. provide a signature at the end of this document. return this form to the address below immediately following completion of the field experience as a final course grade will not be posted until this form has been received. Rio Salado Student Field Experience Requirements You are responsible for contacting the Field Experience Specialist prior to beginning a placement. 1. You may only observe the same mentor teacher for two course field experiences. 2. Provide the mentor with the Mentor Teacher Responsibility information as provided in the course. 3. Complete the required information at the top of this page. 4. Complete and document the minimum required hours in each section. Hours, dates, and times must not be duplicated. A separate form must be submitted for each course for which you are enrolled. All pages of this document must be returned. 4. Make a copy of this form prior to submitting it to your mentor teacher. In the event of a form being lost, you will still have your hours and dates available for re-verification. 5. Provide your mentor teacher and/or administrator a verification form with section A completed. Your mentor teacher and/or administrator will complete section B. Provide a stamped envelope with the following address: Rio Salado College ATTN: Your Instructor s Name P.O. Box 63310, Phoenix, AZ 85082-3310 Your Mentor Teacher or Administrator will return the form in the envelope you provide. Forms will not be accepted directly from Rio Salado pre-service teacher candidates.
Field Experience Verification Form: To be completed by student prior to submitting to mentor teacher/administrator for verification. Counting this course, how many classes with a field experience requirement are you currently enrolled in? How many field experience classes have you completed and been graded out of? Complete the following: Observation (5 hours) Mentor Teacher/Administrator Initials Start Time: End Time: Time: Description of Activity Observed: :
Complete the following: Tutoring (3 hours) Mentor Teacher/Administrator Initials Date: Start Time: End Time: Time: Description of Activity: :
Complete the following: Classroom Teaching Time (2 hours) Mentor Teacher/Administrator Initials Date: Start Time: End Time: Time: Description of Activity:
Skilled 2C Performance-Based Field Experience Mentor Teacher Assessment Tool: To be completed by the mentor teacher. Mentor Teacher: Please have a discussion with the Rio Salado pre-service teacher candidate about your evaluation of their work prior to returning this form to the address below immediately following completion of the field experience; a final course grade will not be posted until this form has been received. If you are uncomfortable sharing your evaluation with Rio Salado s pre-service teacher candidate and would prefer that Rio s teacher education office meet with the student, please contact our office. Directions: Each Rio Salado student must be evaluated on the evaluation form for each field experience. The evaluation must be completed and signed by the mentor teacher that observed the Rio Salado pre-service teacher candidate s work in the classroom. An overall rating is achieved by compiling the student s scores in each area assessed. General Questions For scores of 2 = and 1 = provide an explanation in the Comments area. Your comments will assist Rio Salado College in creating individualized intervention/remediation plans for the pre-service teacher candidate. 1. The Rio Salado Teacher Candidate was respectful of students in the classroom. [InTASC 9(m); CEC 2, 9] 2. The Rio Salado Teacher Candidate was appropriately and professionally dressed.[intasc 9(o); CEC 9] 3. Although the time spent with Rio Salado s Teacher Candidate s was limited, please rate their oral communication skills. [InTASC 3(f); CEC 9] 4. Although the time spent with Rio Salado s Teacher Candidate s was limited, please rate their level of social adjustment, from your perspective. [InTASC 3(r); CEC 5, 9]
Skilled Skilled 2C Classroom Observation Time 5. The Rio Salado Teacher Candidate remained engaged and interested in the classroom activities during his/her observation time. [InTASC 9(n); CEC 10] 6. The Rio Salado Teacher Candidate followed the lead of the mentor teacher and interacted with students when it was appropriate or remained unobtrusive and observed, when appropriate. [InTASC 9(n); CEC 10] Tutoring Time 7. The Rio Salado Teacher Candidate consulted with me about which students to tutor and the necessary content to cover in the tutoring session. [InTASC 7(o), 9(a), 10 (b); CEC 10] 8. The Rio Salado Teacher Candidate worked well with students. [InTASC 1(h,i,j); 2 (l,m,n); 3 (e,q); 4 (b,l,r); 6 (s); CEC 5]
Skilled 2C Classroom Teaching Time Performance 9. The Rio Salado Student engages learners in learning experiences in the discipline(s) that encourage learners to understand, question, and analyze ideas from diverse perspectives so that they master the content. [InTASC 4(b); CEC 4] 10. The Rio Salado Student stimulates learner reflection on prior content knowledge, links new concepts to familiar concepts, and makes connections to learners experiences. [InTASC 4(d); CEC 4] 11. The Rio Salado Student recognizes learner misconceptions in a discipline that interfere with learning, and creates experiences to build accurate conceptual understanding. [InTASC 4(e); CEC 4] 12. The Rio Salado Student uses supplementary resources and technologies effectively to ensure accessibility and relevance for all learners. [InTASC 4(g); CEC 3] 13. The Rio Salado Student creates opportunities for students to learn, practice, and master academic language in their content. [InTASC 4(h); CEC 3]
Skilled 2C Disposition 14. The Rio Salado Student realizes that content knowledge is not a fixed body of facts but is complex, culturally situated, and ever evolving. S/he keeps abreast of new ideas and understandings in the field. InTASC 4(o) 15. The Rio Salado Student recognizes the potential of bias in his/her representation of the discipline and seeks to appropriately address problems of bias. InTASC 4(q) 16. The Rio Salado Student is committed to work toward each learner s mastery of disciplinary content and skills. InTASC 4(r) Grand Overall Field Experience Rating (Select One from Grand above): Skilled (41-64 points) (25-40 points) (18-24 points) Reflects only pre-service teacher candidates who possess and demonstrate a truly exemplary understanding, mastery, and consistent integration of relevant concepts and professional teaching skills while completing their field experience requirements. These individuals regularly engage in activities that intentionally focus on student success. Reflects a pre-service teacher candidate with the skills and knowledge of a student who has successfully completed some teacher education course work. Such candidates have mastered important concepts and demonstrated the ability to apply these to concrete problems, but in contexts of limited situations. Reflects a pre-service teacher candidate who is a new student to the field of education. Such candidates are engaged in their baccalaureate or post-baccalaureate course work in teacher education course work. However, the Beginning Candidate possesses only a limited or superficial knowledge and awareness of concepts associated with educational concepts. This is the minimum rating in order for a student to be successful in a field experience. Reflects a pre-service teacher candidate, regardless of program level, who is not engaged in the educational process; including but not limited to unprofessional dress,
(0 17 points) inappropriate behavior with students, and general non-concern for the well-being of classroom students and education staff. Please indicate the strengths of the Pre-Service Teacher Candidate: Do you give permission for Rio Salado to share your evaluation information with the student? Yes No Mentor Teacher Payment will be processed upon receipt of this form. To formalize the payment process, please visit our website at: http://www.riosalado.edu/programs/education/insideedu/pages/mentor-teacher-payment.aspx Information not received by June 30 th of any year will result in forfeiture of stipend. Payment is not applicable if student is teaching on an emergency certificate, long-term substitute assignment, Teacher- In-Residence or completing only observation hours in your classroom. Mentor Teacher (Observing and/or tutoring in a certified mentors classroom.) District : School Grade Level: Teacher : Subject Area: Signature : Administrator- The administrator signature is ONLY necessary for Rio Salado pre-service candidates using their own classroom and observing a certified teacher(s) outside of their classroom. District : School Grade Level: Administrator (print name): Position: Signature : Date: Student is: Regular Certified Intern/Emergency Certified Long-term Sub(4+weeks in same classroom) No Certification Required for Employment *Note: Payments are not made for students who are completing field experience hours under one of the above employment opportunities as signed off by an administrator.