AGPA Institute Observer Evaluation Form

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* Instructor/Leader(s)

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* Title of Institute

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* Observed for (length of time)

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* Observer

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* Date of Observation

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* I. Please rate for all groups when seen during time of observation

	Not Well				Extremely Well	N/A
Manages boundaries	Manages boundaries Not Well	Manages boundaries	Manages boundaries	Manages boundaries	Manages boundaries Extremely Well	Manages boundaries N/A
Attends to contact / learning objectives	Attends to contact / learning objectives Not Well	Attends to contact / learning objectives	Attends to contact / learning objectives	Attends to contact / learning objectives	Attends to contact / learning objectives Extremely Well	Attends to contact / learning objectives N/A
Establishes safety	Establishes safety Not Well	Establishes safety	Establishes safety	Establishes safety	Establishes safety Extremely Well	Establishes safety N/A
Promotes cohesion	Promotes cohesion Not Well	Promotes cohesion	Promotes cohesion	Promotes cohesion	Promotes cohesion Extremely Well	Promotes cohesion N/A
Focuses on here-and-now	Focuses on here-and-now Not Well	Focuses on here-and-now	Focuses on here-and-now	Focuses on here-and-now	Focuses on here-and-now Extremely Well	Focuses on here-and-now N/A
Explores the there-and-then (outside of group material)	Explores the there-and-then (outside of group material) Not Well	Explores the there-and-then (outside of group material)	Explores the there-and-then (outside of group material)	Explores the there-and-then (outside of group material)	Explores the there-and-then (outside of group material) Extremely Well	Explores the there-and-then (outside of group material) N/A
Attends to Group-as-a-whole-process	Attends to Group-as-a-whole-process Not Well	Attends to Group-as-a-whole-process	Attends to Group-as-a-whole-process	Attends to Group-as-a-whole-process	Attends to Group-as-a-whole-process Extremely Well	Attends to Group-as-a-whole-process N/A
Attends to inter-personal process	Attends to inter-personal process Not Well	Attends to inter-personal process	Attends to inter-personal process	Attends to inter-personal process	Attends to inter-personal process Extremely Well	Attends to inter-personal process N/A
Attends to intrapsychic process	Attends to intrapsychic process Not Well	Attends to intrapsychic process	Attends to intrapsychic process	Attends to intrapsychic process	Attends to intrapsychic process Extremely Well	Attends to intrapsychic process N/A
Explores transference	Explores transference Not Well	Explores transference	Explores transference	Explores transference	Explores transference Extremely Well	Explores transference N/A
Explores resistance	Explores resistance Not Well	Explores resistance	Explores resistance	Explores resistance	Explores resistance Extremely Well	Explores resistance N/A
Explores conflict	Explores conflict Not Well	Explores conflict	Explores conflict	Explores conflict	Explores conflict Extremely Well	Explores conflict N/A
Explores scapegoating	Explores scapegoating Not Well	Explores scapegoating	Explores scapegoating	Explores scapegoating	Explores scapegoating Extremely Well	Explores scapegoating N/A
Welcomes leadership challenges	Welcomes leadership challenges Not Well	Welcomes leadership challenges	Welcomes leadership challenges	Welcomes leadership challenges	Welcomes leadership challenges Extremely Well	Welcomes leadership challenges N/A

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* II. Please rate for all groups when seen during time of observation

	Not Well				Extremely Well	N/A
Maintains Institute fomat	Maintains Institute fomat Not Well	Maintains Institute fomat	Maintains Institute fomat	Maintains Institute fomat	Maintains Institute fomat Extremely Well	Maintains Institute fomat N/A
Manages / makes use of group process	Manages / makes use of group process Not Well	Manages / makes use of group process	Manages / makes use of group process	Manages / makes use of group process	Manages / makes use of group process Extremely Well	Manages / makes use of group process N/A
Pursues stated learning objectives	Pursues stated learning objectives Not Well	Pursues stated learning objectives	Pursues stated learning objectives	Pursues stated learning objectives	Pursues stated learning objectives Extremely Well	Pursues stated learning objectives N/A
Demonstrates subject expertise	Demonstrates subject expertise Not Well	Demonstrates subject expertise	Demonstrates subject expertise	Demonstrates subject expertise	Demonstrates subject expertise Extremely Well	Demonstrates subject expertise N/A
Effectively balances cognitive & emotional learning	Effectively balances cognitive & emotional learning Not Well	Effectively balances cognitive & emotional learning	Effectively balances cognitive & emotional learning	Effectively balances cognitive & emotional learning	Effectively balances cognitive & emotional learning Extremely Well	Effectively balances cognitive & emotional learning N/A

