Raven EMS Education Program Manual
Instructor Evaluation by Program Director Form

Instructor name:

Date observed:

Observed by:

Topic of instruction:

Preparation	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Instructor was well prepared for class (Question required by NCOEMS).
Instructor was well organized (Question required by NCOEMS).
Instructor displayed wisdom (Question required by NCOEMS).
Instructor knows the subject well (Question required by NCOEMS).
Instructor appeared professional (Question required by NCOEMS).
Instructor accounted for different learning styles (Question required by NCOEMS).

Interaction with Students	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Treated students as equals (Question required by NCOEMS).
Treated students with respect (Question required by NCOEMS).
Courteous to students (Question required by NCOEMS).
Flexible with students (Question required by NCOEMS).
Approachable (Question required by NCOEMS).
Genuinely interested in the students’ opinions (Question required by NCOEMS).
Understanding (Question required by NCOEMS).
Cares about the students (Question required by NCOEMS).
Sensitive to the student needs (Question required by NCOEMS).
Patient (Question required by NCOEMS).
Fair (Question required by NCOEMS).

Classroom Management	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Created a felling of goodwill in the class (Question required by NCOEMS).
Got everyone involved (Question required by NCOEMS).
Encouraging (Question required by NCOEMS).
Allowed enough time for questions (Question required by NCOEMS).
Used class time well (Question required by NCOEMS).
Made clear what standard of work was expected (Question required by NCOEMS).
Ability to motivate (Question required by NCOEMS).
Demonstrated how work should be done (Question required by NCOEMS).
Stimulated students to follow-up on points raised in class (Question required by NCOEMS).
Authoritative (Question required by NCOEMS).
Listened to students (Question required by NCOEMS).
Displayed a sense of humor (Question required by NCOEMS).
Remained on task (Question required by NCOEMS).

Mentoring	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Served as a role model (Question required by NCOEMS).
Fostered personal relationships (Question required by NCOEMS).
Gave of self (Question required by NCOEMS).
Willing to help on a personal level (Question required by NCOEMS).
Believed in students (Question required by NCOEMS).
Challenged students (Question required by NCOEMS).
Suggested specific way to improve (Question required by NCOEMS).
Encouraged independence (Question required by NCOEMS).

Helpfulness	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Made self available for consultation (Question required by NCOEMS).
Provided positive feedback (Question required by NCOEMS).
Made self available outside of class time (Question required by NCOEMS).
Returned graded assignments promptly (Question required by NCOEMS).
Provided feedback on written work (Question required by NCOEMS).

Presentation	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Charismatic (Question required by NCOEMS).
Displayed a professional attitude (Question required by NCOEMS).
Made the objectives of each lesson clear (Question required by NCOEMS).
Used audio/visual aids well (Question required by NCOEMS).
Provided clear demonstrations (Question required by NCOEMS).
Made the aims of testing clear (Question required by NCOEMS).
Stressed the important points of the lesson (Question required by NCOEMS).
Presented material in an interesting way (Question required by NCOEMS).
Enthusiastic (Question required by NCOEMS).
Communicated well (Question required by NCOEMS).
Good speaking voice (Question required by NCOEMS).
Used relevant examples (Question required by NCOEMS).
Used a variety of teaching methods (Question required by NCOEMS).

Comments and Signatures
Comments:
Instructor signature:
Program director signature:

Change Log (3.85.250.IEPD)

Date	Author	Description of Change	Citations
2023-12-13	Becker, T.Theron Jack Becker	Created this form.
2024-07-31	Becker, T.Theron Jack Becker	Split Program Director Review Form into two forms: Each Course and Annual.
2025-01-03	Becker, T.Theron Jack Becker	Moved online from Adobe InDesign document.

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