Colleen A. Thoma, PhD

Please respond to the items of your present concerns, or how you feel about your involvement or potential involvement with The  Self-Determined Learning Model of Instruction.  We do not hold to any one definition of this program, so please think of it in terms of your own perceptions of what it involves.  Remember to respond to each item in terms of your present concerns about your involvement or potential involvement with the above named innovation.  Thank you for taking time to complete this task.

Your Name

I am concerned about student's attitudes toward this innovation. Irrelevant Not True Somewhat True Very True

I now know of some other approaches that might work better. Irrelevant Not True Somewhat True Very True

I don't even know what the innovation is. Irrelevant Not True Somewhat True Very True

I am concerned about not having enough time to organize myself each day. Irrelevant Not True Somewhat True Very True

I would like to help other faculty in their use of the innovation. Irrelevant Not True Somewhat True Very True

I have a very limited knowledge about the innovation. Irrelevant Not True Somewhat True Very True

I would like to know the effect of reorganization on my professional status. Irrelevant Not True Somewhat True Very True

I am concerned about conflict between my interests and my responsibilities. Irrelevant Not True Somewhat True Very True

I am concerned about revising my use of the innovation. Irrelevant Not True Somewhat True Very True

I would like to develop working relationships with both our faculty and outside faculty using this innovation. Irrelevant Not True Somewhat True Very True

I am concerned about how the innovation affects students. Irrelevant Not True Somewhat True Very True

I am not concerned about this innovation. Irrelevant Not True Somewhat True Very True

I would like to know who will make the decisions in the new system. Irrelevant Not True Somewhat True Very True

I would like to discuss the possibility of using the innovation. Irrelevant Not True Somewhat True Very True

I would like to know what resources are available if we decide to adopt this innovation. Irrelevant Not True Somewhat True Very True

I am concerned about my inability to manage all the innovation requires. Irrelevant Not True Somewhat True Very True

I would like to know how my teaching or administration is supposed to change. Irrelevant Not True Somewhat True Very True

I would like to familiarize other departments or persons with the progress of this new approach. Irrelevant Not True Somewhat True Very True

I am concerned about evaluating my impact on students. Irrelevant Not True Somewhat True Very True

I would like to revise the innovationís instructional approach. Irrelevant Not True Somewhat True Very True

I am completely occupied with other things. Irrelevant Not True Somewhat True Very True

I would like to modify our use of the innovation based on the experiences of our students. Irrelevant Not True Somewhat True Very True

Although I donít know about this innovation, I am concerned about things in this area. Irrelevant Not True Somewhat True Very True

I would like to excite my students about their part in this approach. Irrelevant Not True Somewhat True Very True

I am concerned about time spent working with nonacademic problems related to this innovation. Irrelevant Not True Somewhat True Very True

I would like to what the use of the innovation will require in the immediate future. Irrelevant Not True Somewhat True Very True

I would like to coordinate my effort with others to maximize the innovation's effects. Irrelevant Not True Somewhat True Very True

I would like to have more information on time and energy commitments required by this innovation. Irrelevant Not True Somewhat True Very True

I would like to know what other faculty are doing in this area. Irrelevant Not True Somewhat True Very True

At this time, I am not interested in learning about this innovation. Irrelevant Not True Somewhat True Very True

I would like to determine how to supplement, enhance, or replace the innovation. Irrelevant Not True Somewhat True Very True

I would like to use feedback from students to change the program. Irrelevant Not True Somewhat True Very True

I would like to how my role will change when I am using the innovation. Irrelevant Not True Somewhat True Very True

Coordination of tasks and people is taking too much of my time. Irrelevant Not True Somewhat True Very True

I would like to know how this innovation is better than what we have now. Irrelevant Not True Somewhat True Very True

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Copyright 1974.  Procedures for Adopting Educational Innovations/CBAM Project,
R&D Center for Teacher Education, University of Texas at Austin.