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School of Education
Empowerment for Learning

Lesson Plan Template and Scoring Rubric

2023-2024 pilot
Name: ________________________________________ _ Score: _____________
SPA standards as appropriate based on lesson objective: CEC 5.0-5.2, 5.5, 5.7; NCTM 4B, 4E; NCSS 2A-2E; NSTA 2A, 2B, 2C, 4A, 4B, 4C; CAEP K-6 3C, 3D; NASM
3D4, 3D5; ILA 1.1, 2.2; NCTE I, III, XI; NCSS 2A, 2B, 3B; ACTFL 4A, 4C; AMLE 4A, 4D; SHAPE HEALTH 2A-F, 3A-C, 4B, 5A; SHAPE PE 3A, C-F, 5B

School/School District ______________________ Collaborating Teacher ________________________________________

Grade Level ___________ Number of students in class ______________
Lesson Title ____________________________________________________________________________________________
Unit Title (if applicable)_________________________________________________________________________________

Performance Ineffective Developing Accomplished Exemplary

Criteria
Multiple parts of the lesson The assignment is developing This is the level at which The assignment contains all of
plan are missing or but not-yet at a level that could most pre-service teachers the elements in a final, well-
incomplete be considered basic should score: the basic developed lesson plan
elements of the assignment
are there but need
development and depth
Context: Students and Classroom Environment
1. Describe the interests, SES, ethnicity, and cultural backgrounds of the students in this class.
2. Describe the diverse needs of students in class. (It is not acceptable to state that differentiation is not necessary.)
Ask questions of the cooperating teacher you will partner with for this lesson. How many students are identified in the
categories below? What accommodations and modifications are necessary for these students?

Special Education and/or struggling students (e.g., 504 plans, IEP, etc.)
Gifted and Talented
English Language Learners

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3. Describe student prior knowledge and experience related to this lesson.

O
Describes the class in Describes the class in general Describes the class in general Describes the class in general
KTPS/InTASC general without mentioning and mentions aspect(s) of and recognizes diversity in the and recognizes diversity in the
1A, 1B, 1E, 1G, diversity diversity classroom and discusses how classroom and discusses how to
2A, 3F, 4D, 6H, to differentiate the procedures, differentiate the procedures,
7B, 7D, 8A, 8C materials, or assessments materials, and assessments
CAEP P-6 1A,
B, C, 2A, B, C, Prior knowledge not Prior knowledge mentioned Prior knowledge discussed in Prior knowledge discussed in
D, 3A, B, C, D, addressed detail detail including assessment data
5A

Kentucky Academic Standards and Measurable Learning Objectives

1. Copy and paste the lesson’s Kentucky Academic Standard(s)
2. Write a measurable objective(s) that clearly states what students will be doing or learning (as related to the standard) and
describes the acceptable level of performance for each student connected to the formative assessment.

Learning Lesson objective is an Lesson objective is NOT Lesson objective is measurable Lesson objective is measurable
Targets/Objectiv action statement (Example: measurable and based on what students and based on what students will
e students will complete will know or be able to do as a know or be able to do as a result
worksheet) result of the lesson and relates of the lesson and is clearly
KTPS/InTASC to current lesson’s KAS connected to the lesson’s KAS
7A and formative assessment
CAEP P-6 1B,
3C, D, 4A, 5A

Formative Assessment(s)
1. Copy/paste a copy of your formative assessment(s) and answer key(s) or sample student response(s).
2. If appropriate, copy/paste rubric.

Formative No formative assessment Formative assessment provided Formative assessment and Formative assessment and
Assessment provided answer key, rubric, or sample answer key, rubric, AND sample
student response provided student response provided

KTPS/InTASC

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6B, 6D, 6F, 6G,

8B Formative assessment age Formative assessment age Formative assessment age
CAEP K-6 3A, appropriate but does not appropriate AND appropriate AND
B, C, D comprehensively covers KAS comprehensively covers KAS comprehensively covers KAS
AND is aligned to measurable
objective
Resources
If resources are not original to the candidate; include the source. All items included in a portfolio must be original to the
candidate.
1. Copy/paste powerpoint presentation and/or other lesson materials (such as handouts, etc.).
2. List links to videos or multimedia that will be used in the lesson.

Resources DOES NOT include copies Includes SOME copies of class Includes ALL copies of class Includes ALL copies of class
of class handouts, and handouts, and presentations as handouts, presentations as handouts, and presentations
KTPS/InTASC presentations needed needed and cites sources as needed
1C, 4F, 4G, 5C
CAEP K-6 1C,
t2A, B, C, D, 5C
Lesson Procedures
1. Describe how you will capture student attention and introduce the lesson topic. (Consider “I can” statements, connecting
to prior knowledge, a “hook” that captures students’ attention.)

2. Describe the steps and time intervals involved in delivering the content in the lesson. (What higher and lower order
questions will you ask? How will you describe/demonstrate the key concepts or skills? What key vocabulary and
definitions will you share? How will you connect the content to student real-life experience? How will you provide
opportunities for students to engage with each other and the content? How will you differentiate the lesson to meet
student needs? Reference your formative assessments.)

