Appendix B

Data Collection Instruments 
1

Appendix B-1

Math Professional Development Study

End-of-Year Teacher Survey

June 2014

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of 

information unless such collection displays a valid Office of Management and Budget (OMB) control 

number. The valid OMB control number for this information collection is XXXX-XXXX. The time required to 

complete this information collection is estimated to average 30 minutes per response. This information 

collection is voluntary. If you have any comments concerning the accuracy of the time estimate(s) or 

suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202–

4651. If you have comments or concerns regarding the status of your individual submission of this form, 

write directly to: Thomas Wei, U.S. Department of Education, Institute of Education Sciences, Room 500H, 

555 New Jersey Ave. NW, Washington, DC 20208-5500.
2

Dear Teacher:

The Math Professional Development Study (MPD) is an important national study designed to test 

innovative models of professional development for mathematics instruction in the fourth grade. 

Your participation is important and appreciated, but you do have the right to skip any question that 

you do not wish to answer. The following are responses to some general questions concerning your 

participation.

What is the purpose of this survey?

The purpose of this survey is to obtain background information about the teachers within the study 

as well as information about their instructional contexts and professional development experiences 

in mathematics.

Who is conducting this survey?

The U.S. Department of Education’s Institute of Education Sciences commissioned the MPD study, 

and American Institutes for Research is administering the study survey. 

Why should you participate in this survey?

Policymakers and educational leaders rely on findings from studies, such as the MPD study, to 

inform their decisions. The current study will fill a critical gap in the mathematics and professional 

development research base regarding what is effective for improving fourth-grade mathematics 

achievement.

Will your responses be kept confidential?

American Institutes for Research follows the confidentiality and data protection requirements of 

IES (The Education Sciences Reform Act of 2002, Title I, Part E, Section 183). Responses to this 

data collection will be used only for statistical purposes. The reports prepared for the study will 

summarize findings across the sample and will not associate responses with a specific school or 

individual. We will not provide information that identifies respondents to anyone outside the study 

team, except as required by law. Additionally, no one in your school or district will see your 

responses.

How will your information be reported?

The information you provide will be combined with the information provided by others in statistical 

reports. No individual data that link your name or e-mail address with your responses will be 

included in the statistical reports. 

Thank you for your cooperation in this very important effort!
3

Professional Development Experiences 

Related to Mathematics and Mathematics Teaching and Learning

Professional development refers to a variety of activities intended to enhance your professional knowledge and 

skills, including workshops, seminars, institutes, college courses, coaching, mentoring, teacher networks, getting observed 

and receiving feedback on your teaching, and committee work.

1. Counting only professional development activities that focused on mathematics or 

mathematics teaching and learning, what is the total number of hours you participated

in each of the following activities during summer 2013 and the 2013-2014 school year?

For each activity, write the total number of HOURS you spent, rounding up to the nearest whole hour.

Mark “0” if you participated in none.

Please do NOT count the same hours in more than one row.

Professional Development Activity

Hours of 

Professional 

Development

a. Attended traditional course/workshop/seminar-style professional 

development that focused on mathematics or mathematics teaching 

and learning (e.g., Intel Math)

hours

b. Participated in collaborative professional learning communities or 

planning groups with other teachers that focused on mathematics or 

mathematics teaching and learning (e.g., Mathematics Learning 

Communities)

hours

c. Classroom teaching was observed and was given feedback that focused 

on mathematics or mathematics teaching and learning by someone 

with knowledge of mathematics instruction (e.g., a coach, department 

chair, or mentor)

hours

d. Participated in other types of professional development that focused 

on mathematics or mathematics teaching and learning. Please explain: 

______________________________________________________

hours

[Skip Pattern: If respondent added 0 hours to every row in Question 1, the respondent will be directed to answer 

Question 12. Otherwise move to Skip Pattern for Question 2.]
4

[Skip Pattern: If respondent added hours to Question 1, Row a, the respondent will be directed to answer 

Questions 2, 3, and 4. Otherwise move to Skip Pattern for Question 5.]

2. In your traditional course/workshop/seminar-style professional development activities 

that focused on mathematics or mathematics teaching and learning during summer 2013 

and the 2013-2014 school year, how often did you do the following activities?

Check one box for each row.

Activity During

Professional Development

Never/ 

Rarely Sometimes Often

Most or 

All of the 

Time

a. Solve mathematics problems    

b. Share your solutions to mathematics 

problems with other teachers in small- or 

large-group settings

   

c. Discuss mathematics topics that appear in 

mathematics curricula above or below the 

current grade you teach

   

d. Explore the conceptual underpinning of K–

8 mathematics concepts    

e. Practice using a variety of representations to 

illustrate a given mathematical concept

   

f. Practice analyzing student work on 

mathematics problems    

g. Practice writing story problems for students 

you teach    

h. Explore the connections between 

mathematics topics and solution methods    

i. Explore the ways students commonly 

approach mathematics problems    

j. Explore common student misconceptions 

and errors in mathematics    
5

3. In your traditional course/workshop/seminar-style professional development activities 

that focused on mathematics or mathematics teaching and learning during summer 2013 

and the 2013-2014 school year, how often were the following topics a focus?

Check one box for each row.

Topic Area

Never/ 

Rarely Sometimes Often

Most or All 

of the Time

a. Addition, subtraction, multiplication, 

and division    

b. Connections between addition, 

subtraction, multiplication, and 

division

   

c. Fractions and operations with 

fractions    

d. Algebra    

e. Connections between algebra and 

arithmetic    

f. Decimals    

g. Exponents    
6

4. To what extent do you agree or disagree with the following statements about your 

experiences in your traditional course/workshop/seminar-style professional 

development activities that focused on mathematics or mathematics teaching and 

learning during summer 2013 and the 2013-2014 school year?

Check one box for each row.

Your Experience Was...

Strongly 

Disagree

Somewhat 

Disagree

Somewhat 

Agree

Strongly 

Agree

a. Consistent with your own goals for your 

professional development    

b. Complementary to your use of districtadopted curricular materials    

c. Related to the mathematics content you 

taught this year    

d. Logically connected from one day or 

session to the next    

e. Clear about how you could use what you 

learned from the professional development 

experience in your classroom

   

f. Focused on practices that district or school 

leaders expect you to demonstrate in your 

classroom

   
7

[Skip Pattern: If respondent added hours to Question 1, Row b, the respondent will be directed to answer 

Questions 5, 6, and 7. Otherwise move to Skip Pattern for Question 8.]

5. In your collaborative professional learning communities or planning group activities that 

focused on mathematics or mathematics teaching and learning during summer 2013 and 

the 2013-2014 school year, how often did you do the following activities?

Check one box for each row.

Activity During

Professional Development

Never/ 

Rarely Sometimes Often

Most or 

All of the 

Time

a. Solve mathematics problems    

b. Share your solutions to mathematics 

problems with other teachers in small- or 

large-group settings

   

c. Discuss mathematics topics that appear in 

mathematics curricula above or below the 

current grade you teach

   

d. Explore the conceptual underpinning of K–

8 mathematics concepts    

e. Practice using a variety of representations to 

illustrate a given mathematical concept

   

f. Practice analyzing student work on 

mathematics problems    

g. Practice writing story problems for students 

you teach    

h. Explore the connections between 

mathematics topics and solution methods    

i. Explore the ways students commonly 

approach mathematics problems    

j. Explore common student misconceptions 

and errors in mathematics    
8

6. In your collaborative professional learning communities or planning group activities that 

focused on mathematics or mathematics teaching and learning during summer 2013 and 

the 2013-2014 school year, how often were the following topics a focus?

Check one box for each row.

Topic Area

Never/ 

Rarely Sometimes Often

Most or All 

of the Time

a. Addition, subtraction, multiplication, 

and division    

b. Connections between addition, 

subtraction, multiplication, and 

division

   

c. Fractions and operations with 

fractions    

d. Algebra    

e. Connections between algebra and 

arithmetic    

f. Decimals    

g. Exponents    
9

7. To what extent do you agree or disagree with the following statements about your 

experiences in collaborative professional learning communities or planning groups that 

focused on mathematics or mathematics teaching and learning during summer 2013 and 

the 2013-2014 school year?

Check one box for each row.

Your Experience Was...

