Learning Experience Survey
Name (Optional)
First Name Last Name
You are reflecting on a(n)
On-site learning Virtual learning
Location
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Engagement Date
Month Day Year
Date
Learning Topic
Consultant Name
First Name Last Name
Please rate how knowledgeable do you feel regarding the topic of this session?
1
2
3
4
5
1 is Not at All, 5 is Excellent
How satisfied are you with the following statements.
Not Satisfied Somewhat Satisfied Satisfied Very Satisfied N/A
Examples of the topic(s)
Content
Facilitator's teaching style
Overall, how satisfied are you with today's learning experience?
In what ways do you think the presenter challenged your thinking?
Providing me with new information Sharing relevant evidence as to how and why to consider new approaches Providing time for me to apply new learning Holding me and my peers accountable for knowing our impact by considering ways to utilize our learning from today’s session to enhance learning for students None of the above Other
In what ways do you think the presenter moved your learning forward?
I learned at least one new strategy I can immediately use in my classroom or work environment As a result of the workshop I know more about the topic(s) covered and will share new learning with peers who were not in attendance As a result of the workshop, I would like to learn more about the topic(s) presented None of the above Other
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Should be Empty:

	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied	N/A
Examples of the topic(s)
Content
Facilitator's teaching style

Learning Experience Survey