Handout 4: Rubric and Checklist Template

Directions: Use the table template below to create a rubric that will help students to self-reflect on their
learning experiences. Prior to developing your rubric, we suggest that you review other rubrics and checklists.
Visit the Exemplars webpage for examples of different rubrics and checklists. To learn how to create a rubric,
read Using Rubrics from the Center for Teaching Innovation at Cornell University.

Part 1. Identify the competency, skills, learning targets, or learning processes that you want students to self-
assess. We encourage you to review the Minnesota Social and Emotional Competencies to identify learning
targets. If you are interested in learning about additional daily goals or long-term goals that students might self-
reflect upon regularly, visit Edutopia’s Self-Assessment, Social and Emotional Development, Daily Goals and Big
Goals. As you compose your learning targets, ensure that they are written in a way that students can
understand.

1. ____________________________________________________________________

2. ____________________________________________________________________

3. ____________________________________________________________________

Part 2. Determine whether a checklist (quick checks) or rubric (complex projects) better serves your purpose.

Part 3. Create the checklist or rubric. Remember that an effective checklist or rubric requires a well-defined set
of indicators that allow students to gauge their learning objectively. If you are interested in seeing examples of
strategies related to social and emotional competencies, review:

 The rubric from Edutopia’s Self-Assessment, Social and Emotional Development Rubric .
 North Dakota’s SEL Student-Friendly Scales, K-12
 Marzano’s article, Building SEL Skills Through Formative Assessment
 Additional resources are provided in Handout 6, Reflection and Additional Information.

Indicator Exceeding Performance Meeting Performance In Need of Improvement

1.

2.

3.

4.