2013 CHEMISTRY ANNUAL REVIEW DOC

WSU Ph.D. Annual Progress Review
Page 1
Student
Name
Academic Year
Evaluation period
from
Student
Information
Student
to
Name
Last Name
First Name
Middle Initial
AccessID
Degree Program
College/School
Department
Major
Concentration (if applicable)
Minor (if applicable)
Semester you entered the Graduate Program
Semester
Have you taken a leave of absence during your time in Graduate School?
If yes, how many semesters?
Years in Program
Year
Yes
No
If yes, for what reason?
Dissertation
Information
Student
Dissertation Advisor
Last Name
Has your dissertation advisor has changed in the past year?
Do you have more than one dissertation advisor?
Yes
First Name
Access ID
Yes No
No If yes, please list him/her below.
Additional Advisor
Last Name
First Name Access ID
Department
Have your committee members changed in the past year?
Yes
Date Appointed
No If yes, please list them below.
Member Added
Last Name
First Name Access ID
Department
Date Appointed
Member Added
Last Name
First Name Access ID
Department
Date Appointed
WSU Ph.D. Annual Progress Review
Page 2
Student
Name
Academic Year
Evaluation period
from
Dissertation
Information
Student
(cont.)
to
Member Removed
Last Name
First Name Access ID
Department
Date Appointed
Member Removed
Last Name
First Name Access ID
Department
Date Appointed
Comments
Faculty
Comments
Course Work
Student
Total graduate credits (courses)
Courses you took during this review period.
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
Semester/Year
Course Number and Name
Grade
WSU Ph.D. Annual Progress Review
Page 3
Student
Name
Academic Year
Evaluation period
from
Student
(cont.)
Current term GPA to
Cumulative GPA
Do you have any Incomplete (I) or unsatisfacatory (B- or lower) grades on your graduate transcript?
Yes
No
If yes, please describe your plan to remediate these grades.
Grade remediation plan
Do the courses you have taken satisfy your Plan of Work (POW) or Individualized Development Plan (IDP)?
Yes No
If no, which courses are outside of your POW or IDP?
Comments
Faculty
Comments
Program
Milestones
Student
Entry or profiency requirements – date satisfied (semester/year).
SpeakingAnalytical
Select One
Select One
BiochemistryInorganic
Select One
Select One
OrganicPhysical
Select One
Select One
Chemical
SafetyResponsible
Conduct of Research
Select One
Select One
Qualifying Exams – date satisfied (semester/year).
Written Qualifying Exams (Cumes)
Pass If In Progress, how many Cumes points have you acquired to date?
Oral Qualifying Exam
Pass
No Pass Deferred Decision In Progress
No Pass
WSU Ph.D. Annual Progress Review
Page 4
Student
Name
Academic Year
Evaluation period
from
Student
(cont.)
to
If outcome was Deferred Decision or No Pass, what are your comments on this outcome and what are you
plans for retaking the exam?
Select One
2nd attempt at Oral Exam
Date completed (semester/year)
Plan of Work filed
Select One
Select One
PhD
Candidacy Status
Date completed (semester/year)
Date completed (semester/year)
Dissertation
Prospectus
Select One
Date completed (semester/year)
Select One
Pre-defense
Exam
Date completed (semester/year)
Select One
Seminar
requirement 1
Date completed (semester/year)
Seminar
requirement 2
Select One
Date completed (semester / year)
I only need to complete my final dissertation and defense.
Yes
Were any of the above Program Milestones unsatisfactory or late?
No
Yes
No
If yes, please explain
Please comment on your progress towards your degree and expected completion date.
Additional Comments
Faculty
Is this student making sufficient progress to complete his/her degree in 5 years
Please comment on this student’s progress towards completion of his/her degree.
7 years?
WSU Ph.D. Annual Progress Review
Page 5
Student
Name
Academic Year
Evaluation period
from
Faculty
(cont.)
Additional Comments
Skills
Evaluation
Faculty
Specific Skills – Potential areas of weakness and development plans
to
The following evaluation is to be based on national standards and expectations for doctoral students in this
student’s specific discipline.
Skill Matrix ranking
N/A
Not Applicable
1 - 2
Very weak For each value below 5, indicate the nature of the
3 - 4
Emerging weakness and actions through which the student
5 - 6
Minimum standard will continue to develop that skill.
7 - 8
Strong
9 -10
Exceptional
Rank
Specific Skill or competency Nature of weakness and actions for development
Rank
Oral communication
Rank
Written communication
Professionalism
Rank
Rank
Depth of knowledge on his/her
specific topic of scholarship
Rank
Depth of knowledge in his/her field
Rank
Breadth of knowledge in his/her field
Rank
Experimental design
Rank
Experimental execution
Rank
Mentoring of undergraduate assistants
Rank
Vision and creativity
WSU Ph.D. Annual Progress Review
Page 6
Student
Name
Academic Year
Evaluation period
from
to
Faculty
(cont.)
