Parent-Child Mother Goose Program®
Teacher Self-Evaluation Form
Each term, send a completed copy of this form, together with your program reports and copies
of the participant responses, by mail, Fax, or email to:
Assessment Secretary
PCMG Inc
PO Box 557
Ringwood Victoria 3134
Fax: 03 9380 6733
Email: pcmg.au.assessment@gmail.com
You can complete this form electronically, or you can print it and complete by hand. In each
area, tick a check box, and be sure to provide a comment.
Learning about the program and how to teach it is an on-going process. We expect in the first
few terms you will have some areas in which you are achieving Program standards
consistently and others where you are having difficulty. Please evaluate yourself carefully and
honestly. You may find it helpful to talk with, and get feedback from, your co-teacher.
Feel free to call the Parent-Child Mother Goose Program office at any time with questions or
concerns, or with stories from your program. We will be delighted to hear from you:
Phone: 03 9388 1599 Ext 145 (or toll-free within Victoria: 1800 171 882 Ext 145)
Your name
Type here
Your co-teacher’s name
Type here
Date of your Teacher
Training Workshop
Type here
Program term start date
Type here
Program term end date
Type here
Date of this evaluation
Type here
Is this your first, second,
third or later term (specify)?
Type here
Name of organisation hosting
Parent-Child Mother Goose
Program
Type host organisation name
Address of organisation
hosting Parent-Child Mother
Goose Program
Type street number and street name
Type suburb or city
Type state
Type postcode
Contact details for
organisation hosting ParentChild Mother Goose Program
Type organisation phone number
Type organisation email address
Contact person at organisation
Type here
Teacher Self-Evaluation Form
Page 1
hosting Parent-Child Mother
Goose Program
Teacher Self-Evaluation Form
Page 2
Necessary tasks and responsibilities
Before the session
I make reminder phone calls to participants.
always
sometimes
not at all
I need support
Comments
Type here (required)
I arrive at the expected time before the start
time of the teaching session.
always
sometimes
not at all
I need support
Comments
Type here (required)
I take part in room and refreshment setup.
always
sometimes
not at all
I need support
Comments
Type here (required)
During the session
I am aware of wandering children and am
aware of potential problems they present.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 3
I respond appropriately to problems in the
group.
always
sometimes
not at all
I need support
Please
elaborate
Type here (required)
I assist with serving refreshments.
always
sometimes
not at all
I need support
Comments
Type here (required)
I am aware of, and respond appropriately
to, the needs of participants during the
refreshment break.
always
sometimes
not at all
I need support
Comments
Type here (required)
After the session
I allow sufficient time for post-session
tasks, record keeping and planning.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 4
I participate in clean-up.
always
sometimes
not at all
I need support
Comments
Type here (required)
I sit down with my co-teacher to discuss all
aspects of the session.
always
sometimes
not at all
I need support
Comments
Type here (required)
I participate in recording statistics.
always
sometimes
not at all
I need support
Comments
Type here (required)
I participate in writing the session record.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 5
I reflect on the responses of the individuals,
and make insightful observations about
individuals as well as about the group as a
whole.
Comments
always
sometimes
not at all
I need support
Type here (required)
I suggest actions to meet the needs of
participants.
always
sometimes
not at all
I need support
Comments
Type here (required)
I participate in planning the next session
based on my and my co-teacher’s
observations.
always
sometimes
not at all
I need support
Comments
Type here (required)
I reflect on my own work during the
session.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 6
Program content
Parent-Child Mother Goose Program uses rhymes, songs and stories to foster attachment
between parents and children, and to nurture a repertoire of resources that parents can share
with their children during joyful, challenging and sad times, and to ease the stresses of
everyday life. A Parent-Child Mother Goose Program teacher builds a repertoire of oral
material that she or he can use with confidence, that addresses the needs of participants as a
group and individually, and that is appropriate to the program and its participants.
