INSTRUCTIONS: Use this form when writing your PDP.

Wisconsin Department of Public Instruction

PDP WRITING FORM AND CHECKLIST
PI-PDP-1 (Rev. 08-09)

Professional Development Plan (PDP) forms available at: http://dpi.wi.gov/tepdl/pdp.html

BIOGRAPHICAL INFORMATION
Educator Name

Educator Telephone Area/No.

Robyn Hellenbrand

(608) XXX-XXXX

Educator Address Street, City, State, Zip

Educator Fax Area/No.

310 Bayley Avenue, Platteville, WI 53818

E-Mail Address

Educator File No.*

[email protected]
Educator School District

Platteville School District

Current Educational Assignment

No. of Years in Current Assignment

Elementary Physical Education Teacher

Years of Educational Experience

Month/Year PDP Submitted for Goal Approval (Initial Educators Only)

Month/Year Plan Submitted for PDP Verification

*Educator file numbers may be found on the DPI Educator License lookup at: http://dpi.wi.gov/tepdl/lisearch.html.
Present Licensure Stage

Licensure Category

Initial Educator

Teacher

Professional Educator

Administrator

Master Educator

Pupil Services

Date Current License Expires

6-30- 17

PROFESSIONAL DEVELOPMENT PLAN

Step I: Preparing to Write the PlanREFLECTION

Reflect and prepare to write your PDP goal in Step II. While reflection is a required step in the PDP process, recording your reflection
below is optional.

As I completed my first year I noticed that students in my classroom where getting bullied by their peers. Some of the
advanced students would make fun of or make nasty comments about the lower success students. It was hard to get students to pair
up with different partners and would live people out if I didnt make groups sometimes.
Step II: Writing the PlanCOMPONENTS
A. Description of School and Teaching, Administrative, or Pupil Services Situation
WISEdash Illinois Students Illinois Interactive Report Card
I am currently on my second year of teaching physical education to elementary students in the Platteville School District. I am the
only physical education teacher at Westview Elementary School for approximately 237 students. Platteville School District has four
total schools in a rural setting with the University of Wisconsin-Platteville in the same community. Westview Elementary is mostly
made up white students at 88.2% with a few Asian and Black students as well. The percentage of students without disabilities is
87.3% and the percentage with disabilities is the remaining 12.7%. Students not an economic disadvantage is 60.8% and students at
an economic disadvantage is 39.2%.
Review Checklist for Description of School Situation
Did you include a description of your teaching, pupil services, or administrative position?
Did you include the number of years you have taught, been an administrator, or been in pupil services?
Did you include whether the school is located in an urban, suburban, or rural setting?
Did you include the ethnic, special needs, and socioeconomic makeup of the school population?
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PI-PDP-1
PROFESSIONAL DEVELOPMENT PLAN (contd)

Did you include your building goals/mission and/or district goals/mission?

B. Description of Goal to be Addressed

It is recommended that you use this stem: I will (research, study, learn, apply, etc.) So that (describe what you want to see
happening differently with student learning).

I will research the main causes of the bullying that is happening in our school, so that students will feel more comfortable and
safe about coming to class and participating.

Review Checklist for Description of the Goal

Did you describe how your goal will impact your professional growth?
Did you describe how your professional growth will have an effect on student learning?

C. Rationale for the Goal: Links to Professional Situation and Wisconsin Educator Standards
Based on your reflection, describe the reason for your goal. Describe how your goal is linked to your educational situation, and
write out the Wisconsin Educator Standards (two or more) that you will focus on to meet your goal.

School is meant to be a safe and comforting place for students to come and work towards educational goals. As a physical
education teacher I want to see students capable of participating in every activity and not feel like that will be teased about doing it.
If students feel welcomed in the classroom they will be more willing to come to class and participate. My PDP goal will focus on
developing standards five and six. As a teacher I want to know how to manage my classroom so everyone is welcomed and treated
fairly. I also want to communicate well with my students and co-workers to help my students feel comfortable in every given
situation.
Review Checklist for Rationale for the Goal
Does the rationale tell how your goal connects to your school, teaching, administrative, or pupil services situation? (Choose the
category that applies to your situation)
Did you write out the Wisconsin Educator Standards that you will focus on to meet your goal? (must select two or more)

D. Plan for Assessing and Documenting the Goal

Record the anticipated methods you will use to assess your professional growth and the effect on student learning. It may be
helpful to review steps III and IV when writing your assessment plan as they outline what is necessary when documenting your
completed plan.

I will assess my professional growth by collaborating with co-workers and the guidance counselor and see if they notice a
difference in students attitudes. Students should feel more welcomed and wanting to participate. As a physical education teacher I
will assess my students learning by noticing if students can group together without cause complications. Complications that could
happen would be leaving a student out, making unfair teams, or making inappropriate comments about another individual. If they
can come into the classroom and work together fairly I will know that I made progress towards my goal.
Review Checklist for Plan for Assessing and Documenting Achievement of the Goal
Did you include in the plan the anticipated methods you will use to assess your professional growth?
Did you include in the plan the anticipated methods you will use to assess the effect on student learning?