3. Describe the lesson wrap-up. (How will you or the students review the main concept(s) of the lesson? How does this
lesson connect to what students will do in lessons that follow?)

Lesson LISTS the sequence of DESCRIBES the sequence of DESCRIBES the sequence of DESCRIBES the sequence of

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Procedures strategies/procedures and strategies/procedures and strategies/procedures and strategies/procedures and

activities which helps activities which helps students activities which helps students activities which help students
students attain the learning attain the learning objective attain the learning objective attain the learning objective
KTPS/InTASC objective AND discusses group structure AND discusses group structure
7A, 7C, 8E, 8F, and behavior expectations
8I
CAEP K-6 1B, Little or no attempt to Introduction gathers student Introduction gathers student Introduction gathers student
3C, D, F, 5A gather student attention OR attention OR sets purpose for attention OR sets purpose for attention AND sets purpose for
set purpose for the lesson the lesson WITHOUT relating the lesson AND relates to the lesson AND relates to
to students’ prior knowledge students’ prior knowledge students’ prior knowledge

Lesson description does not Lesson description includes Lesson description includes Lesson description includes
include a formative formative assessment(s), formative assessment(s), which formative assessment(s), which
assessment however, it does not align with aligns with the objective(s) OR aligns with the objective(s) AND
the objective(s) and KAS KAS KAS

Lesson procedures DOES Engages all learners with Engages all learners with a Engages all learners with a
NOT include questions mostly lower order questions mixture of higher and lower mixture of higher and lower
order questions order questions AND
metacognitive processes

Lesson procedures does not Engages all learners by Engages all learners by Engages all learners by
develop concepts developing concepts without developing concepts, including developing concepts, including
key vocabulary vocabulary, models, vocabulary, models,
opportunities to develop skills opportunities to develop skills,
and real-life applications

Differentiation is described Differentiation is described in

Differentiation is NOT based on context for groups of detail for group AND individual
mentioned Differentiation is mentioned students students

Realistic time intervals are Realistic time intervals are

Time intervals are NOT included in lesson procedures included in lesson plan and
included Time intervals are included, includes descriptions of
but NOT realistic transitions

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End of lesson includes a End of the lesson includes a

End of lesson DOES NOT summary or review of lesson summary or review of lesson led
include a summary or End of lesson includes a led by TEACHER; revisits by STUDENTS; revisits purpose
review summary or review of lesson purpose for the lesson for the lesson
led by TEACHER without
revisiting purpose for the
lesson

Professional Writing evidenced by 8 or Writing evidenced by 5-7 Professional writing is Professional attention to formal
Writing more errors in clarity of errors in clarity of writing, evidenced by 1-4 errors in writing is evidenced by clarity of
writing, spelling, usage, spelling, usage, and/or clarity of writing, spelling, writing as well as absence of
and/or grammar grammar usage, and/or grammar spelling, usage, and grammatical
errors
Candidates teaching a stand-alone lesson should complete the lesson reflection document.
Candidates teaching a unit should complete the unit reflection document.

1. Use the formative assessment data for each lesson objective to sort the students’ performance into three categories. (KTPS/InTASC 6C,
6L, 6O)

Objective 1

a. Below Criteria _____ # of students

b. Meets Criteria _____ # of students

c. Exceeds Criteria _____ # of students

Attach a copy of the formative assessment with the criteria or rubric used to determine the students’ performance on each of the

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lesson’s learning targets/objectives. Retain copies of student work for possible inclusion in portfolio.

2. Based on the formative assessment data, how successful was the lesson? Did the students meet the objective(s)? (KTPS/InTASC 9I)
(CAEP K-6 3E)

What will you do for those students who did not meet the learning objective? For those students who exceeded the criteria?
(KTPS/InTASC 9H) (CAEP K-6 3E)

3. To what extent did classroom procedures, student conduct, and/or physical space contribute to or hinder student learning?
(KTPS/InTASC 3D)

4. Did you depart from your plan? If so, how and why? (KTPS/InTASC 7F, 7L, 7Q) (CAEP K-6 1A, 3C, D, 4G)

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5. If you had the opportunity to teach this lesson again to the same group of students, what would you do differently, and why?
(KTPS/InTASC 9G) (CAEP K-6 3E, 4H, 5B, C)

6. Based on your lesson results and reflection, what do you see as the next step(s) in your professional growth for addressing the needs?
(KTPS/InTASC 9K) (CAEP K-6 5B)

Lesson Reflection Reflection incomplete Reflection is complete but Reflection is complete with Reflection is complete with
(KTPS/InTASC lacks sufficient evidence of general evidence of analysis of specific evidence of analysis of
6G, 6N, 7F, 7I, analysis of student learning, student learning, instruction, student learning, instruction, and
8B, 9H) instruction, and professional and future professional future professional development
development, based on data development based on data based on data with student work
with NO student work samples with student work samples samples

Campbellsville University School of Education Lesson Plan Scoring Rubric 2023-2024