Roles & Responsibilities (Tool #2: Learning Experience Survey)

This survey can be used to gather input about the student learning experience – what is working well and areas that could be improved. The feedback received can be used to make adjustments to strengthen the learning experience for everyone. 

The intended audience for this survey is students.

Please adapt the content of this form to meet your needs — you may want to include additional data points to assist with reviewing the feedback. For younger students, you may want to modify the survey to gather input from the family/caretaker; or, the family/caretaker and the student could work together to complete the survey. For older students, they can complete the survey independently. If you are looking for family/caretaker input, the survey could be modified or the family/caretaker and student could complete the survey together.  The language used in the linked Google Forms survey is included below. 

Learning Experience Survey

Google Forms version (link will force a copy):  Roles & Responsibilities (Tool #2: Learning Experience Survey)

Tell us about your learning experience—what is going well and what could be improved. All responses are anonymous and will be used to make adjustments to create a better learning experience for everyone.

Rate the following statements on a linear scale of 1 to 3, selecting the option that best aligns with your learning experience.

Answer key:

  • 1=Hardly Ever/Rarely
  • 3=Almost Always/Always
  1. I know what is expected of me during class (arrival, participation, group work)
    Rate:
  2. I can quickly find and access the needed instructional materials and supplies.
    Rate:
  3. I understand the assigned work and it is easy to follow.
    Rate:
  4. I don’t feel rushed or overwhelmed during class.
    Rate:
  5. I have enough time to complete classwork/homework.
    Rate:
  6. I am given the opportunity to work independently.
    Rate:
  7. I am given the opportunity to work in small groups during class.
    Rate:
  8. My teacher is available to assist me outside of class.
    Rate:
  9. I can access and use the class software applications.
    Rate: 
  10. I am able to successfully submit classwork and homework.
    Rate: 

Please share comments or suggestions about your learning experience.