PERFORMANCE EVALUATION FORM

ANNUAL PERFORMANCE EVALUATION

DEPARTMENT OF HEALTH SCIENCE

Name: ____________________________________
Department: ________________________________

YEAR: January _______ through December _________

This form covers the period from January through December. Please forward your completed form to the Department of Health Science by the deadline date determined by your department head (usually sometime in November). Be sure to include appropriate documentation for each section as evidence of your accomplishments.

I. TEACHING (50 TO 60% EFFORT UNLESS OTHERWISE NEGOTIATED)

Basic interpretation code or rating scale: 1 = Poor, 2 = Fair, 3 = Average, 4 = Good, 5 = Excellent

  1. Formal course evaluations. The "Raw Score" is the numerical average of all course evaluations completed during the year being evaluated.

    2. SCALE:

    RAW SCORE

    1.0

    2.0

    3.0

    4.0

    5.0

    MERIT POINTS

    0

    0

    1

    10

    20

     

    SUBTOTAL OF MERIT POINTS FOR SECTION A: _____ PTS OUT OF 20 POSSIBLE

     

  2. Chairman's evaluation
This section is to be completed by your department head. It is essential that you submit documentation as evidence of your accomplishments in these areas.
  1. Written materials (course organization, content, goals/objectives, activities, updated bibliography, assignments, evaluation methods, grade assignment). Up to 5 merit points.
  2. Observations: Attendance/accessibility, kept office hours, class observations, student comments. Up to 5 merit points.
  3. New curriculum/course development, modifications/update, prepared/taught new course. Up to 3 merit points.

SUBTOTAL OF MERIT POINTS FOR SECTION B: _____ PTS OUT OF 13 POSSIBLE

 C. Student advisement and thesis committee work.
  1. Number of documented advisement sessions/year

    2. # sessions / year

    50

    55

    60

    65

    70

    75

    80

    85

    Merit Points

    1

    2

    3

    4

    5

    6

    7

    8

     

  2. Graduate committees served on (including those you chaired):

    3.  # committees served on

    1

    2

    3

    4

    5

    6

    Merit points

    0.5

    1.0

    1.5

    2.0

    2.5

    3.0

     

  3. Graduate committees that you chaired:

# committees chaired

1

2

3

4

5

6

Merit points

0.5

1.0

1.5

2.0

2.5

3.0
 

SUBTOTAL OF MERIT POINTS FOR SECTION C: _____ PTS OUT OF 14 POSSIBLE

 D. Teaching Improvement Activities

# events

1

2

3

4

5

6

Merit points

0

1

2

3

4

5

 

SUBTOTAL OF MERIT POINTS FOR SECTION D: _____ PTS OUT OF 5 POSSIBLE

TOTAL MERIT POINTS FOR TEACHING (SECTIONS A-D): _____ PTS OUT OF 52 POSSIBLE

ADJUSTED SCORE = _____ PTS OUT OF _____ PTS POSSIBLE

Calculations and conversions for adjusted score:

Total merit points earned in teaching sections A-D = percentage score

52 points possible
Percentage score x Teaching percentage effort = Adjusted total points earned

Example: A faculty member earned 43 merit points in teaching sections A-D. They had selected a teaching percentage effort of 60%. Thus, 43/52 = 82%. Then, 82% x 60 = 49. This person’s adjusted score was 49 out of 60 points.

 

II. RESEARCH AND PUBLICATIONS (20 TO 40% EFFORT UNLESS OTHERWISE NEGOTIATED)

 

POINT VALUE

BOOKS, MONOGRAPHS, BOOK CHAPTERS

 

Single authored book

Multiple-authored book

Edited, annotated, mongraph work

Book Chapter

40

35

30

25

NATIONAL JOURNAL ARTICLES

 

Refereed articles

Non-refereed articles

Editorials

Abstracts

Other professional endeavors

25

15

8

10

10

DISTRICT PUBLICATIONS

 

Refereed articles

Non-refereed articles

Editorials

Abstracts

Other professional endeavors

15

9

5

5

8

LOCAL / STATE PUBLICATIONS

 

Refereed articles

Non-refereed articles

Editorials

Abstracts

Other professional endeavors

10

6

4

4

5

PROFESSIONAL / PEER PRESENTATIONS / PAPERS

 

National

District/Regional

Local/state

8

5

4

FUNDED RESEARCH

 

External

Internal

Submitted and not funded (external)

Submitted and not funded (internal)

20

10

8

4

 

ACCEPTED (NOT YET IN PRINT). If fully documented, may count 10% of value for category in which it would normally fall (each title can receive credit only once).

