Self-Reflection and Self-Assessment Templates.docx
1.
Weekly Introspective Reflection
Whatwas I successful in?
What was I not successful
in?
What skills did I learn?
What still challenges me?
Feedback Synthesis
Constructive feedback I received this week:
2.
Constructive Feedback
#1
Constructive Feedback
#2
ConstructiveFeedback
#3
The synthesis of all of the constructive feedback I received has led to this better
understanding:
Areas I have established competency in: What area do I still need to improve in:
My plan for utilizing this constructive feedback to improve:
Is the feedback I received inclusive, does it contribute to or diminish equity and
inclusion? How can it be improved in the future? Can I raise questions/concerns to
ensure learning inclusivity?
3.
Learning Goal SettingProcess
I.A
What is my learning goal?
I.B
What areas/skillsets am I
hoping to improve?
II.A
How will I improve in these
areas/skillsets?
II.B
What is/are my
objective(s)?
III.A
When will I enact this
goal?
III.B
How do I plan to achieve
this goal?
IV.A
How will I know I’ve
achieved this goal?
IV.B
What is my measure for
4.
achievement and success?
Self-Paced“Informal” Learning Tracker
I have succeeded in:
(note lesson/study)
I realized my achievement by…
(note means of assessment)
I made progress on:
(note the mastery, level of
mastery)
I know I did made progress
because:
(note means of progress
measurement/assessment)
I need to make more progress
on:
(note the lack of mastery,
insufficient skills)
I need to make more progress in
these areas because they align
with my objectives/goals:
(note why progress in these areas
is key to achieve objectives/goals)
Is my learning comprising
diverse perspectives and
feedback?
(note if inclusive language and
imagery could help achieve
objectives/goals)
5.
Weekly Pre-Reflection
How muchtime will I
dedicate to my informal
learning?
Am I managing to keep
up with my informal
learning without falling
behind?
Should I modify the
amount of time I’m
committing to informal
learning outside of
class?
If YES, what changes
will I make during this
week?
Which learning
outcomes were most
difficult to achieve last
week?
What made these
learning objectives
challenging to achieve?
What plan(s) will I
employ to attain
success with these
informal learning
outcomes?
How will I enact this
plan?
How will I measure
6.
achieving this plan?
Self-Evaluation
Providean overview of
the feedback received:
Do you have any
concerns or questions
regarding your feedback
that you would like to be
clarified?
What is your emotional
response to this
feedback?
How do you self-measure
your level of work or
mastery of skills in
relation to your
performance?
How do you self-measure
your mastery and
outcome in relation to
the pre-set standard or
plan?
What action(s) did you
take to influence the
outcome of your
assignment?
What action(s) will you
take next time?
A. Ask clarifying questions
B. Outline my assignment
C. Use(d) feedback to revise
D. Use(d) a rubric to
complete my assignment
E. Other? Note below:
7.
What is yourstrategy for
achieving your
objective(s) and your
plan of action?
A. I plan to meet with my instructor for feedback…
B. I plan to submit a revised version of my assignment for
feedback…
C. ____________________________________________________
_________
D. ____________________________________________________
_________
E. ____________________________________________________
_________
F. ____________________________________________________
_________
G. ____________________________________________________
_________
What is your intended
timeline for
accomplishing your
objective(s) or plan of
action?
Miscellaneous (Feedback for DEI)
* This week’s self-reflection and self-assessment activities addressed an important issue,
Diversity, Equity, and or Inclusion challenge, facing my learning.
* This week’s self-reflection and self-assessment activities helped me be better informed about
the importance of Diversity, Equity, and or Inclusion.
* The inclusion of Diversity, Equity, and or Inclusion in this week’s self-reflection and self-
assessment activities is beneficial for improving my learning.
* This week’s self-reflection and self-assessment activities is beneficial for improving my
personal awareness of Diversity, Equity, and or Inclusion.
8.
* This week’sself-reflection and self-assessment activities should continue in future sessions
because they encouraged my awareness of Diversity, Equity, and or Inclusion.
* I would recommend these self-reflection feedback templates to my peers.
* I would NOT recommend these self-reflection feedback templates to my peers.
* Do you have any comments to share? Can these feedback templates be more inclusive?
How?