Assessment Artifact Submission Form (Semester) (Type or Word-Process Only)
Faculty Name:
Program Name:
Department and Course:
PSLO Measured:
Name of Assignment:
Description of Assignment:
Explanation of how the artifact measures the PSLO
□
□
Is the artifact a product of an
online,
face to face, or
(Check the appropriate box to identify the format)
Type of
Artifac
t
□ blended/hybrid assignment?
Please type an “X” next to applicable description below
Embedded Questions (selected questions from an exam)
Performance/project/essay (scored with a rubric)
(Be sure to include the rubric and an explanation of how to read it or what it measures.)
Assignment (not scored with a rubric)
(On a separate page, explain the assignment, and provide a key if possible)
Indirect measures (student reflections on their own learning, your general reflections on student learning)
Other (Ask Mark Knowles for help in identifying type before submission)
Description:
Artifact
#
1
2
3
4
5
6
7
8
9
10
Identify the Artifacts
Type out the name of each artifact, even if they are all from the same assignment.
Your program manager will ask you for a specific number of artifacts.
Artifacts are randomly selected from population.
1 Course + section
Name or Description of Variable
Rating
(0 – 4)
1 course per form,
1 or more sections
1) Submit this form electronically to your program manager, who will forward all department documents to Mark Knowles.
2)
Provide hard copies of the tests/assignments, student artifacts, and related rubrics to your program manager.