Attachment K
ERSG Observational Program Implementation Fidelity Measure
Suggested times for two observation points:
Around group 6 (or prior to Thanksgiving and Winter Break))
Around group 16 (or prior to Spring Break)
Selection of groups for observation:
Random selection of one group per facilitator for each observation point.
With current staffing: 4 male and 3 female facilitators will be observed.
Observer:
Counseling Manager/ Supervisor
Form Approved
OMB No. 0920-0861
Exp. Date: 08/31/2013
Public
Reporting burden of this collection
of information is estimated at 15 minutes per response, including
the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a currently valid OMB
control number. Send comments regarding this burden estimate or any
other aspect of this collection of information, including
suggestions for reducing this burden to CDC/ATSDR Reports Clearance
Officer, 1600 Clifton Road NW, MS D-24, Atlanta, GA 30333; Attn:
PRA (0920-0861).
School Code: __________________________________________________________________
Facilitator Code: ________________________________________________________________
Date of Observation: ____________________________________________________________
Group Session: _________________________________________________________________
To which extent did the content of group discussions focus on abusive or healthy relationships?
Content or discussion about abusive or healthy relationships occurred during most of this session (relationships could be in families, dating relationships, friendships, work, etc.).
Content or discussion about abusive or healthy relationships occurred in half of this session.
Content or discussion about abuse or healthy relationships occurred in less than half of this sessions
Please identify other content or themes discussed:
________________________________________________________
To which extent did the facilitator use discussion questions suggested in the curriculum or similar questions?
Discussion questions from the curriculum or similar questions used in all or most of this session
Discussion questions from the curriculum or similar questions used in some parts of this session
Discussion questions from the curriculum or similar questions not used in this session.
Please identify what types of discussion questions the facilitator used:
________________________________________________________________________________________________________________________
To which extent did the facilitator use activities suggested in the curriculum or similar activities?
Activities suggested in the curriculum or similar activities used throughout the session
Activities suggested or similar activities used in some part of the session
Activities suggested or similar activities not used in this session.
Please identify what types of activities the facilitator used:
________________________________________________________________________________________________________________________
How did the facilitator use group time in this session?
frequently used group time (beyond check in) to support individual members who were in distress or sharing feelings.
occasionally used group time (beyond check in) to support individual members.
used group time primarily for structured activities.
To which extent did the facilitator allow group members to direct the group session?
frequently gave room for group members to raise questions and issues (or initiate discussion) about relationships that are relevant to them even if they are not planned in the curriculum.
occasionally gave room to group members to raise questions and issues about relationships even if they are not planned in the curriculum.
followed the curriculum sequence and structure
Did the facilitator use check-in or icebreakers at the beginning of the session?
Used in this session
Not used in this session
How much time did the facilitator spend on supporting and exploring personal experiences of group members?
30 minutes spent on general support, review of personal issues and experiences during this session
15 – 30 minutes given to general support in this session
Less than 15 minutes given to general support in this session.
How would you describe the role of the facilitator in this session?
facilitator talked less and allowed group to initiate and lead discussion
facilitator initiated discussion but then group took the lead
facilitator initiated most of the discussion and talked more as group members were passive and quiet
How would you describe the participation in this session?
Participation was balanced (everyone participates more or less equally)
Participation was semi-balanced, but some participants dominated while others were more quiet or withdrawn.
Participation was very much dominated by a few participants
What was the level of support among participants in this session?
high level of support among participants
moderate level of support among participants
low level of support among participants
Did you see participants learning new skills and strategies in this session?
Most participants demonstrated or reported using new communication or problem solving strategies in relationships
A few participants demonstrated or reported using new communication or problem solving strategies in relationships
Participants didn’t demonstrate or report using new communication or problem solving strategies in relationships
To which extent did participants share personal experiences?
Participants frequently shared personal experiences and feelings in this session
Participants sometimes shared personal experience and feelings in this session
Participants didn’t share personal experiences and feelings in this session
What did group members learn or gain by being in this group? How were members in this group impacted by the program?
________________________________________________________________________________________________________________________________________________________________________________________________________________________
Did students express any concerns about the observer in the room?
________________________________________________________________________________________________________________________________________________________________________________________________________________________
Did the facilitator notice any marked differences in the group members because of the observer? (Or, did the facilitator describe the observed group as different in any way from an unobserved group?)
________________________________________________________________________________________________________________________________________________________________________________________________________________________
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Aoki, Agnes |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |