FACULTY ADVISOR SURVEY FOR NONTRADITIONAL LEARNING ACTIVITIES

The purpose of this survey is to provide descriptive information and assessment data. Please complete this survey during
 the final examination period of the semester in which the nontraditional learning activity occurred. (After submitting the form, you may click here to verify that your results were received)

 I. Descriptive Information     Instructor (last name first or only last name) Course Section Number       Course Number and Title          Semester Year
    A. Check to indicate the most appropriate category of nontraditional learning activity 
    research          internship     travel study     service learning                 

    B. Nontraditional learning activity identified above was a component of a traditional classroom, laboratory, or library experience.
   Yes     No

    C. Number of students involved    

    D. Brief description of the activity

    E. Check each of the following that apply to the activity you supervised

1. Procedures (Check all that apply)

eligibility requirements were clearly established in writing  
student(s) filed applications presenting evidence of eligibility  
faculty/Department or School approved applicant  
worksite was designated  
a faculty advisor was assigned to work with student(s)  
an external supervisor was identified at worksite  
orientation was conducted for student(s) prior to the beginning of the activity  
faculty advisor met regularly with student(s)  
faculty advisor and worksite supervisor remained in contact with each other  
faculty advisor reported to the School/Department the appropriateness of the worksite for future nontraditional learning activities

2. Instruments used to evaluate outcomes

pre-test  
pre-survey  
journals  
portfolios  
daily work logs  
meetings with student(s)  
contacts with worksite supervisor  
post-test  
post-survey  
student(s) wrote paper(s) and/or made presentation(s) reflecting on the transformative nature of  the nontraditional learning experience  
worksite supervisor provided evaluation(s) of student(s) performance  
other (explain)

II. Assessment Data

The survey items below are designed to solicit your feedback regarding the participation of the student(s) under your supervision in the nontraditional learning activity identified above. For questions 1-8, select  the responses that most closely reflect assessment data you captured. Feel free to elaborate on your responses in the “comment” space below each item.

1. The student(s) functioned in a supervised, real world setting.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

2. Throughout the activity, the student(s) engaged in structured opportunities for meaningful reflection on the significance and implications of their experiences.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

3. The student(s) applied traditionally acquired knowledge and/or ideas in practical, real world contexts.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

4. The student(s) discovered additional knowledge and/or insights.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

5. The student(s) gained enhanced knowledge specific to the subject matter of a discipline or course.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

6. The student(s) interacted with persons whose values and/or culture differed from their own.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

7. The student(s) demonstrated awareness of their own value systems.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

8. The student(s) demonstrated awareness of values and/or cultures different from their own.  
Strongly Disagree    Disagree    Neither Agree Nor Disagree    Agree     Strongly Agree
Comments/Examples 

9. In addition to the developments covered above, did the activity affect student knowledge or value systems in other ways? If so, identify and discuss. 

III. Identify and discuss improvements you plan to make as a result of analysis of available assessment data 

IV. Identify and discuss improvements you have made as a result of analysis of available assessment data.

V. Suggestions you have to improve the procedure for assessment of nontraditional learning activities.