Self-Assessment Form

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Rubric for Online Instruction
Self-Assessment Form
Course Name/Number _____________________________________________
Instructor/Designer _______________________________________________
Rubric Category
[Rating of B (Basic), E (Effective), X (Exemplary)]
Rating
1. Learner Support & Resources
a. ______________________________________________________________
______________________________________________________________
b. ______________________________________________________________
______________________________________________________________
c. ______________________________________________________________
______________________________________________________________
2. Online Organization & Design
a. ______________________________________________________________
______________________________________________________________
b. ______________________________________________________________
______________________________________________________________
c. ______________________________________________________________
______________________________________________________________
d. ______________________________________________________________
______________________________________________________________
e. ______________________________________________________________
______________________________________________________________
3. Instructional Design & Delivery
a. ______________________________________________________________
______________________________________________________________
b. ______________________________________________________________
______________________________________________________________
c. ______________________________________________________________
______________________________________________________________
d. ______________________________________________________________
______________________________________________________________
e. ______________________________________________________________
______________________________________________________________

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