For your self-analysis of poor course performance, print and complete this form page for each course in which you received a grade of “D” or “F” during the prior semester.
Course name __________________________________
Grade I received _______________________________
Semester I took the course _______________________
Instructor’s name ______________________________
Rate the following elements and their contribution to your lack of success on a scale of 0 to 5.
- 0 means the element was not very significant in your lack of success.
- 5 means the element was very significant in your lack of success.
Attendance
This class met _______ days a week for ______ hours a day.
Number of class sessions I missed:
_____ none _____ fewer than 3 _____ more than 3 _____ about half _____ most
0 1 2 3 4 5
Academic skills background (reading ability, math background, study skills)
0 1 2 3 4 5
Academic content background (success in prerequisite course/s)
0 1 2 3 4 5
Preparation and study (average hours per week _______)
(Examples: reading text in advance, timely work on projects and papers)
0 1 2 3 4 5
Taking useable class notes
0 1 2 3 4 5
Class participation (attention, discussion)
0 1 2 3 4 5
Personal motivation (I “liked the class”, or I “took it because I had to”)
0 1 2 3 4 5
Please answer the following three questions with a sentence or two.
1. What out-of-class contact did you have with the instructor?
2. Did you seek any peer assistance such as tutoring or study group?
3. In Summary: What were the most significant reasons for lack of success?