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Description of Practicum Forms

Pre-Practicum/Practicum Observation

The supervising practitioner and college supervisor will use the Pre-Practicum/Practicum Observation Form and/or a running script of the supervision session to formally document progress and guide student development. The college supervisor and the supervising practitioner will complete this form a minimum of two times during the pre-practicum and three times during the practicum. It is important to separate the forms and leave a copy for the student so he/she can reflect on the feedback between observations. One copy should be retained by the college supervisor to be placed in the student’s file at the end of each semester.

Preservice Performance Assessment Guidelines & SC PPA Rubric

The rubric and guidelines should be used to determine whether or not there is evidence that the candidate has met each of the standards and indicators detailed on the preservice performance assessment form. They can be found in program specific Fieldwork Handbooks.

Practicum Midterm Evaluation

The student, supervising practitioner and college supervisor must complete a midterm evaluation. The purpose of the midterm evaluation is to indicate whether or not the candidate is on track to meet the license specific professional standards and to identify the candidate’s strengths and areas needing improvement for each standard.

Midterm Assessment of Subject Matter Knowledge

The supervising practitioner completes this form at the middle of the practicum. The results of this assessment should be discussed in a three-way meeting (student, supervising teacher and college supervisor) at the midterm. There is a separate subject matter knowledge form for each teaching program.

Intervention Warning Form

This form should be filled out at the midterm if there is any chance the practicum student may not be able to meet all state professional standards and is at risk of not being recommended for licensure.

Practicum Final Evaluation – Preservice Performance Assessment Form

The college supervisor is responsible for submitting the final preservice performance assessment (PPA) form to the Educator Preparation Office.

Students are responsible for providing evidence of how each professional standard has been met. Students must submit a draft copy of the preservice performance assessment form, with the evidence column filled in, to their college supervisor and supervising practitioner prior to the midterm. A revised copy of the PPA, with only the evidence column filled in, must be submitted to the college supervisor and supervising practitioner 3-5 days prior to the final evaluation meeting. The college supervisor and supervising practitioner must verify, add and/or subtract evidence from the form, fill out all other sections, sign each page and sign the last page of the form indicating whether or not the candidate has met all of the standards. This form must be submitted to the Office of Educator Preparation & Licensure together with the practicum report.

Things to Remember – Practicum Report

This is a list of things to remember regarding the official Practicum Report and the PPA.

Practicum Reports

The practicum report serves as page one of the Preservice Performance Assessment form. It should be completed on an ongoing basis, using black ink only to sign this form after each observation. It is to be delivered by the college supervisor to the Office of Educator Preparation and Licensure together with the Preservice Performance Assessment form (final evaluation) upon completion of the practicum. It is used as evidence to the MA Department of Elementary and Secondary Education as verification that the requirements have been met for licensure.

Time Record and Activity Report

This form is to be completed at the end of the practicum. All students are responsible for keeping track of their hours throughout the experience and entering them onto this form and getting the signature of their supervisor. It will be submitted to the Office of Educator Preparation and Licensure, who will calculate the total number of hours and enter them onto the Practicum Report. This form will be kept on file for state review.

Evaluation of College Supervision

Students complete this form at the end of the practicum. The form is submitted to the Office of Educator Preparation.

Student Evaluation of the Practicum

Students complete this form at the end of the practicum. The form is submitted to the Office of Educator Preparation. It provides evaluation information so that Springfield College can monitor all Educator Preparation Programs and make appropriate adjustments and improvements when needed.

Supervising Practitioner Evaluation of the Practicum

The Office of Educator Preparation mails this form to the supervising practitioner. It provides evaluation information so that Springfield College can monitor all Educator Preparation Programs and make appropriate adjustments and improvements when needed.

College Supervisor Evaluation of the Supervising Practitioner

The Office of Educator Preparation mails this form to the college supervisor. It provides evaluation information on the supervising practitioner and the site.

Practicum Policies & Process

• Read About Practicum Policies
• Read About Practicum Process

Forms

• Practicum Interview Record (.pdf)
• Practicum Observation Form (.pdf)
• Practicum Time Record and Activity Report (.pdf)
• School Counselor Time Record and Activity Report (.pdf)