Strongly 

Disagree

Somewhat 

Disagree

Somewhat 

Agree

Strongly 

Agree

a. Consistent with your own goals for your 

professional development    

b. Complementary to your use of districtadopted curricular materials    

c. Related to the mathematics content you 

taught this year    

d. Logically connected from one day or 

session to the next    

e. Clear about how you could use what you 

learned from the professional 

development experience in your classroom

   

f. Focused on practices that district or 

school leaders expect you to demonstrate 

in your classroom

   
10

[Skip Pattern: If respondent added hours to Question 1 Row c, the respondent will be directed to answer Question 

8. Otherwise move to Skip Pattern for Question 9.]

8. In the feedback you received after a video or in-person observation of your classroom 

teaching that focused on mathematics or mathematics teaching and learning during 

summer 2013 and the 2013-2014 school year, how often were the following topics a focus 

of the feedback?

Check one box in each row

Topic Area

Never/ 

Rarely Sometimes Often

Most or All 

of the Time

a. How you made connections between 

mathematics topics and/or 

representations

   

b. How you conveyed the meaning of 

mathematical procedures    

c. How you remediated student errors    

d. How you responded to student thinking    

e. The clarity, precision, and correctness of 

your mathematics presentations    

f. Providing you with useful feedback 

about your teaching of mathematics    
11

[Skip Pattern: If respondent added hours to Question 1 Row d, the respondent will be directed to answer 

Questions 9, 10, and 11. Otherwise, the respondent will be directed to answer question 12.]

9. In your other types of professional development (i.e., excluding traditional 

course/workshop/seminar-style professional development, collaborative professional 

learning communities or planning group activities, and classroom observations and 

feedback) that focused on mathematics or mathematics teaching and learning during 

summer 2013 and the 2013-2014 school year, how often did you do the following 

activities?

Check one box for each row.

Activity During

Professional Development

Never/ 

Rarely Sometimes Often

Most or 

All of the 

Time

a. Solve mathematics problems    

b. Share your solutions to mathematics 

problems with other teachers in small- or 

large-group settings

   

c. Discuss mathematics topics that appear in 

mathematics curricula above or below the 

current grade you teach

   

d. Explore the conceptual underpinning of K–

8 mathematics concepts    

e. Practice using a variety of representations to 

illustrate a given mathematical concept

   

f. Practice analyzing student work on 

mathematics problems    

g. Practice writing story problems for students 

you teach    

h. Explore the connections between 

mathematics topics and solution methods    

i. Explore the ways students commonly 

approach mathematics problems    

j. Explore common student misconceptions 

and errors in mathematics    
12

10. In your other types of professional development (i.e., excluding traditional 

course/workshop/seminar-style professional development, collaborative professional 

learning communities or planning group activities, and classroom observations and 

feedback) that focused on mathematics or mathematics teaching and learning during 

summer 2013 and the 2013-2014 school year, how often were the following topics a focus?

Check one box for each row.

Topic Area

Never/ 

Rarely Sometimes Often

Most or All 

of the Time

a. Addition, subtraction, multiplication, 

and division    

b. Connections between addition, 

subtraction, multiplication, and 

division

   

c. Fractions and operations with 

fractions    

d. Algebra    

e. Connections between algebra and 

arithmetic    

f. Decimals    

g. Exponents    
13

11. To what extent do you agree or disagree with the following statements about your 

experiences in other types of professional development (i.e., excluding traditional 

course/workshop/seminar-style professional development, collaborative professional 

learning communities or planning group activities, and classroom observations and 

feedback) that focused on mathematics or mathematics teaching and learning during 

summer 2013 and the 2013-2014 school year?

Check one box for each row.

Your Experience Was...

Strongly 

Disagree

Somewhat 

Disagree

Somewhat 

Agree

Strongly 

Agree

a. Consistent with your own goals for your 

professional development    

b. Complementary to your use of districtadopted curricular materials    

c. Related to the mathematics content you 

taught this year    

d. Logically connected from one day or 

session to the next    

e. Clear about how you could use what you 

learned from the professional 

development experience in your classroom

   

f. Focused on practices that district or 

school leaders expect you to demonstrate 

in your classroom

   
14

Mathematics Instruction

12. How much total time did you spend teaching mathematics each day to your regular 

fourth-grade class LAST WEEK?

If last week was not a typical week or did not have a full schedule of classes, answer for the most recent week that 

did.

