國民國小實習檔案評量表（境外實習適用）

實習檔案評量表（國民小學師資類科）

Internship Evaluation Form (Elementary School Teacher Education Program)

一、基本資料（General information）

實習學生姓名（Student teacher）：____________________

師資培育之大學（Teacher education university）：_______________________

實習機構名稱（Internship organization/school）：__________________________

二、教學實習項目實習檔案評量表(評量教師簽名：_________________________)

Practical Education Training Profile Assessment Scale (Signature of rating teacher)

※請查看實習學生表現證據來源後(依師培大學所規定為主)，對照左方的參考檢核重點給予評量等第。 Please rate and comment in accordance with the index and indicator after reviewing relevant portfolio.
指標 Index	參考檢核重點 Check indicator	評量等第Rating (請勾選)			實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
指標 Index	參考檢核重點 Check indicator	優良Excellent	通過Pass	待改進To be improved	實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
A 課程設計與教學 Curriculum Design and Teaching	A-1設計適切的教學方案 Designing appropriate teaching programs				教學計畫（教案）P-2-R Teaching plan/lesson plan 學生學習成果評估P-3-R Learning outcome rating 教學前會談紀錄表P-4-R-1 Record sheet of pre-teaching meeting 教學演示評量表P-4-R-2 Teaching demonstration assessment scale 教學後會談紀錄表P-4-R-3 Record sheet of post-teaching meeting
	A-2掌握教學重點並善用教學技巧 Master teaching priorities and make good use of teaching skills
	A-3適切實施學習評量 Appropriate implementation of learning assessment
B班級經營與輔導 Class Management and Counselling	B-2 建立有助於學習的情境 Create learning situations				教學計畫（教案）P-2-R Teaching plan/lesson plan 學生學習成果評估P-3-R Learning outcome rating 教學前會談紀錄表P-4-R-1 Record sheet of pre-teaching meeting 教學演示評量表P-4-R-2 Teaching demonstration assessment scale 教學後會談紀錄表P-4-R-3 Record sheet of post-teaching meeting 教育實習省思P-5-R Reflections on educational internship 教育實習計畫P-7-E Educational internship plan 教育實習成果P-8-E Educational internship outcome 行政工作觀察A-1-R Administrative work observation 參與行政活動規劃與執行A-2-R Participate in the planning and execution of administrative activities
C 專業精進與服務 Professional Advancement and Service	C-2 累積專業知能與自信 Accumulated professional knowledge and confidence				見習P-1-R Clerkship 教學後會談紀錄表P-4-R-3 Record sheet of post-teaching meeting 教育實習省思P-5-R Reflections on educational internship 教育實習理念P-6-E Education internship concepts 教育實習計畫P-7-E Educational internship plan 教育實習成果P-8-E Educational internship outcome 專業成長計畫P-9-E Professional development plan 研習省思S-1-R Reflections on professional development training
	C-3 遵守教育專業倫理與規範 Compliance with Educational Professional Ethics and Norms
	C-4 熱忱投入教職工作 Dedicated to teaching

三、導師實習項目實習檔案評量表(評量教師簽名：_________________________)

Practical Education Training Profile Assessment Scale (Signature of rating teacher)

※請查看實習學生表現證據來源後(依師培大學所規定為主)，對照左方的參考檢核重點給予評量等第。 Please rate and comment in accordance with the index and indicator after reviewing relevant portfolio.
指標 Index	參考檢核重點 Check indicator	評量等第Rating (請勾選)			實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
指標 Index	參考檢核重點 Check indicator	優良Excellent	通過Pass	待改進To be improved	實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
B班級經營與輔導 Class Management and Counselling	B-1輔導個別學生 Counselling individual students				學生學習成果評估P-3-R Learning outcome rating 教育實習理念P-6-E Education internship concepts 教育實習計畫P-7-E Educational internship plan 教育實習成果P-8-E Educational internship outcome 行動研究P-10-E Action research 班級經營規劃T-1-R Class management plan 學生個別事件處理T-2-R Handling of individual student incidents 班級團體事務T-3-R Class group matters 親師活動的參與及省思T-4-R Participation in and reflections on parent-teacher activities
B班級經營與輔導 Class Management and Counselling	B-3積極參與班級親師生活動 Actively participate in parent-teacher-students activities
C 專業精進與服務 Professional Advancement and Service	C-2 累積專業知能與自信 Accumulated professional knowledge and confidence				教育實習省思P-5-R Reflections on educational internship 專業成長計畫P-9-E Professional development plan 研習省思S-1-R Reflections on professional development training
	C-3 遵守教育專業倫理與規範 Compliance with Educational Professional Ethics and Norms
	C-4 熱忱投入教職工作 Dedicated to teaching

四、行政實習項目實習檔案評量表(評量教師簽名：_________________________)

Practical Education Training Profile Assessment Scale (Signature of rating teacher)

※請查看實習學生表現證據來源後(依師培大學所規定為主)，對照左方的參考檢核重點給予評量等第。 Please rate and comment in accordance with the index and indicator after reviewing relevant portfolio.
指標 Index	參考檢核重點 Check indicator	評量等第(請勾選)				實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
指標 Index	參考檢核重點 Check indicator	優良Excellent	通過Pass	待改進To be improved		實習學生表現證據來源 Relevant portfolio	實習輔導教師評語欄Comments 如有特殊表現或狀況可在此加以註記
C 專業精進與服務 Professional Advancement and Service	C-1 認識並支援學校行政 Know and support school administration				見習P-1-R Clerkship 教學後會談紀錄表P-4-R-3 Record sheet of post-teaching meeting 教育實習省思P-5-R Reflections on educational internship 教育實習理念P-6-E Education internship concepts 教育實習計畫P-7-E Educational internship plan 教育實習成果P-8-E Educational internship outcome 專業成長計畫P-9-E Professional development plan 行動研究P-10-E Action research 行政工作觀察A-1-R Administrative work observation 參與行政活動規劃與執行A-2-R Participate in the planning and execution of administrative activities 研習省思S-1-R Reflections on professional development training
	C-2 累積專業知能與自信 Accumulated professional knowledge and confidence
	C-3 遵守教育專業倫理與規範 Compliance with Educational Professional Ethics and Norms
	C-4 熱忱投入教職工作 Dedicated to teaching