UHD Faculty Feedback on Supplemental
Instruction Program (SI)

Course Name: ___________________________  Instructor:
______________________________

Course CRN: ____________________________ SI Leader:
______________________________

Use the following scale, unless the
question indicates otherwise:  (a)
strongly agree  (b) agree  (c) neither agree nor disagree  (d) disagree  (e) strongly disagree

(Mark
answer here)

1. It was helpful to have the SI leader in class

2. The SI leader was knowledgeable and prepared

3. The SI leader was concerned about student learning

4. I would request an SI leader for future/other classes

5. I would recommend requesting an SI leader to other faculty

6. I was satisfied with the schedule of SI session times and locations

7. The SI leader demonstrated good attendance

8. The SI leader was supportive of the SI program and the course

8a. If yes, in what ways?

8b. If no, what could have helped?

9. What did you find most frustrating about SI?

10. What did you find most helpful about SI?

11a. How would you rate your SI leader experience? Circle.

(a) Excellent

(b) Good

(c) Fair

(d) Poor

11b.What could have made the experience better?

12. How would you rate the overall effectiveness of the SI component of your
course? Circle.

(a) Excellent

(b) Good

(c) Fair

(d) Poor

13. Did you use any particular techniques or incentives to encourage students
to attend the SI sessions? If so, please describe. Were these techniques or
incentives helpful?

14. Did you employ your SI leader to help carry out any
in-class activities, such as lab activities or collaborative learning
activities? If so, please describe.