Example and Sample Forms

Appendix III

Example and Sample Forms

Figure III.B.1.1 Example DELI Form for Tracking Student Progress

Figure III.B.1.2 Transfer Credit Agreement

College of Engineering
Transfer Credit Agreement

(Attach copy of course description(s)

from transfer school’s course catalog)

Name Social Security Number

Engineering Major Telephone Number ( )

Send confirmation to:

addresscitystatezip

Approval is requested to substitute transfer credit from

school name

for U of I College of Engineering course work.

city & state

UI COURSE(S)

TRANSFER COURSE(S)

COURSE NO.COURSE TITLESH

COURSE NO.COURSE TITLESH/QH

Indicate if credit is semester hrs

(SH) ORquarter hrs (QH)

Please explain why you prefer to complete this course work at another institution.

CREDIT FROM TWO-YEAR COLLEGES:A maximum of 64 semester hours (SH) of degree credit from two-year colleges will be accepted toward the 128 SH required for graduation. If a student has earned more than 64 SH of degree credit from two-year colleges, the additional credit and grades will be used in computing the cumulative grade point average at the University of Iowa. The additional credit may be used to satisfy specific course requirements, but will not apply toward the 128 SH required for graduation.

NOTE: A grade of C- or above is required for transfer credit to be applied toward a BSE degree.

Evaluated by:Adviser Date

(Required for all departmental major substitutions)

Dept. Chair Date

(Required for all departmental major substitutions)

Stdt Dev. Ctr Date

(Required for all non-departmental major substitutions)

Core Crse Coord.Date

(Required for all core course - 057:*** - substitutions)

office use only:

The University of Iowa requests this information for the purpose of possible course credit. No persons outside the University are routinely provided this information, except for items of directory information such as name and local address. Responses to items marked "optional" are optional; responses to all other items are required. If you fail to provide the required information, the University may not be able to process your request.

Please return to Gail at 3501 3124 SC when finished. Thank you.4/97

Table B.3.1 – Blank COW form for Engineering Core Course

Course Outcomes Worksheet (COW)

57:007 STATICS

FALL 2000-01

Created 6 November 2000 by Forrest M. Holly

Last modified 15 November 2000 by C.C. Swan

Course Goals

Supports ABET Outcomes

/ Course Activity / Basis for Course-Goal Assessment
EASY survey assessment by students and instructor
EASY survey assessment by students and instructor
EASY survey assessment by students and instructor
EASY survey assessment by students and instructor
EASY survey assessment by students and instructor
EASY survey assessment by students and instructor

○ denotes moderate contribution to the outcome ● denotes substantial contribution to the outcome

ASSOCIATED EASY SURVEY QUESTIONS

Question

No. / Course
Goal / EASY Assessment Statement (soliciting 1-6 disagree-agree response, plus comments)
1
2
3
4
5
6
7

ABET Outcomes a) – k)

(Used for core-course assessments)

Engineering graduates will have the following attributes:

(a) an ability to apply knowledge of mathematics, science, and engineering;

(b) an ability to design and conduct experiments as well as to analyze and interpret data;

(d) an ability to function on multidisciplinary teams;

(e) an ability to identify, formulate, and solve engineering problems;

(f) an understanding of professional and ethical responsibility;

(g) an ability to communicate effectively in oral (o), written (w), and graphical (g) forms;

(h) the broad education necessary to understand the impact of engineering solutions in a global and societal context;

(i) a recognition of the need for and an ability to engage in lifelong learning;

(j) a knowledge of contemporary issues;

(k) an ability to use the techniques, skills, and modern engineering

Figure III.B.3.2 – Example EASY Survey for Core Course

Figure III.B.3.4 Blank CAR Form for a Core Course

Course Assessment Report

College of Engineering

The University of Iowa

(Revision of 27 November 2001)

Course Number: / Semester/Year
Course Name:
COORDINATOR: / SIGNATURE:
DATE:
INSTRUCTOR: / SIGNATURE: (optional)
OTHER : / SIGNATURE: (optional)

Please attach the course syllabus and course outcomes worksheet (COW).

Assessment Techniques:

Please indicate which of the following techniques were used in assessing the course and your judgment of their utility in assessing achievement of the Course Learning Goals.

Assessment Technique / Used, provided useful data / Used, not recommended
Homework
Exams
Quizzes
Projects
Written Reports (other than projects)
Oral Reports
Student Self-Evaluation
Student Peer-Evaluation
Course Portfolios
Class Surveys (e.g., EASY)
Instructor Observation
Other [specify]

ASSESSMENT RESULTS: (How were each of the course learning goals (from the COW) achieved? Support your assessments qualitatively and/or quantitatively with data from each of the assessment techniques used (see Table on previous page). Explain the relation of the present assessment results to previous ones.)

2. SUMMARY OF RECENT REMEDIAL ACTIONS: (and their estimated effect)

3. RECOMMENDED NEW REMEDIAL ACTIONS, IF ANY:

4. RECOMMENDED CHANGES TO COURSE LEARNING GOALS:

5. RECOMMENDED MODIFICATIONS TO ASSESSMENT TECHNIQUES:

6. SIGNIFICANT DEVIATIONS IN COURSE CONTENT FROM SYLLABUS (SUMMARIZE):

COURSE SUPPORT

TA SUPPORT FROM THE COLLEGE (IN TERMS OF FTE):

OTHER TA SUPPORT AND SOURCE (IN TERMS OF FTE):

TA RESPONSIBILITIES:

WAS THE TA SUPPORT ALLOCATED TO YOUR SECTION SUFFICIENT? PLEASE ELABORATE.

IF USED, WAS THE COMPUTER HARDWARE AND SOFTWARE SUPPORT FROM CSS ADEQUATE? PLEASE ELABORATE WITH SUGGESTIONS FOR IMPROVEMENT.

WERE THE FACILITIES (CLASSROOM, LABS, ETC.) ADEQUATE? PLEASE ELABORATE WITH SUGGESTIONS FOR IMPROVEMENT.

COURSE ORGANIZATION/CONTENTS

LECTURE (HOURS/WEEK): DISCUSSION (HOURS/WEEK):

LABORATORY (HOURS/WEEK):TOTAL NUMBER OF STUDENTS:

TEXTBOOK AUTHOR AND TITLE:

PLEASE COMMENT ON THE SUITABILITY OF THE TEXTBOOK AND ITS TIMELY AVAILABILITY.

TEACHING AIDS:

PLEASE ATTACH A COPY OF THE SYLLABUS THAT WAS DISTRIBUTED TO THE CLASS, A SAMPLE OF CLASS HANDOUTS IF AVAILABLE, AND THE COURSE ASSESSMENT WORKSHEET (COW) FOR THE COURSE. USE THE SPACE BELOW TO DESCRIBE ANY PARTICULAR PROBLEMS YOU MIGHT HAVE HAD WITH THIS COURSE (E.G., UNUSUAL ATTRITION, LACK OF PREREQUISITES, UNUSUAL GRADE DISTRIBUTION, ETC.) OR ANY INNOVATIONS/IDEAS THAT SHOULD BE CONSIDERED IN THE FUTURE.