Exhibit 1g.5.2 Candidate Disposition Form
Instructor/Staff Name
Course/CRN
Instructor/Staff E-mail
Term/Semester
Instructor/Staff Telephone Number
In our on-going effort to ensure our students are demonstrating the dispositions necessary to be effective educators, we need your feedback. Please fill out this
form electronically regarding any concerns you have about any of your students’ dispositions. Please fill out a separate form for each student about whom you
have a concern. If there are no concerns, please check no concerns in the box below. Return the form(s) to your program chair via e-mail at the end of the term,
or if there is a major concern/incident in class, please fill it out and send it asap.
Check here if there were no dispositional concerns in this class.
Student’s Name
Student ID
DISPOSITION
Intellectual Commitment
Demonstrates formal thinking capacity (thinks critically,
collects and analyzes data, anticipates multiple
consequences, makes sound decisions, and is open to
alternative viewpoints.
Respectfulness
Appropriately responds to and communicates with
others, including hearing feedback and responding
constructively to criticism. Is reflective and willing to
wrestle with ideas outside of his/her cognitive
framework.
Campus
CONCERN (Please describe in
detail the event(s) and date(s).
If the concern revolves around
something the student said,
please quote exactly what
he/she said.
Date
INTERVENTION/OUTCOME
Please document what
intervention(s) you have done
with the student.
DISPOSITION
Professionalism
Demonstrates awareness of personal and professional
style, strengths, and weaknesses. Monitors personal and
professional performance and plans appropriate selfimprovement. Has a sense of humor and can relate
happily with students, faculty, and others in a flexible,
non-defensive manner.
Empathy
Demonstrates patience, flexibility, and compassion in
working with others. Is relaxed around adults and
children.
Socio-Cultural Competence
Is able to give students positive attention and
reinforcement. Demonstrates good attending behavior
and is respectful of differences in values, styles, and
cultures.
Responsibility
Takes responsible action when faced with problems and
conflicts. Communicates directly and willingly accepts
responsibility for errors or negative impact on others.
Commitment to Professional Development
Enjoys and is committed to learning about, with, and
from students, peers, and faculty. Is open to new ideas
and feedback in order to remain current to the
profession.
Ethical Behavior
Maintains the highest level of integrity, honesty,
confidentiality, and fairness both personally and
professionally at all times.
CONCERN
INTERVENTION/OUTCOME