Monday: Minutes teaching mathematics

Tuesday: Minutes teaching mathematics

Wednesday: Minutes teaching mathematics

Thursday: Minutes teaching mathematics

Friday: Minutes teaching mathematics
15

Certification

13. Which of the following describes the teaching certificate you held in June 2013 (i.e., the 

beginning of the summer prior to this past school year) in this state?

Check only one box.

 Regular or standard state certificate or advanced professional certificate

 Certificate issued after satisfying all requirements except the completion of a 

probationary period

 Certificate that requires some additional coursework, student teaching, or passage of 

a test before regular certification can be obtained

 Certificate issued to persons who must complete a certification program in order to 

continue teaching

 I do not have any of the above certifications in THIS state
16

Education and Preservice Training

14. By June 2013 (i.e., the beginning of the summer prior to this past school year) had you 

earned any of the following degrees, diplomas, or certificates?

Please check No or Yes in each row then, if applicable, write in the major code from the List of Codes that 

follows.

If you have earned more than one credential per row, report the one most relevant to your current teaching 

assignment (e.g., if you have earned two different master’s degrees, use row b to report the master’s degree that is 

most relevant to your current teaching assignment).

Degree Earned

Major Field

Code (From 

List of Codes)

a. Bachelor’s degree  No 

 Yes 

b. Master’s degree  No 

 Yes 

c. Educational specialist, professional diploma, or 

certificate of advanced graduate studies (at least 

one year beyond master’s level)

 No 

 Yes 

d. Doctorate or professional degree (e.g., Ph.D., 

Ed.D., M.D., L.L.B, J.D., D.D.S.)

 No 

 Yes 

List of Codes: Major Field of Study

Code Major Field

01 Elementary education or early childhood education

02 Secondary or middle grades education, general

03 Mathematics education 

04 Mathematics 

05 Other mathematics-related subject (e.g., statistics, economics, engineering)

06 English language arts

07 Natural science (e.g., biology, chemistry, physics, earth science)

08 Social science (e.g., anthropology, geography, history, psychology)

09 Special education

10 English as a second language

11 Other (e.g., foreign language, health education, business, computer science)
17

15. By June 2013 (i.e., the beginning of the summer prior to this past school year) had you 

completed at least one college course (undergraduate or graduate) in any of the 

following mathematics or mathematics-related subjects?

Please check the number of courses completed in each row. Do not count any course twice.

Include Advanced Placement courses completed in high school for which you received college credit.

Type of Course

Number of Courses Completed

0 1 2 3 or More

a. College algebra (not abstract or linear algebra)    

b. Geometry or trigonometry    

c. Precalculus    

d. Calculus or differential equations    

e. Mathematics for elementary teachers (i.e., a course 

for teachers in which the majority of time was 

focused on mathematics, not on how to teach 

mathematics or how students learn mathematics)

   

f. Mathematics education or methods of teaching 

mathematics (i.e., a course for teachers in which 

the majority of time was focused on how to teach 

mathematics and how students learn mathematics, 

not mathematics, itself)

   

g. Statistics or probability, including statistical 

methods in the social sciences (e.g., econometrics 

or psychometrics)

   

h. Other mathematics or mathematics-related courses 

(e.g., abstract algebra, linear algebra, differential 

equations, number theory, mathematical logic, set 

theory, foundations of mathematics) (please 

specify): 

_______________________________________

   
18

Experience

16. How many years of teaching experience do you have in each of the following settings?

For each row, write the number of years, using whole numbers only.

Count school year 2013-2014 as one full year.

Setting Number of Years

a. Teaching in total Years

b. Teaching at this school Years

c. Teaching an elementary school class where your responsibilities included 

instruction in multiple subjects, including mathematics Years

d. Teaching an elementary class where your responsibilities included solely 

mathematics instruction Years

e. Teaching mathematics content that would be considered by your district 

to be above the fourth-grade curriculum Years

Demographics

17. Are you male or female?

 Male

 Female

18. Are you of Hispanic or Latino origin? 

 Yes

 No
19

19. What is your race? 

Check one or more box.