Please comment on the specific developmental gains the student has made since the last review.
Financial
Support
Student
Did you receive financial support from WSU or an external source during the period of this review?
Yes No
Funding Source
If yes, please identify your primary funding source and semester/year of funding.
Semester/Year
I worked outside of WSU or my primary funding source during part or all of this review period.
Part-time
Full-time
Hours/week
Employer
Dates of employment
I particpated in a paid training-related internship or program during part or all of this review period.
Employer Dates of employment
Comments
Faculty
Comments
Research &
Scholarship
Student
Please list all of your publications published during this review period. Provide full reference citation
indicating whether submitted (and date of submission), accepted, or published.
Title & Author(s)
Citation
Submitted
Yes
No
Date of submission
Accepted
Published
WSU Ph.D. Annual Progress Review
Page 7
Student
Name
Academic Year
Evaluation period
from
Student
(cont.)
to
Title & Author(s)
Citation
Submitted
Yes
No
Date of submission
Accepted
Published
No
Date of submission
Accepted
Published
Applied
Received
Applied
Received
Applied
Received
Title & Author(s)
Citation
Submitted
Yes
Awards/Fellowships
Award/Fellowship
Award/Fellowship
Award/Fellowship
Presentations at conferences (level: regional, national, international)
Title
Conference
Name
Dates
Level
Name
Dates
Level
Name
Dates
Level
Title
Conference
Title
Conference
WSU Ph.D. Annual Progress Review
Page 8
Student
Name
Academic Year
Evaluation period
from
Student
(cont.)
to
Patents
Name
PTO#
Applied
Awarded
Applied
Awarded
Name
PTO#
Other research activities
Other professional development activities
Additional achievements that do not fit in the above categories.
Comments
Faculty
Comments
Teaching
Student
Identitfy your teaching responsibilities/duties for each semester during this review period.
Semester
Course
Number/section
Title
Teaching repsonsibilities
SET course evluations numerical rating Q1
Faculty
Performance evaluation
Q2
Q24 Summative rating
WSU Ph.D. Annual Progress Review
Page 9
Student
Name
Academic Year
Evaluation period
from
Student
Semester
to
Course
Number/section
Title
Teaching repsonsibilities
SET course evluations numerical rating Q1
Faculty
Performance evaluation
Student
Semester
Q2
Q24 Summative rating
Course
Number/section
Title
Teaching repsonsibilities
SET course evluations numerical rating Q1
Q2
Q24 Faculty
Performance evaluation
Student
Pedagogical development activities undertaken during this review period.
Self-assesment of teaching
Comments
Faculty
Comments
Director of
Graduate
Studies
Comments
Summative rating
WSU Ph.D. Annual Progress Review
Page 10
Student
Name
Academic Year
Evaluation period
from
to
What are your current career or professional aspirations?
Career
Development
Student
Have these changed during this review period?
Yes
No If yes, how?
What skills must you still acquire or further develop to reach these career or professional goals?
What actions are you taking or plan to take to acquire these skills?
Have you experienced specific challenges in the program? what are your plans for overcoming these challenges?
Yes
No
If yes,
How would you alter the program to better support students facing these or similar challenges?
Comments
Faculty
Comments
WSU Ph.D. Annual Progress Review
Page 11
Student
Name
Academic Year
Evaluation period
from
Assessment
and Goals
Student
to
Student Self-evaluation
Please comment on your progress during this review period. What specifically did you achieve and how did
you develop?
What are your goals for the next year?
Faculty
Dissertation Advisor
Please comment on the student’s progress during this review period. What specifically did he/she achieve
and how did he/she develop?
Dissertation Committee
Did the dissertation committee meet during this review period?
date of meeting
members absent
Yes
No If yes,
Please comment on the student’s progress during this review period. What specifically did he/she achieve
and how did he/she develop?
CV Upload
Student
Please attach a copy of your current CV using the NIH or NSF Biographical Sketch format.
WSU Ph.D. Annual Progress Review
Page 12
Student
Name
Academic Year
Evaluation period
from
to
Signatures
StudentDate
Dissertation AdvisorDate
Dissertation Advisory Committee Member Date
Dissertation Advisory Committee Member Date
Dissertation Advisory Committee Member Date
Dissertation Advisory Committee Member Date
Director of Graduate Studies (Department or School/College)
Date
Dean of the WSU Graduate School
Date