1. Educational Technology Leadership Internship Supervisor Evaluation Form
Technology Leadership Internship Supervisor Evaluation
Directions
Thank you for your supervision and mentoring of a Lamar University Educational Technology
Leadership Intern. This is a service to the intern, to the profession, and the technology
leadership program at Lamar University. We are asking you to complete the following
Educational Technology Leadership Internship Supervisor Evaluation (ETLISE).
The ETLISE can be used to structure a final summative conversation and conference with the
intern, as the culminating event of the Internship/Practicum Experience. You are free to share
the evaluation and your responses with the Interns (at your discretion) or you can just talk about
it in general terms. We do need you to return it to Lamar as we will also be using this for
purposes of program improvement. It is not entered as a grade for the student. In the event that
there were multiple supervisors, just complete the sections applicable to the work done under
your supervision.
Basic Information
Rebecca Pruneda
Intern Name:
Beverly Warren/ Jan Brady
Supervisor/Mentor:
Fairmeadows Elementary School/ Byrd Middle School
Site Location:
04/27/2012
Date:
Evaluation Definitions
With regard to the Tech Facilitator Standards, the intern was
Exemplary consistently engaged and demonstrated excellence in completing
his/her activities and responsibilities.
The intern was engaged and successful with his/her activities and
Proficient responsibilities.
The intern was occasionally successful with his/her activities and
Minimally responsibilities, but needed to demonstrate greater proficiency and skill
Proficient in practicing this competency.
The intern was rarely successful with his/her activities and
Unacceptable responsibilities and needed much greater proficiency and skill in
practicing this competency.
Standard I -Technology Operations and Concepts
The Educational Technology Facilitator demonstrates an in-depth understanding of technology
operations and concepts.
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2. Educational Technology Leadership Internship Supervisor Evaluation Form
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator I.A
The Technology Facilitator
demonstrates knowledge, 3
skills, and understanding of
concepts related to technology
(as described in the ISTE
NETS-T).
Technology Facilitation
Performance Indicator I.B
The Technology Facilitator
demonstrates continual 3
growth in technology
knowledge and skills to stay
abreast of current and
emerging technologies.
Comments
Assisted in mentoring new teachers with technology training
TF I.A
Completed district training and implementation of problem
TF I.B based learning
Standard II - Planning and Designing Learning Environments
and Experiences
Educational Technology facilitators plan, design, and model effective learning environments
and multiple experiences supported by technology.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator II.A
The Technology Facilitator
designs developmentally 3
appropriate learning
opportunities that apply
technology-enhanced
instructional strategies to
support the diverse needs of
learners.
Technology Facilitation
Performance Indicator II.B
The Technology Facilitator
applies current research on 3
teaching and learning with
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3. Educational Technology Leadership Internship Supervisor Evaluation Form
technology when planning
learning environments and
experiences.
Technology Facilitation
Performance Indicator II.C
The Technology Facilitator 3
identifies and locates
technology resources and
evaluates them for accuracy
and suitability.
Technology Facilitation
Performance Indicator II.D
The Technology Facilitator
plans for the management of 3
technology resources within
the context of learning
activities.
Technology Facilitation
Performance Indicator II.E
The Technology Facilitator
plans strategies to manage 3
student learning in a
technology-enhanced
environment.
Technology Facilitation
Performance Indicator II.F
The Technology Facilitator
identifies and applies 3
instructional design principles
associated with the
development of technology
resources.
Comments
On-line spec. ed. Teachers group focusing on technology
TF II.A Planned & implemented research project for sp. Ed. Students
applies basic tech. skills and uses a paired working
arrangement
On-line spec. ed. Teachers group focusing on technology
TFII.B Planned & implemented research project for sp. Ed. Students
applies basic tech. skills and uses a paired working
arrangement
On-line spec. ed. Teachers group focusing on technology
TFII.C Planned & implemented research project for sp. Ed. Students
applies basic tech. skills and uses a paired working
arrangement
District resources for teachers
TFII.D
Provided new strategies in grade level
TFII.E
TFII.F Open source/ creative commons checklist & tip sheet
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4. Educational Technology Leadership Internship Supervisor Evaluation Form
Standard III – Teaching, Learning, and the Curriculum
Educational Technology facilitators apply and implement curriculum plans that include methods
and strategies for utilizing technology to maximize student learning.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator III.A
The Technology Facilitator 3
facilitates technology-
enhanced experiences that
address content standards
and student technology
standards.
Technology Facilitation
Performance Indicator III.B
The Technology Facilitator 3
uses technology to support
learner-centered strategies
that address the diverse
needs of students.
Technology Facilitation
Performance Indicator III.C
The Technology Facilitator 3
applies technology to
demonstrate students’ higher-
order skills and creativity.
Technology Facilitation
Performance Indicator III.D
The Technology Facilitator 3
applies technology to
demonstrate students’ higher-
order skills and creativity.
Technology Facilitation
Performance Indicator III.E
The Technology Facilitator 3
uses current research and
district/region/state/national
content and technology
standards to build lessons and
units of instruction.
Comments
Included in action research plan
TFIII.A
On-line spec. ed. Teachers group focusing on technology
TFIII.B Planned & implemented research project for sp. Ed. Students
applies basic tech. skills and uses a paired working
arrangement
Included in action research plan
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5. Educational Technology Leadership Internship Supervisor Evaluation Form
TFIII.C
Included in action research plan
TFIII.D
Included in action research plan
TFIII.E
Standard IV – Assessment and Evaluation
Educational Technology facilitators apply technology to facilitate a variety of effective
assessment and evaluation strategies.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator IV.A
The Technology Facilitator 3
applies technology in
assessing student learning of
subject matter using a variety
of assessment techniques.
