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?

Your responses are protected from disclosure by federal statute (P.L. 107-279, Title I, Part E, 

Sec.183). All responses that relate to or describe identifiable characteristics of individuals may be 

used only for statistical purposes and may not be disclosed, or used, in identifiable form for any 

other purposes, unless otherwise compelled by law.

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.

In this section, you will be asked about professional development in which you participated during summer 2013 

and school year 2013-2014. 

1. Considering ALL your professional development activities during summer 2013 and the 

following 2013-2014 school year, did you participate in any professional development 

related to mathematics or mathematics teaching and learning?

 Yes [Skip Pattern: respondent directed to question 2]

 No [Skip Pattern: respondent directed to question 9]

2. During summer 2013 and the following 2013-2014 school year, what is the total number of 

hours you spent in each of the following mathematics or mathematics teaching and 

learning professional development activities?

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 short, stand-alone professional development session(s) 

lasting two days or less (including partial days) in mathematics or 

mathematics teaching and learning

hours

b. Attended longer professional development program(s) lasting three or 

more days in mathematics or mathematics teaching and learning (e.g., 

Intel Math, Mathematics and Science Partnership Program)

hours

c. Was observed and given feedback related to mathematics and/or 

mathematics teaching and learning by someone with knowledge of 

mathematics instruction (e.g., a coach, department chair, or mentor)

hours

d. Attended mathematics or mathematics education course(s) for credit, 

such as a university course(s), that extended throughout several weeks hours

e. Participated in teacher study groups, networks, or collaborations 

supporting professional development in mathematics (e.g., 

Mathematics Learning Community [MLC], Professional Learning 

Community)

hours

f. Other (e.g., participated in committees or task forces related to 

mathematics, observed mathematics instruction in other schools) hours
4

3. How much did the professional development you received in mathematics and in

mathematics teaching and learning during summer 2013 and the following 2031-2014 

school year emphasize each of the following topics? 

Check one box for each row.

Topic

Not an 

Emphasis

Minor 

Emphasis

Moderate 

Emphasis

Major 

Emphasis

a. Deeper understanding of mathematics

topics covered in elementary school 

(Grades K–5)

   

b. Deeper understanding of mathematics

topics covered in Grades 6–12    

c. How students think about and learn 

mathematics (including common student 

difficulties)

   

d. How to use representations to convey 

mathematics concepts

   

e. How to analyze students’ work to 

understand their thinking    

f. 

Other (please specify): 

________________________

   
5

4. In your mathematics and mathematics teaching and learning professional development 

activities during summer 2013 and the following 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 mathematics concepts    

f. Practice analyzing student work on 

mathematics problems    

g. Practice writing story problems for students 

you teach    

h. Explore common student approaches to a 

variety of mathematics problems    

i. Explore connections between mathematics 

topics (e.g., connections between arithmetic 

and algebra)

   
6

5. To what extent did each of the following improve as a result of your participation in 

mathematics and in mathematics teaching and learning professional development 

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

Check one box for each row.

Area of Improvement

No 

Improvement 

Improved 

a Little

Improved 

a Moderate 

Amount

Improved 

a Large 

Amount

a. Your understanding of addition, 

subtraction, multiplication, and 

division

   

b. Your understanding of connections 

between addition, subtraction, 

multiplication, and division

   

c. Your understanding of fractions and 

operations with fractions    

d. Your understanding of algebra    

e. Your understanding of connections 

between algebra and arithmetic    

f. Your understanding of decimals    

g. Your understanding of exponents    

h. Your ability to see connections 

between multiple representations for 

mathematics

   

i. Your ability to connect different 

approaches to mathematics problems    

j. Your understanding of common 

student approaches to mathematics 

problems

   

k. Your ability to analyze student work 

to gain insight into student 

understanding

   
7

6. In your mathematics and mathematics teaching and learning professional development 

activities during summer 2013 and the following 2013-2014 school year, how often was 

your experience... 

Check one box for each row.

Your Experience Was...

Never/ 

Rarely Sometimes Often

Most or 

All of the 

Time

a. Consistent with your own goals for your 

professional development    

b. Aligned with state or district standards 

and/or assessments    

c. Supportive of the use of district-adopted 

curricular materials    

d. Supportive of your school’s improvement 

efforts    

e. Relevant to the mathematics you taught this 

year

   

f. Focused on material at the right level of 

difficulty, given your prior knowledge of 

mathematics and mathematics teaching

   

g. Logically connected from one day or session 

to the next    

h. Clear about what you should learn from the 

professional development experience    

i. Clear about how you could use what you 

learned from the professional development

experience in your classroom

   

j. Focused on practices that you were expected 

to demonstrate in your classroom    
8

[Skip Pattern: If respondent added hours to Question 2 Row c, the respondent will be directed to answer 

questions 7 and 8. Otherwise, the respondent will be directed to answer question 9.]

7. To what degree did the feedback you received on your instruction following a video or 

in-person observation emphasize the following topics?

Check one box in each row

Topic

Not an 

emphasis

Minor 

emphasis

Moderate 

emphasis

Major 

emphasis

a. The degree to which the lesson made 

connections between mathematics topics 

and/or representations

   

b. The degree to which students discussed or 

were presented with the reason “why” a series 

of steps works

   

c. The degree to which activity in the lesson 

exposed students to a variety of approaches 

and solution methods

   

d. The mathematical language you used in the 

lesson.    

e. The degree to which the mathematics and 

mathematical notation you presented was 

correct. 

   

f. The way in which you worked with students 

who had errors in their work or thinking.    

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

observation feedback you received this year?

Check one box in each row

These experiences...

Strongly 

disagree Disagree Agree

Strongly 

agree

a. Gave me opportunities to work on aspects of 

my teaching.    

b. Provided me with useful feedback about my 

teaching.    

c. Made me pay closer attention to particular 

things I was doing in the classroom.    

d. Led me to think about one or more aspects of 

my teaching in a new way.    

e. Helped me to become a better mathematics 

teacher.    
9

Mathematics Instruction

9. 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

10. In teaching your regular fourth-grade mathematics classes, how much emphasis did you 

give to each of the following during the 2013–2014 school year?

Check one box for each row.

Topic

Not an 

Emphasis

Minor 

Emphasis

Moderate 

Emphasis

Major 

Emphasis

a. Teaching mathematical facts and rules    

b. Presenting and exploring the reasoning 

behind mathematical rules    

c. Using multiple representations(charts, 

pictures, symbols) when teaching a new 

topic 

   

d. Examining student work to gain insight into 

how students are thinking    

e. Having your students justify their solutions 

or explain their reasoning    

f. Encouraging your students to explore 

alternative methods for solving problems    

g. Having your students practice mathematical 

procedures    

h. Explicitly making connections among 

mathematics topics    
10

Beliefs About Mathematics Teaching and Learning

11. Please indicate the degree to which you agree (or disagree) with each of the following.

Check one box for each row.

Belief

Strongly 

Disagree Disagree Agree

Strongly 

Agree

a. Getting the one, correct answer is the most

important part of elementary mathematics.

   

b. Being able to successfully use a rule or formula in 

mathematics is more important to me than 

understanding why and how the rule or formula

works.

   

c. Learning mathematics mainly involves memorizing 

procedures and formulas.    

d. A lot of things in mathematics simply must be 

accepted as true and remembered.

   

e. I like to use mathematics problems that can be 

solved in many different ways.

   

f. When I teach mathematics, I often find it difficult 

to interpret students’ wrong answers.

   

Certification

12. Which of the following describes the teaching certificate did you hold 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

 Probationary certificate (issued after satisfying all requirements except the 

completion of a probationary period)

 Provisional or other type of certificate given to persons who are still participating in 

what the state calls an “alternative certification program”

 Temporary certificate (requires some additional college coursework, student 

teaching, and/or passage of a test before regular certification can be obtained)

 Waiver or emergency certificate (issued to persons with insufficient teacher 

preparation who must complete a regular certification program in order to continue 

teaching)

 I do not have any of the above certifications in THIS state.
11

Education and Preservice Training

13. 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)
12

14. 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): 

_______________________________________

   
13

Experience

15. 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

16. What is your gender? 

 Male

 Female

17. Are you of Hispanic or Latino origin? 

 Yes

 No
14

18. 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
15

Treatment Teacher Addendum

19. Please indicate the degree to which you agree (or disagree) with each of the following.

Check one box for each row.

Program

Strongly 

Disagree Disagree Agree

Strongly 

Agree

a. I am satisfied with the Intel professional 

development opportunities I have participated in 

this year.

   

b. I am satisfied with the MLC professional 

development opportunities I have participated in 

this year.

   

c. I am satisfied with the Video Feedback 

professional development opportunities I have 

participated in this year.

   
16

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.
17

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 
18

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.