E. Plan to Meet the Goal: Objectives, Activities, Timeline, and Plan for Collaboration
Note: Completion dates will be filled in during Step III as each objective/activity is completed.
OBJECTIVE 1

I will research the implications of bullying in physical education.

Activities

Timeline

Collaboration

Attend WHPE conference

Fall 2014

Conference Presenters

Create posters

Spring 2015

Art Teacher

PDP Writing Form2009

Date Completed

PI-PDP-1

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OBJECTIVE 2

I will adjust my classroom management plan.

Activities

Timeline

Collaboration

Adjust grouping with partners/teams

Spring 2015

Other PE Teachers

Options on handling bullying situations

Fall 2015

Co-Workers

Date Completed

OBJECTIVE 3

Activities

Timeline

Collaboration

Date Completed

Activities

Timeline

Collaboration

Date Completed

Activities

Timeline

Collaboration

Date Completed

OBJECTIVE 4

OBJECTIVE 5

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PI-PDP-1
PROFESSIONAL DEVELOPMENT PLAN (contd)

Review Checklist for Objectives, Activities, Timeline, and Plan for Collaboration
1. Objectives
Did you include objectives that directly address the goal?
Did you include objectives that are observable and verifiable?
2. Description of Activities and Timelines
Did you align your activities with your goal and objectives?
Did you extend the activities through multiple years of the licensure cycle?
Did you state a timeline for completing the activities?
3. Plan for Collaboration
Did you include collaboration with others in your plan?

Initial educators must submit Step II, A-E, to a PDP Team for Goal Approval.
Step III: Annual Review of the PDP
Annual reviews are done in years two, three, and four and will be submitted as part of your completed plan in the last year of your
licensure cycle.

Return to Step II E and enter completion dates for each activity completed.

Professional Educators must complete a five-year plan with three annual reviews.

Write a reflection in year two summarizing the progress made towards completing your goal.
Indicate, in your reflection, how you grew professionally and/or how your professional growth had an effect on student learning.
Write any revisions to your objectives or activities in the revision area.
Return to this step annually until your PDP is complete and ready to be submitted for verification.

Initial Educators may complete a 3, 4, or 5 year plan. One annual review is required for a three-year plan, two annual reviews are
required for a four-year plan, and three annual reviews are required for a five-year plan. If there is a substantial change to your GOAL,
you must complete and resubmit section II A-II E to a team for review and approval of the new goal.

Reflection (Year 2)

Revision (if needed)

Date:

Date:

Reflection (Year 3)

Revision (if needed)

Date:

Date:

Reflection (Year 4)

Revision (if needed)

Date:

Date:

PDP Writing Form2009

Review Checklist for Annual Review

Did you include in your reflection how you grew professionally and/or how your professional growth had an effect on student
learning?
Did you include any revisions to your objectives or activities?
Did you fill in completion dates for activities? (refer to Step II E of your plan)

Step IV: Documentation of Completion of the PDP

Your PDP must include 3-5 pieces of evidence that document professional growth and the effect on student learning. Number and label
each piece of evidence (i.e., 1. Student test score analysis). You may use a single piece of evidence that focuses solely on professional
growth or the effect on student learning as long as your completed plan includes both types of documented evidence. When attaching
evidence, please include the number and label entered below.

A. Evidence of Professional Growth and the Impact of Professional Growth on Student Learning

Number and label each piece of evidence.

Indicate whether each piece of evidence documents professional growth, the effect on student learning, or both.
Describe each piece of evidence identifying what is documented and the relationship of the evidence to the goal.

1.
2.
3.
4.
5.
Review Checklist for Evidence of Completion of Your Plan
Did you provide three to five pieces of evidence?
Did you describe how your evidence documents your professional growth?
Did you describe how your evidence documents the effect on student learning?

B. Reflection and Summary

Describe how you grew professionally in the Wisconsin Educator Standards identified in your PDP.
Describe in detail the effect of your professional growth on student learning.
Describe how you collaborated with others while working on your PDP.

Review Checklist for Summary and Reflection Statement

Did you describe how you grew professionally in the Wisconsin Educator standards identified in your plan?
Did you describe the effect of your professional growth on student learning?
Did you describe how you collaborated with others?

C. Submitting the Completed PDP for Plan Verification

Submit your completed PDP including your 3-5 pieces of labeled evidence to a PDP Team no later than January 15
of the final year of the plan. If you are an Initial Educator, include a copy of your signed Goal Approval Signature
Form(s).

PDP Writing Form2009