Appendix A

Self-Assessment Surveys

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Student Self-Assessment Survey: Empathy

Note: This survey is designed to stimulate reflection and discussion. It will not be counted for a grade.

Directions: Place a 1 (strongly disagree), 2 (disagree), 3 (not sure), 4 (agree), or 5 (strongly agree) after each item.

  1. As long as everyone gets what they want, everyone will be happy. ___
  2. People can view things differently and still be kind and caring. ___
  3. I can't learn much from people who are different from me. ___
  4. When people disagree with me, I ask them why they feel that way. ___
  5. I only enjoy hanging around people like me. ___
  6. People who are different can have much more in common than it might seem at first. ___
  7. If people who see things differently than me knew what I know, they would see things the same way that I do. ___
  8. It is important for everyone's voice to be heard. ___
  9. I try to figure what others want in a relationship with me. ___
  10. If you are right, others will be eager to join you. ___

Scoring:

  • ___ (A) Total points for 2, 4, 6, 8, 9
  • ___ (B) Total points for 1, 3, 5, 7, 10
  • ___ (C) Subtract (B) from (A) for your "empathy" score

If you scored

  • 18 or higher: You understand empathy.
  • 14–17: You should give a bit more thought to issues of empathy.
  • 13 or lower: You and your teacher should have a conversation about empathy.
Student Self-Assessment Survey: Self-Control

Note: This survey is designed to stimulate reflection and discussion. It will not be counted for a grade.

Directions: Place a 1 (strongly disagree), 2 (disagree), 3 (not sure), 4 (agree), or 5 (strongly agree) after each item.

  1. I can improve my self-control in school situations. ___
  2. It is better to be creative than to have self-control. ___
  3. Having strong self-control means that you will always be successful. ___
  4. I can improve my self-control in situations outside of school. ___
  5. Using self-control always means resisting something fun. ___
  6. If you are good at something, you won't need much self-control. ___
  7. Before a challenging situation, it is helpful to anticipate why it might be hard to manage self-control. ___
  8. After a challenging situation, it is important to reflect on what made it hard to maintain self-control. ___
  9. We naturally have self-control in areas at which we excel. ___
  10. Improving my self-control in one area can help it improve in other areas. ___

Scoring:

  • ___ (A) Total points for 1, 4, 7, 8, 10
  • ___ (B) Total points for 2, 3, 5, 6, 9
  • ___ (C) Subtract (B) from (A) for your "self-control" score

If you scored

  • 18 or higher: You understand self-control.
  • 14–17: You should give a bit more thought to issues of self-control.
  • 13 or lower: You and your teacher should have a conversation about self-control.
Student Self-Assessment Survey: Integrity

Note: This survey is designed to stimulate reflection and discussion. It will not be counted for a grade.

Directions: Place a 1 (strongly disagree), 2 (disagree), 3 (not sure), 4 (agree), or 5 (strongly agree) after each item.

  1. There are times when it is OK to be less than honest. ___
  2. If I am not sure what is right or wrong, there is a family member or educator I can talk to. ___
  3. It's important for me to be honest even if other people don't know I am. ___
  4. It's most important for me to be honest when money is involved. ___
  5. Everyone deserves to be treated in an honest way. ___
  6. As long as I am being honest, it is not important for others to know how I think. ___
  7. As long as you believe something, it doesn't matter whether you show it and others know it. ___
  8. If someone else is being dishonest or unfair, I should let them know. ___
  9. Being honest may mean saying something that costs me. ___
  10. It is important that my friends know that I agree with them. ___

Scoring:

  • ___ (A) Total points for 2, 3, 5, 8, 9
  • ___ (B) Total points for 1, 4, 6, 7, 10
  • ___ (C) Subtract (B) from (A) for your "integrity" score

If you scored

  • 18 or higher: You understand integrity.
  • 14–17: You should give a bit more thought to issues of integrity.
  • 13 or lower: You and your teacher should have a conversation about integrity.
Student Self-Assessment Survey: Embracing Diversity

Note: This survey is designed to stimulate reflection and discussion. It will not be counted for a grade.

Directions: Place a 1 (strongly disagree), 2 (disagree), 3 (not sure), 4 (agree), or 5 (strongly agree) after each item.

  1. Every student comes to school with the same chances for success. ___
  2. I have close friends of different races, ethnicities, and genders. ___
  3. Everyone would get along better if we all knew more about my culture. ___
  4. I respect the holidays and celebrations of religions and groups that are different than mine. ___
  5. I consciously reach out to students who are in a minority group (racial, religious, sexual orientation, etc.). ___
  6. The election of President Obama means that racial bias is no longer a problem in the United States. ___
  7. I am comfortable being around people regardless of their sexual orientation. ___
  8. Boys are naturally better athletes and leaders than girls. ___
  9. It's OK to use stereotypical language as long as you're just kidding. ___
  10. I understand that society has favored some groups over others. ___

Scoring:

  • ___ (A) Total points for 2, 4, 5, 7, 10
  • ___ (B) Total points for 1, 3, 6, 8, 9
  • ___ (C) Subtract (B) from (A) for your "embracing diversity" score

If you scored

  • 18 or higher: You understand embracing diversity.
  • 14–17: You should give a bit more thought to issues of embracing diversity.
  • 13 or lower: You and your teacher should have a conversation about embracing diversity.
Student Self-Assessment Survey: Grit

Note: This survey is designed to stimulate reflection and discussion. It will not be counted for a grade.

Directions: Place a 1 (strongly disagree), 2 (disagree), 3 (not sure), 4 (agree), or 5 (strongly agree) after each item.

  1. No matter how difficult a task is, I keep trying. ___
  2. I would rather practice something I do well than try to learn something new. ___
  3. I am often distracted when things are hard. ___
  4. Learning in school should be easy. ___
  5. I usually work harder than my classmates. ___
  6. It is important to me that I don't make mistakes. ___
  7. I would rather get a B in a new area of learning than an A in an area I'm already good at studying. ___
  8. Learning needs to be fun. ___
  9. It's OK if I make a mistake or two while learning. ___
  10. If something is difficult, I am sure to devote extra time to it. ___

Scoring:

  • ___ (A) Total points for 1, 5, 7, 9, 10
  • ___ (B) Total points for 2, 3, 4, 6, 8
  • ___ (C) Subtract (B) from (A) for your "grit" score

If you scored

  • 18 or higher: You understand grit.
  • 14–17: You should give a bit more thought to issues of grit.
  • 13 or lower: You and your teacher should have a conversation about grit.