Rhymes
I am able to choose rhymes that meet the
goals of the Parent-Child Mother Goose
Program.
always
sometimes
not at all
I need support
Comments
Type here (required)
I have a repertoire of the following number
of rhymes that I can use with confidence:
1-3
4-6
7-10
11-14
15 +
I need support
Comments
Type here (required)
I seek new rhymes to add to my repertoire
of rhymes.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 7
Songs
I am able to choose songs that meet the
goals of the Parent-Child Mother Goose
Program.
always
sometimes
not at all
I need support
Comments
Type here (required)
I have a repertoire of the following number
of songs (including lullabies and dancing
songs) that I can use with confidence:
1-3 songs
4-7 songs
8-10 songs
I need support
Comments
Type here (required)
I am adding to my repertoire of songs.
always
sometimes
not at all
I need support
Comments
Type here (required)
Stories
I am able to choose stories that meet the
goals of the Parent-Child Mother Goose
Program.
always
sometimes
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 8
I have a repertoire of the following number
of stories that I can use with confidence:
1-2 stories
3-4 stories
5 or more
stories
I need support
Comments
Type here (required)
I am adding to my repertoire of stories.
always
sometimes
not at all
I need support
Comments
Type here (required)
I am able to plan a well-balanced session
using rhymes, songs and stories that meet
the goals of the Parent-Child Mother
Goose Program.
Comments
always
sometimes
not at all
I need support
Type here (required)
Relating to participants
Parent-Child Mother Goose Program teachers know that all parents come to the program with
both strengths and challenges, and work with parents respectfully, building on the strengths
they already have.
I work to create a welcoming
atmosphere.
completely
somewhat
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 9
I am able to connect with the adult
participants in a meaningful way.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I communicate support and openness in
dealing with problems.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I have realistic expectations of the children,
and communicate these to the parents.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I know and use positive strategies for
dealing with a child whose behaviour is of
concern within the group.
completely
somewhat
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 10
I am able to respond appropriately to
parents with concerns about their children’s
behaviour or welfare.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I have and share knowledge of community
resources with the adults.
completely
somewhat
not at all
I need support
Comments
Type here (required)
Group leadership and teaching skills
A Parent-Child Mother Goose Program teacher is able to work at many levels at once:
teaching rhymes, observing behaviour and interactions, adapting the plans for the day to the
needs of the group as they arise, and allowing space for contributions by parents.
I am comfortable in the role of group leader
and teacher.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I am able to use a variety of teaching
strategies.
completely
somewhat
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 11
I am aware of the needs of the group and
of individuals in the group.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I am able to take the initiative and keep the
program moving at a relaxed pace that
allows for contributions by the parent
participants, and for enough repetitions of
the rhymes so that parents are able to learn
the material by heart.
Comments
completely
somewhat
not at all
I need support
Type here (required)
Outreach
I am aware of potential referral sources for
the Parent-Child Mother Goose Program.
fully aware
just beginning
I need support
Comments
Type here (required)
I contact referral sources and distribute
information about the program.
fully able
just beginning
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 12
I am able to prepare and present a ParentChild Mother Goose Program outreach
session to other community workers and
programs.
Comments
fully able
just beginning
I need support
Type here (required)
Ideas and goals of the program
Parent-Child Mother Goose Program teachers must understand the philosophy underlying the
program and must express this understanding through the ways in which they perform their
role in the program.
I understand why we use the methods and
choose the content of the Parent-Child
Mother Goose Program.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I understand the goals of the program.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I understand the needs of the participants.
completely
somewhat
not at all
I need support
Comments
Type here (required)
Teacher Self-Evaluation Form
Page 13
My way of teaching and relating to group
members reflects my understanding of the
principles and goals of the Parent-Child
Mother Goose Program.
Comments
completely
somewhat
not at all
I need support
Type here (required)
Other
I feel supported by my management and
organisation to teach the program.
completely
somewhat
not at all
I need support
Comments
Type here (required)
I am receiving the assistance I need from
the Parent-Child Mother Goose Program.
completely
somewhat
not at all
I need support
Comments
Type here (required)
My goals for the next term of practicum experience
I have identified the following as areas that I need to work on in the next term of practicum
experience.
Type here (required)
Teacher Self-Evaluation Form
Page 14
My goals for the next term are:
Type here (required)
To reach these goals, I need the following kinds of support:
Type here (required)
Anything else you think is important
Type here
Teacher Self-Evaluation Form
Page 15