 White

 Black or African American 

 Asian

 Native Hawaiian or other Pacific Islander

 American Indian or Alaska Native
20

Appendix B-2

Impact Evaluation of Math Professional 

Development

District Archival Records Collection Protocol

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of 

information unless such collection displays a valid OMB control number. The valid OMB control number 

for this information collection is XXXX–XXXX. This information collection is voluntary. The estimated 

time required to complete this information request is 20 hours per response, including the time to 

review instructions, search existing data resources, gather the data needed, and complete and review 

the information collection. If you have any comments concerning the accuracy of the time estimate(s) or 

suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 

20202–4537. If you have comments or concerns regarding the status of your individual submission of 

this form, write directly to: Thomas Wei, U.S. Department of Education, Institute of Education Sciences, 

Room 500H, 555 New Jersey Avenue, NW, Washington, DC 20208-5500.
21

District Archival Records Collection Protocol

The Math Professional Development Study requests district administrative records for the students in 

participating teachers’ classrooms.

In this protocol we specify the data elements requested for all students in the participating teachers’ 

classrooms at three points in time: (1) summer/fall 2013 when classroom assignments are formed; (2) in 

March 2014; and (3) at the time that the spring 2014 state assessment is administered. 

We will work with the district to determine the most efficient process for providing the requested data. 

The data elements that will be requested are listed below.

1. Classroom Roster Records

At three points in time: (1) summer/fall 2013 when classroom assignments are formed; (2) in March 

2014; and (3) at the time that the spring 2014 state assessment is administered, the study team will 

request files that include the following:

 Date

 School

 Teacher ID (participating teachers)

 Student ID (students in participating teachers’ classrooms)

Student records will be requested for the students in these classroom roster records, as specified in 

the next section.

2. Student Records 

Student assessment and demographic records will be used to describe the student sample, conduct 

baseline equivalence analyses, and conduct impact analyses for study reports. More specifically, the 

purpose of the archival student achievement and demographic records is to provide:

 Demographic variables used to describe the characteristics of students who were in the 

participating teachers’ classes;

 Demographic and prior achievement variables used to test for baseline equivalence and as 

covariates (i.e. control variables) in analyses of the impact of the study’s PD intervention on 

student achievement scores. 

 Achievement variables (i.e., students’ fourth grade mathematics achievement on state 

assessment) used as outcome measures in analyses of the impact of the study’s PD intervention 

on student achievement scores.

Requested Data Elements in Student Achievement and Demographic Records

A. Identifiers 
22

A student identifier is needed to link student data across years and to link data across files if 

achievement, demographic, and other data are provided in separate files. The identifier need not be 

the actual identification (ID) number used by the district. We anticipate creating a “crosswalk” file, 

which contains the study ID linked to local IDs and would remain within the district. This file would 

permit the necessary links while at the same time ensuring that student names and local IDs do not 

leave the district office. In addition, by making it possible for the project team to carry out the 

linking of files, an identifier would reduce the burden on the district. We plan to work with the 

districts involved in the study to develop a strategy for collecting the required achievement data 

that meets the needs of the study and is feasible for the districts, while meeting confidentiality 

requirements.

B. Student Background Variables 

 Month and year of birth (MM/YYYY)

 Gender 

 Ethnicity (current U.S. census categories) 

 Race 

 Enrolled grade in SY2012-13 and SY2013-14

 National School Lunch Program status in SY2012-13 and SY2013-14

 Free

 Reduced

 Neither

 English language learner status in SY2012-13 and SY2013-14

 Individualized Education Plan status in SY2012-13 and SY2013-14

 School entry and exit dates in SY2012-13 and SY2013-14

 Attendance for SY2012-13 and SY2013-14 

 Number of days absent

 Number of days attended

C. Student Achievement Variables for SY2012-13 and SY2013-14 

 Mathematics score code (e.g., A = absent, D = no info for student)

 Mathematics language version (e.g., E = English, S = Spanish)

 Mathematics test version (e.g., S = regular, M = modified, T = alternate)

 Mathematics performance level (provide corresponding level description)

 Mathematics scale score

 Mathematics scale score standard error of measurement

Student records will be requested for all students in the participating teachers’ classrooms at the three 

specific timepoints: (1) summer/fall 2013 when classroom assignments are formed; (2) in March 2014; 

and (3) at the time that the spring 2014 state assessment is administered. 

We know that the SY2013-14 achievement and attendance data will not be available until summer 2014. 

As noted earlier, we will work with each district to determine the most efficient process for providing 

the requested data.