Q01
Message
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Teacher Self-Evaluation and Reflective Practice Survey
A structured self-reflection for teachers covering instructional practices, classroom management, student engagement, and professional growth priorities, plus an AI follow-up interview that digs into a specific teaching moment behind the numbers instead of stopping at a rating.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
14 questions · ~7 min
Q02
MatrixRequired
How often does each of the following describe your teaching this term?
6 rows × 5 columns
- I clearly communicate the learning objective for the lesson
- I adjust instruction for students with different skill levels or needs
- I use quick checks (questions, exit tickets, polls) to see if students understood before moving on
- I foster a classroom climate where students feel safe participating
- I incorporate student feedback into how I plan lessons
- +1 more
Columns: Never · Rarely · Sometimes · Often · Every lesson
Q03
Opinion ScaleRequired
Overall, how effective do you feel your instruction was this term?
Scale: 1 – 10
Min:Not effective at allMax:Extremely effective
Q04
Multiple ChoiceRequired
In the last month, how often did you change your plan mid-class because students weren't getting it?
- Never
- Once or twice
- About weekly
- Most classes
- Almost every class
Q05
Rating ScaleRequired
How would you rate your classroom management this year — keeping the room running smoothly and respectfully?
Range: 1 – 5
Min:Needs a lot of workMax:Excellent
Q06
Best–Worst Trade-off (MaxDiff)Required
Looking at the areas below, which would you most want to develop over the next year, and which is least of a priority for you right now?
- Differentiating instruction for varied learners
- Classroom management strategies
- Using technology to support learning
- Using formative assessment data to guide teaching
- Culturally responsive teaching practices
- Communicating with parents and families
- Managing workload and time
- Increasing student engagement and participation
Pick best & worst per setBest:Most want to developWorst:Least priority right now
Q07
Opinion ScaleRequired
How confident do you feel using student data (grades, quizzes, assessments) to adjust how you teach?
Scale: 1 – 7
Min:Not confident at allMax:Extremely confident
Q08
Multiple Choice
Which of these has been your biggest day-to-day challenge in the classroom this year?
- Not enough time to plan or grade
- Keeping students engaged
- Reaching students at very different levels
- Managing behavior
- Giving timely, useful feedback
Q09
Long Text
Describe one lesson or unit from this year you're genuinely proud of. What made it work?
Q10
AI Interview
Ask the teacher to walk you through the specific lesson or moment they mentioned they're proud of (or, if they skipped it, a recent lesson they'd rate near their overall effectiveness score). Probe what students were struggling with beforehand, what the teacher specifically did differently, and how they knew it worked. If their effectiveness rating was low or their confidence in using data was low, gently explore what's getting in the way and what support would actually help.
Q11
Multiple Choice
How many years have you been teaching, including this year? (optional)
- 1st year
- 2-4 years
- 5-9 years
- 10-19 years
- 20+ years
- Prefer not to say
Q12
Short Text
What subject and/or grade level(s) do you primarily teach this year? (optional, e.g., '7th grade math')
Q13
Multiple Choice
What type of school do you teach at? (optional)
- Public school
- Private school
- Charter school
- Other
- Prefer not to say
Q14
Message
Thank you for taking the time to reflect. Your answers, along with our short conversation, will be used to shape your own professional growth plan and, in aggregate, to guide school-wide support and coaching.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Goes beyond rating scales (matrix, opinion scale, max-diff on growth priorities) by including an AI follow-up interview that asks the teacher to walk through the specific lesson or moment behind their answers, not just record a number.
- Pairs quantitative self-assessment (instructional effectiveness, classroom management rating, data-use confidence) with open reflection prompts like describing a lesson they're proud of, then probes that story further.
- Captures context (years teaching, subject/grade, school type) as optional fields so results can be segmented without forcing every respondent to answer.
- Closes with a transparent thank-you/consent message about how responses and the short conversation will be used, keeping the process clear to participants.
Jotform
Teacher Self Evaluation Form TemplateA ready-to-use, customizable form builder template covering standard teacher self-evaluation categories. It's built for quick deployment and easy editing with Jotform's drag-and-drop builder, but it's a static form rather than an interactive interview. No mention of any follow-up questioning beyond what's typed by the survey designer.
What it does well
- Fast to customize and deploy via Jotform's builder
- Familiar form-based UI for respondents
- Likely supports standard field types (ratings, text, choice)
Where it falls short
- No adaptive follow-up questioning — respondents answer fixed questions only
- No voice interview option or guided screen-share tasks
- No automated per-response quality scoring or transparent prompt methodology
Typeform
Teacher Self Evaluation FormTypeform's conversational one-question-at-a-time format makes a static self-evaluation feel more engaging than a traditional form. It's a fielding-ready template, but the conversational feel is a fixed UI pattern, not a dynamic AI interview that adapts based on what a teacher actually says.
What it does well
- Polished, conversational question flow improves completion rates
- Easy to customize branding and question wording
- Good mobile-friendly respondent experience
Where it falls short
- No genuine adaptive AI probing — question order and logic are pre-set, not generated from responses
- No voice AI interview or screen-share task capability
- No automated quality scoring of open-text responses
QuestionPro
Course evaluation sample questions and survey templateThis is a survey-template/example-questions page combining student course evaluation and teacher evaluation content, more of a reference library than a single fielding-ready teacher self-reflection instrument. Useful for question ideas, but it's oriented around student-rated teacher evaluation rather than a teacher's own structured self-reflection.
What it does well
- Broad library of sample evaluation questions to draw from
- Established survey platform with standard question types
- Covers both course and teacher evaluation angles
Where it falls short
- Presented as a question-bank/guide rather than a packaged self-evaluation instrument
- No adaptive AI follow-up interview or voice interview option
- No transparent, teacher-specific per-response quality scoring or auto-generated reflective report
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.