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* III. Overall Assessment - complete for all groups

	Poor				Excellent	N/A
Emotional sensitivity / empathic attunement of leader	Emotional sensitivity / empathic attunement of leader Poor	Emotional sensitivity / empathic attunement of leader	Emotional sensitivity / empathic attunement of leader	Emotional sensitivity / empathic attunement of leader	Emotional sensitivity / empathic attunement of leader Excellent	Emotional sensitivity / empathic attunement of leader N/A
Works well with co-leader	Works well with co-leader Poor	Works well with co-leader	Works well with co-leader	Works well with co-leader	Works well with co-leader Excellent	Works well with co-leader N/A
Overall level of group engagement	Overall level of group engagement Poor	Overall level of group engagement	Overall level of group engagement	Overall level of group engagement	Overall level of group engagement Excellent	Overall level of group engagement N/A
Overall, rate how well this group was conducted	Overall, rate how well this group was conducted Poor	Overall, rate how well this group was conducted	Overall, rate how well this group was conducted	Overall, rate how well this group was conducted	Overall, rate how well this group was conducted Excellent	Overall, rate how well this group was conducted N/A

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* IV. Other aspects - complete for all groups

	Poor				Excellent	N/A
Group size	Group size Poor	Group size	Group size	Group size	Group size Excellent	Group size N/A
Room size	Room size Poor	Room size	Room size	Room size	Room size Excellent	Room size N/A
Room temperature	Room temperature Poor	Room temperature	Room temperature	Room temperature	Room temperature Excellent	Room temperature N/A
Noise level	Noise level Poor	Noise level	Noise level	Noise level	Noise level Excellent	Noise level N/A

Other (please specify)

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* Were there any important elements conspicuously missing during your observation?

Yes

No

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* Please describe them:

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* What was the gender balance of the group?

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* What was the diversity (e.g. age, ethnicity, nationality, disability, sexual identity/orientation) balance of the group?

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* V. Table Group Participation - Leader 1

	Poor				Excellent	N/A
Attendance at meetings	Attendance at meetings Poor	Attendance at meetings	Attendance at meetings	Attendance at meetings	Attendance at meetings Excellent	Attendance at meetings N/A
Level of openness vs defensiveness	Level of openness vs defensiveness Poor	Level of openness vs defensiveness	Level of openness vs defensiveness	Level of openness vs defensiveness	Level of openness vs defensiveness Excellent	Level of openness vs defensiveness N/A
Effectiveness of communication about their group's process	Effectiveness of communication about their group's process Poor	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process Excellent	Effectiveness of communication about their group's process N/A
Engagement with tablemates	Engagement with tablemates Poor	Engagement with tablemates	Engagement with tablemates	Engagement with tablemates	Engagement with tablemates Excellent	Engagement with tablemates N/A
Engagement with consultants	Engagement with consultants Poor	Engagement with consultants	Engagement with consultants	Engagement with consultants	Engagement with consultants Excellent	Engagement with consultants N/A

Other (please specify)

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* V. Table Group Participation - Leader 2

	Poor				Excellent	N/A
Attendance at meetings	Attendance at meetings Poor	Attendance at meetings	Attendance at meetings	Attendance at meetings	Attendance at meetings Excellent	Attendance at meetings N/A
Level of openness vs defensiveness	Level of openness vs defensiveness Poor	Level of openness vs defensiveness	Level of openness vs defensiveness	Level of openness vs defensiveness	Level of openness vs defensiveness Excellent	Level of openness vs defensiveness N/A
Effectiveness of communication about their group's process	Effectiveness of communication about their group's process Poor	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process	Effectiveness of communication about their group's process Excellent	Effectiveness of communication about their group's process N/A
Engagement with tablemates	Engagement with tablemates Poor	Engagement with tablemates	Engagement with tablemates	Engagement with tablemates	Engagement with tablemates Excellent	Engagement with tablemates N/A
Engagement with consultants	Engagement with consultants Poor	Engagement with consultants	Engagement with consultants	Engagement with consultants	Engagement with consultants Excellent	Engagement with consultants N/A

Other (please specify)

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* VI. Suitability for Institute Leadership (Leader 1)

Yes

No

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* If yes, please describe:

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* VI. Suitability for Institute Leadership (Leader 2)

Yes

No

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* If yes, please describe:

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* VII. Please add comments