Annual Performance Feedback Form for GFT Faculty Members

Teaching, Scholarship and Administration/Service Activities

Name:Date:

Title/Rank:Department:

This form is to be filled out annually by GFT Faculty Members and submitted,along with a current CV,as a PDF file. In advance of thescheduled Performance Review meeting, the Department Head/Section Head or their designate conducting the Performance Review shall prepare their feedbackusing the Summary and Signature Form (in conjunction with the Program Clinical Lead, if biennial review of clinical activities is applicable). The face to face meeting results in, or is followed by filling out the Summary and Signature Form. This form includes the feedback from the Department Head/Section Head or their designate, the Faculty Members’ response, and signatures.

  1. TEACHING

Evaluations of courses, sessions, instructors, primary preceptors, primary residents and elective supervisors are conducted on a regular basis throughout each academic year and form an important component of annual performance review.

Percentage of time for teaching articulated in your Letter of Offer:

Do your teaching responsibilities align with the stated teaching responsibilities in your Letter of Offer?

Yes

No

If no, please explain:

  1. Teaching Accomplishments

Information for this section may be cut and paste from your curriculum vitae. Please only include information relevant to the year during which the performance feedback is being conducted. Provide a list of your teaching activities, including teaching in both clinical and nonclinical settings. For each activity, provide your role/function in the activity, the name of the activity, level of individuals being taught, number of individuals participating, frequency/time of the activity, and student feedback, if available. Include supervision of students and any teaching awards and honours you may have received during this period.

  1. Innovations/Improvements in Teaching

If applicable, please describe any activities you carried out during this reporting period that improved your teaching skills or the teaching services provided to students.

  1. Comments by Faculty member

If you wish, briefly comment on the extent to which you feel you accomplished your teaching goals over the past year following your last performance feedback. Include the challenges you have faced during this academic period, and the approach you took to address these challenges. Discuss what you have done or plan to do with your teaching contributions in response to your teaching outcomes and any feedback you have received. Indicate what you, the department, or the institution could do to enhance your professional development in this academic area.

  1. SCHOLARLY ACTIVITY and/or SCHOLARSHIP (RESEARCH)

If the responsibilities outlined in your Letter of Offer do not include scholarly activity, please move on to Section C.

Percentage of time for scholarly activity articulated in your Letter of Offer:

Do your responsibilities in scholarly activity and/or scholarship (research) align with the stated responsibilities in your Letter of Offer?

Yes

No

If no, please explain:

  1. Summary

Please briefly summarize the main focus of your scholarly work during this reporting period and briefly highlight major findings and accomplishments.

  1. Research Accomplishments and other Scholarly Activities

Information for this section may be cut and paste from your curriculum vitae. Please only include information relevant to the applicable reporting period. Please group information into the following categories where applicable; grant funding, clinical trials participation, publications, presentations, new patents and licenses, research awards and honours, and supervision of students and research trainees including the level of the individual taught and their major accomplishments.

  1. Knowledge synthesis

If applicable, please clearly describe any scholarly work completed during this reporting period in the area of knowledge synthesis that required an intensity of work and hours of commitment not reflected in the publication or grants categories. For example, formal scholarly review of existing knowledge that leads to a major policy change, the development of clinical practice guidelines, or advancement in education scholarship.

  1. Comments by Faculty member

If you wish, briefly comment on the extent to which you feel you accomplished your research goals over the past year since your last performance review report. Include the challenges you have faced during this academic period, and the approach you took to address each challenge. Indicate what you, the department, or the institution could do to enhance your professional development in this academic area.

  1. ADMINISTRATION/SERVICE

If the responsibilities outlined in your Letter of Offer do not include administration/service activities, please move on to Section D.

Percentage of time for administration/service articulated in your Letter of Offer:

  1. Administration/Service to the University

Information for this section may be cut and paste from your curriculum vitae. Please only include information relevant to the year during which the performance feedback is being conducted. Where applicable, please include each of your Departmental, Faculty, Provincial, National and International administrative or service activities, the type of activity, the location of the position/activity, your role and your time/effort in the activity and any major accomplishments. This section should include committee membership, leadership positions and teaching administration.

  1. Administration/Service to Professional/External Organizations

Information for this section may be cut and paste from your curriculum vitae. Where applicable, please include committee activities (e.g. editorial board(s), examination boards, research or educational advisory committees), professional society activities, peer review activities, industry consulting, advising and board memberships applicable to the reporting period. Include in this section other awards and honours not listed in Scholarship and Scholarly Activity or Teaching.

  1. Comments by Faculty member

If you wish, briefly comment on the extent to which you feel you accomplished your administrative/service goals over the past year since your last performance review report. Include the challenges you have faced during this academic period, and the approach you took to address each challenge. Indicate what you, the department, or the institution could do to enhance your professional development in this area.

  1. GOALS FOR 20

Please summarize your goals for the upcoming year. Goals should reflect the responsibilities and expectations outlined in your contract, as well as long term career goals.

Teaching:
Scholarly Activity and/ or Scholarship (Research):
Administration/Service:
Clinical Activities (biennially and if applicable):

______

Signature of Faculty MemberDate

Form Performance Feedback for Annual Teaching, Scholarship and Admin Activities of GFT |March 2014

Appendix F to the FOM Career Development and Performance Feedback Policy 1