Middle School Math Support

Small Group Instruction Feedback Form

Campus

Grade Level

Month

Please selct the month for which you are completing this form.

Classes Utilizing Small Group

Record the number of times you used SGI in the following classes:

On-level:

PACE/Alg:

Small Group Scenario

Enter the number of times you used each of the following this month.

MENU:

COOPERATIVE GROUPS:

CENTERS/STATIONS:

Student Engagement

Select the average level of student engagement for this month.

Purpose

Record the number of times you used SGI for each of the following:
Re-teach

Check for Understanding

Pre-teach

Enrich

Replace Whole Group

Other

Bloom's Taxonomy

At what level(s) of Bloom's were your small group lessons this month? (Check all that apply.)

High-Yield Statagies

What HYS were you able to incorporate into your small group lessons this month?

		Identifying Similarities and Differences
		Summarizing and Note Taking
		Reinforcing Effort and Providing Recognition
		Homework and Practice
		Cooperative Learning
		Non-Linguistic Representations
		Setting Objectives and Providing Feedback
		Generating and Testing Hypotheses
		Cue/Questions/Advanced Organizers

Which topics/concepts did you teach using small groups?

Which lessons/activities did you find most beneficial for increasing your students' understanding?

What aspects of your lessons this month were successful? What led to this success?

What improvements will you make as a result of your lessons?

Based on your observations this month, what are your plans for next month's small group lessons?

Use the scale below to rate the following statements:

1=Strongly Disagree, 2=Disagree, 3=Neutral/Need More Info, 4=Agree, 5=Strongly Agree

Small group lessons were beneficial.

Activities could be connected to current/future instructional topics.

Students not involved with the teacher's small group were on-task and productive.

Students responded well to the management signals.

Teacher was able to work uninterrupted and students sought help from the appropriate source.

Small group instruction was an effective use of class time.