Technology Facilitation
Performance Indicator IV.B
The Technology Facilitator
uses technology resources to 3
collect and analyze data,
interpret results, and
communicate findings to
improve instructional practice
and maximize student
learning.
Technology Facilitation
Performance Indicator IV.C
Apply multiple methods of 3
evaluation to determine
students’ appropriate use of
technology resources for
learning, communication, and
productivity.
Comments
Using on-line tools and programs for assessing And
TFIV.A improving instruction based on results
Using on-line tools and programs for assessing And
TFIV.B improving instruction based on results
Project rubric for teachers/
TFIV.C Project rubric for students
Standard V – Productivity and Professional Practice
Educational technology facilitators apply technology to enhance and improve personal
productivity and professional practice.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
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6. Educational Technology Leadership Internship Supervisor Evaluation Form
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator V.A
The Technology Facilitator 3
uses technology resources to
engage in ongoing
professional development and
lifelong learning.
Technology Facilitation
Performance Indicator V.B
The Technology Facilitator 3
continually evaluates and
reflects on professional
practice to make informed
decisions regarding the use of
technology in support of
student learning.
Technology Facilitation
Performance Indicator V.C
The Technology Facilitator 3
applies technology to increase
productivity.
Technology Facilitation
Performance Indicator V.D
The Technology Facilitator 3
uses technology to
communicate and collaborate
with peers, parents, and the
larger community in order to
nurture student learning.
Comments
Share information from TCEA
TFV.A
Evaluate TX STAR chart to address teacher technology
TFV.B needs
Included in action research plan
TFV.C Assists others using power video for lessons and
presentations
Web page
TFV.D
Standard VI – Social, Ethical, Legal, and Human Issues
Educational technology facilitators understand the social, ethical, legal, and human issues
surrounding the use of technology in P-12 schools and assist teachers in applying that
understanding in their practice.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
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7. Educational Technology Leadership Internship Supervisor Evaluation Form
Performance Indicator VI.A
The Technology Facilitator 3
models and teaches legal and
ethical practice related to
technology use.
Technology Facilitation
Performance Indicator VI.B
The Technology Facilitator
applies technology resources
to enable and empower 3
learners with diverse
backgrounds, characteristics,
and abilities.
Technology Facilitation
Performance Indicator VI.C 3
The Technology Facilitator
identifies and uses technology
resources that affirm diversity.
Technology Facilitation
Performance Indicator VI.D
The Technology Facilitator
enforces classroom 3
procedures that guide
students’ safe and healthy use
of technology and that comply
with legal and professional
responsibilities.
Technology Facilitation
Performance Indicator VI.E
The Technology Facilitator
facilitates equitable access to 3
technology resources for all
students.
Comments
Tip sheet/ guidelines for citing & referencing
VI.A
Accessibility and adaptive tech for gen. ed.
VI.B
Tech to address cultural diversity
VI.C
Resource lists
VI.D
VI.E Included in action research plan
Standard VII – Procedures, Policies, Planning, and Budgeting for
Technology Environments
Educational technology facilitators promote the development and implementation of technology
infrastructure, procedures, policies, plans, and budgets for PK-12 schools.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
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8. Educational Technology Leadership Internship Supervisor Evaluation Form
(1)
Technology Facilitation
Performance Indicator VII.A
Use the school technology 3
facilities and resources to
implement classroom
instruction.
Technology Facilitation
Performance Indicator VII.B
Follow procedures and
guidelines used in planning 3
and purchasing technology
resources.
Technology Facilitation
Performance Indicator VII.C
Participate in professional 3
development opportunities
related to management of
school facilities, technology
resources, and purchases.
Comments
Teacher Z: drive ; Student Z: drive
VII.A
On-line training and learning opportunities
VII.B
Professional development (resources & technology)
VII.C
Standard VIII – Leadership and Vision
Educational technology facilitators will contribute to the shared vision for campus integration of
technology and foster an environment and culture conducive to the realization of the vision.
Criterion Performance Rating
Exemplary Proficient Minimally Unacceptable
(3) (2) Proficient (0)
(1)
Technology Facilitation
Performance Indicator VIII.A
Identify and apply educational
and technology related 3
research, the psychology of
learning, and instructional
design principles in guiding
the use of computers and
technology in education.
Technology Facilitation
Performance Indicator VIII.B
Apply strategies for and 3
knowledge of issues related to
managing the change process
in schools.
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9. Educational Technology Leadership Internship Supervisor Evaluation Form
Technology Facilitation
Performance Indicator VIII.C
Apply effective group process 3
skills.
Technology Facilitation
Performance Indicator VIII.D
Lead in the development and 3
evaluation of district
technology planning and
implementation
Technology Facilitation
Performance Indicator VIII.E
Engage in supervised field- 3
based experiences with
accomplished technology
facilitators and/or directors.
Comments
Professional development (new technology, current research)
VIII.A
Discuss new district tech. plan w/ tech. improvement plan
VIII.B committee member
Tech-buddies
VIII.C
Discuss new district tech. plan w/ tech. improvement plan
VIII.D committee member
Included in action research plan
VIII.E
Signature
Signature
04/27/2012
Date
Contact Information
Feel free to scan the form, attach it to an email message, and return the completed form
to Rosie A. Sellers at the following email address: rosie.sellers@lamar.edu
Address:Lamar University, P.O. Box 10034, Beaumont, TX, 77710
Office: (409) 880-8024
Fax: (409) 880-8685
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