The following is an example of a survey tool you could use to engage students in rating their perceptions of an instructor's teaching and learning approaches. It was published in W.J. McKreachie's book, Teaching Tips: Strategies, Research, and Theory for College and University Teachers. Parts have been updated for inclusive language.

Questionnaire

This questionnaire asks you to comment on various aspects of your course. It has eight brief parts. The first part is intended to assess your perceptions of your learning; the second part is your perceptions of characteristics related to instructor effectiveness. Other parts are not evaluative but are designed to evaluate aspects of teacher style. They ask for a description, not an evaluation. For example, either a high or low degree of structure may be effective.

Thank you for taking the time to fill this form out thoughtfully. Your answers and comments will help your teacher improve the course.

Date: __________________________________________________________

Course: __________________________________________________________

Instructor: __________________________________________________________

Class Standing: FR, SOPH, JR, SR, GRAD

Your GPA in all courses at this institution:

• 3-5-4.0
• 3.0-3.4
• 2.5-2.9
• 2.0-2.4
• 0-1.9

Sex:

Male
Female
Non-binary
Prefer not to disclose
Prefer to self-describe _______________________

Use the following scale:

1. almost never or almost nothing
2. seldom or little
3. occasionally or moderate
4. often or much
5. very often
6. almost always, a great deal
   If not applicable, leave blank

Impact on students

1. This course has stimulated my intellectual curiosity.
   Comments:
   
   
2. I am learning to think more clearly about the area of this course.
   Comments:

Student Information Processing

1. My mind wandered a good deal during class.
   Comments:
   
   
2. The instructor introduced new concepts so fast that I could not grasp them.
   Comments:
   
   
3. I tried to relate the course material to other things I know.
   Comments:
   
   
4. The course is increasing my interest in learning more about this area.
   Comments:

Instructor Effectiveness

1. The instructor is enthusiastic.
   Comments:
   
   
2. The instructor gives good examples of the concepts.
   Comments:
   
   
3. The instructor goes into too much detail.
   Comments:
   
   
4. The instructor is helpful when students are confused.
   Comments:
   
   
5. The instructor seems knowledgeable in many areas.
   Comments:

Rapport

1. The instructor knows the students' names.
   Comments:
   
   
2. The instructor is friendly.
   Comments:

Group Interactions

1. Students volunteer their own opinions.
   Comments:
   
   
2. Students discuss one another's ideas.
   Comments:
   
   
3. Students feel free to disagree with the instructor.
   Comments:

Difficulty

1. The instructor makes difficult assignments.
   Comments:
   
   
2. The instructor asks for a great deal of work.
   Comments:

Structure

1. The instructor plans class activities in detail.
   Comments:
   
   
2. The instructor follows an outline closely.
   Comments:

Feedback

1. The instructor keeps students informed of their progress.
   Comments:
   
   
2. The instructor tells students when they have done a particularly good job.
   Comments:
   
   
3. Tests and papers are graded and returned promptly.
   Comments:

This scale is different

Student Responsibility

1. Definitely false
2. more false than true
3. in between
4. more true than false
5. definitely true
   If not applicable, leave blank

1. I had a strong desire to take this course.
   Comments:
   
   
2. I actively participated in class discussions.
   Comments:
   
   
3. I try to connect what I am learning through the course and my experiences.
   Comments:
   
   
4. I attend class regularly.
   Comments:
   
   
5. I utilize the learning opportunities provided in the course.
   Comments:
   
   
6. I have created learning experiences for myself in connection with the course.
   Comments:
   
   
7. I have helped classmates learn.
   Comments:

Overall Evaluation

Indicate your evaluation of characteristics below using numbers based on the following scale.

1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent

1. Rate the instructor's general teaching effectiveness for you.
   Comments:
   
   
2. Rate the value of the course as a whole to you.
   Comments:

Added Comments Below:

Citation

• McKeachie, W. J. (1994). Teaching tips: Strategies, research, and theory for college and university teachers (9th ed.). Lexington, MA: D. C. Heath & Co.