Appendix 5: Implementation Fidelity Protocol - Academic Sample

	A	B	C	D	E	F	G	H
1	APPENDIX 5: SAMPLE IMPLEMENTATION FIDELITY PROTOCOL (ACADEMIC)
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4	Intervention:	Ready? Read It! Skill Building Program
5	Learner Group:	2-Purple (Jose, McKenzie, Gina, Ron, Evan)
6	Teacher:	Mrs. Nome
7	Week of:	Oct. 4-8
8				As prescribed Y/N
9		SESSION FIDELITY		M	Tu	W	Th	F
10		Session occur as intended? (i.e., frequency)		Y	Y	Y	Y	Y
11		Session duration as intended?		Y	N	N	Y	Y
12		Correct materials used?		Y	Y	Y	Y	Y
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14				Present? Y/N
15		COMPONENT FIDELITY		M	Tu	W	Th	F
16		Critical Components		M	Tu	W	Th	F
17		A.	Teacher-led reading with embedded mini-lesson	Y	Y	Y	Y	Y
18		B.	Paired reading with prescribed correction procedure	Y	Y	Y	N	Y
19		C.	Error correction as outlined in manual	Y	Y	Y	N	N
20		D.	Large group share out	Y	Y	Y	Y	Y
21		E.	Produce, predict, provide routine per teacher manual	Y	Y	N	N	N
22		F.	Teacher summary and re-teach target skill	N	Y	N	N	N
23		G.	NA	-	-	-	-	-
24		Observed (divided by) Total		83%	100%	67%	33%	50%
25		Learner Engagement (High/Low)		L	H	H	H	H
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29		FIDELITY SUMMARY		%
30		Component Fidelity		67%
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