 

SUBTOTAL OF RAW POINTS FOR RESEARCH SECTION: _____

Merit points calculation: 

RAW SCORE

10

15

20

25

30

35

40

45

50+

MERIT POINTS

0

5

10

15

20

25

30

35

40+

 

TOTAL MERIT POINTS FOR RESEARCH: _____ PTS OUT OF 20-40 PTS POSSIBLE

ADJUSTED SCORE = _____ PTS OUT OF _____ PTS POSSIBLE

Calculations and conversions for adjusted score:

Total merit points earned in research section = percentage score

Research percentage effort
Percentage score x Research percentage effort = Adjusted total points earned

Example 1: A faculty member earned 15 merit points in the research section. They had selected a research percentage effort of 40%. Thus, 15/40 = 37%. Then, 37% x 40 = 15. This person’s adjusted score was 15 out of 40 points.

Example 2: A faculty member earned 40 merit points in the research section. They had selected a research percentage effort of 30%. Thus, 40/30 = 133%. Then, 133% x 30 = 40. This person’s adjusted score was 30 out of 30 points since it is not possible to earn more than 100% of available points.

 

III. SERVICE (10 TO 20% EFFORT UNLESS OTHERWISE NEGOTIATED)

This section includes service to the Department, College, University, Profession and Community (local, state and national/international.

Describe service in the spaces below. In exceptional cases, you may wish to include additional information concerning such factors as frequency of meetings, amount of outside or sub-committee work, unusually high committee attendance requirements, etc.

  1. Membership in professional organizations

    2. Description

    Local

    State

    District

    National

    International

    Points

     1

    2

    3

    4

    5

     

     

     

     

     

     
               
               

     

  2. Review/editorial work

    3. Description

    Local

    State

    District

    National

    International

    Points

    5

    10

    15

    20

    25

     

     

     

     

     

     

     

     

     

     

     

     

     

  3. Professional meetings attended

    4. Description

    Local

    State

    District

    National

    International

    Points

    3

    5

    8

    10

    12

     

     

     

     

     

     

     

     

     

     

     

     

     

  4. Committee membership

 

AVERAGE POINT VALUE WORTH

ACTUAL POINT CREDIT GIVEN

DEPARTMENTAL

 

 

Courses and Curriculum

Other Committees

Chair

8

8

3

 

COLLEGE

 

 

Courses and Curriculum

Promotion and Tenure

Other

Chair

12

12

12

4

 

UNIVERSITY

 

 

Senate

Graduate Council

Courses and Curriculum

University Research Council

Other

Chair

16

16

16

16

16

5

 

PROFESSIONAL / COMMUNITY SERVICE

 

 

Elected officer - professional organization

Appointed officer - professional organization

Committee member - professional organization

Workshops/Institutes, etc.

Community presentations/service

Consultantships (not paid)

Consultantships (paid)

Other

20

15

15

15

10

10

4

 

 

SUBTOTAL OF RAW POINTS FOR SERVICE SECTION: _____

Merit points calculation: 

RAW SCORE

25

35

45

55

65

75

85

95+

MERIT POINTS

0

3

5

8

11

14

17

20

 

TOTAL MERIT POINTS FOR SERVICE: _____ PTS OUT OF 10-20 PTS POSSIBLE

ADJUSTED SCORE = _____ PTS OUT OF _____ PTS POSSIBLE

Calculations and conversions for adjusted score:

Total merit points earned in service section = percentage score

Service percentage effort
Percentage score x Service percentage effort = Adjusted total points earned

Example 1: A faculty member earned 9 merit points in the service section. They had selected a service percentage effort of 15%. Thus, 9/15 = 60%. Then, 60% x 15 = 9. This person’s adjusted score was 9 out of 15 points.

Example 2: A faculty member earned 9 merit points in the service section. They had selected a service percentage effort of 10%. Thus, 9/10 = 90%. Then, 90% x 10 = 9. This person’s adjusted score was 9 out of 10 points.

 

 

DEPARTMENT HEAD'S BONUS EVALUATION

Department Head's bonus for Exceptional Contributions to Department (not previously covered and rarely given), maximum of 5% bonus.

Describe Rationale:

 

SUMMARY

SECTION

DESCRIPTION

MERIT POINTS

I

TEACHING

 

II

RESEARCH

 

III

SERVICE

 

IV

BONUS

 

TOTAL

 

 

 

Reviewed by:

Faculty Member's Signature ________________________________

Date __________________

Department Head's Signature _______________________________

Date__________________

 

REV. 5/12/95

UPDATED 08/11/2000