• Confidential Student Volunteer Feedback Form

  • We wish to thank you for volunteering to support this Student, and for your honest feedback.

    Your feedback will be used by the senior teacher to work with the practicum student to understand their skillset as a teacher, and to support any helpful adjustments to their teaching style. Your anonymity will be protected during the review of the class with the Practicum Teacher.

    If you have any questions please email us at info@lifeofwellness.ca

  •  - -
  • Did the Practicum Teacher create an environment that allowed you to feel safe, where your body and autonomy were honored?*
  • Did the Practicum Teacher ask you to share your medical history or request information about how to support you and your practice?*
  • Do you feel that what you shared about you and your body was taken into consideration when guiding your practice?*
  • Did the practicum teacher share their intention for the class?*
  • Did the Practicum Teacher honor this intention?*

  • Explicit Informed Consent

    The following definitions are to provide context for the remaining questions.

    This type of consent is expected before any form of touch, adjustments, assists, or requested adaptation (individualized cues, requests, or recommendations) to a pose or practice.

    Explicit Informed Consent

    Explicit and Informed Consent can be given verbally, in writing, by an unambiguous gesture, or via a consent indicator.
    Silence or lack of resistance, in and of itself, does not demonstrate consent.

    Informed Consent

    • A process in which students are given important information, including possible risks and benefits, the intent of the touch, adjustment, assistance, or request.
      • Without attachment to the result.
      • Giving space for questions and understanding.
    • With the intent to help the student decide for themselves if they wish to accept or decline the request or offered suggestion.

    Autonomy

    The right or condition of self-government.

    Here is an example: 

    "Would you be okay with me supporting you with some guidance for bringing balance to your experience in this pose?"

    (The teach waits for your response. If you say no, your answer is honored. If you say yes, the teacher will continue with more information)

    "I would like to see if aligning your knee with your ankle will support your balance in the pose. I can cue you with words or place my left hand on the outside of your right knee to give you a visual guide. I will then ask you to engage your inner thigh and press your knee towards my hand or verbally communicate for you to stop.

    Then we can check in and see if you find the adjustment helpful.

    How does that sound?"

    (The teacher waits for your response, answers your questions, and honors your agency to stop at any time)

  • Did the Practicum Teacher offer any individual cues, adjustments, assists, or suggestions?*
  • Did the Practicum Teacher gain your explicit informed consent first?
  • Were you provided with the information you needed to understand what was being offered/suggested and the benefits and risks?
  • Do you feel your autonomy was honored?
  • Which of the following, if anything, impacted your autonomy?*
  • Should be Empty: