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1CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Learner Assessment Record
CYQ Level 3 Diploma in Teaching Pilates
3CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Central YMCA Quali!cations Support Services112 Great Russell StreetLondonWC1B 3NQ
020 7343 1800
www.cyq.org.uk
Learner Assessment Record
CYQ Level 3 Diploma in Teaching Pilates
Quali!cation number: 600/4015/4Operational start date: 1 December 2011
Copyright © YMCA Quali!cations (CYQ), 2012
All rights reserved. No part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (electronic, photocopying, recording or otherwise), without the prior written permission of the copyright owners of this pack.
4CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Contents
Introduction ................................................................................................................................................ 5
About CYQ ................................................................................................................................................ 5
Learner assessment record ........................................................................................................................ 5
Quali!cation structure ................................................................................................................................ 6
Assessment speci!cation ........................................................................................................................... 7
Assessment plan ...................................................................................................................................... 14
Health, safety and welfare in the !tness environment – worksheet ......................................................... 16
Know how to support clients who take part in exercise and physical activity – worksheet ..................... 23
Fundamentals of Pilates – worksheet ...................................................................................................... 29
The original exercises, modi!cations and adaptions – worksheet .......................................................... 33
Client pro!le and goal setting ................................................................................................................. 39
Client pro!le, progessive programme and viva checklist ........................................................................ 45
Progessive programme evaluation .......................................................................................................... 48
Session planning – overview ................................................................................................................... 50
Session plan – Pilates .............................................................................................................................. 54
Planning checklist .................................................................................................................................... 60
Session evaluation and re"ection ............................................................................................................ 62
Observation of practical teaching – checklist ........................................................................................... 65
Assessor’s feedback ................................................................................................................................. 72
Assessor question and response sheet ................................................................................................... 73
Summary of achievement ........................................................................................................................ 74
5CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Introduction
About CYQ
CYQ is the UK’s leading health and !tness speci!c awarding body and is a trusted name that enjoys widespread respect within the !tness industry. CYQ quali!cations are designed for people taking their !rst steps in the health and !tness industry or for those already working in the industry wishing to progress their careers. CYQ has been responsible for over 200,000 people launching or progressing their careers.
As an internationally recognised organisation, CYQ has a number of study options available including full time or part time, distance learning and progressive study routes. This variety ensures that there will be a study option that is right for you and which will enable you to increase your knowledge, gain new skills and develop your career. All of CYQ’s proven and established resources and assessment materials have been developed by leading industry experts in consultation with employers and training providers.
For more information, visit www.cyq.org.uk .
Learner assessment record (LAR)
Your learner assessment record is designed to support the assessment of your CYQ Level 3 Diploma in Teaching Pilates. It contains all the paperwork that you, your tutor and your assessor will need in order to complete the quali!cation.
You will share the learner assessment record with both your tutor and assessor, who will use the paperwork contained within to assess you throughout the duration of your training. This document is an essential part of your assessment and should be kept safe. Your tutor and assessor will guide you as to which forms you need at particular times, as well as how the forms should be used and completed.
Upon completion of the CYQ Level 3 Diploma in Teaching Pilates, you will be able to plan, deliver and evaluate safe and effective progressive Pilates sessions.
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Quali!cation structure
To achieve your CYQ Level 3 Diploma in Teaching Pilates, you need to complete the following six units:
Anatomy and physiology for exercise and health Credit: 6 GLH: 43
Level: 3
Health, safety and welfare in a !tness environment Credit: 2 GLH: 16
Level: 2
Principles of exercise, !tness and health Credit: 4 GLH: 28
Level: 2
Know how to support clients who take part in exercise and physical activity Credit: 2 GLH: 13
Level: 2
Programming a Pilates teaching session Credit: 10 GLH: 50
Level: 3
Delivering a Pilates teaching session Credit: 13 GLH: 60
Level: 3
You will gain 37 credits within the Quali!cations and Credit Framework (QCF).
7CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Assessment speci!cation
Your assessment has nine elements across six units:
Assessment element 1 – theory paper
You will be required to successfully complete the externally set theory test from CYQ. Questions will relate to the syllabus for ‘Anatomy and physiology for exercise and health’ unit (A/600/9051, Level 3).
Paperwork that relates to this assessment element
Assessment element 2 – worksheet
You will be required to complete the ‘Health, safety and welfare in a !tness environment’ worksheet. Questions relate to the syllabus for ‘Health, safety and welfare in a !tness environment’ unit (T/600/9016, Level 2). You will be required to fully complete the worksheet to achieve a pass.
Paperwork that relates to this assessment element
Assessment element 3 – theory paper
You will be required to successfully complete the externally set theory test from CYQ. Questions will relate to the syllabus for ‘Principles of exercise, !tness and health’ unit (A/600/9017, Level 2).
Paperwork that relates to this assessment element
Assessment element 4 – worksheet
You will be required to complete the ‘Know how to support clients who take part in exercise and physical activity’ worksheet. Questions relate to the syllabus for ‘Know how to support clients who take part in exercise and physical activity’ unit (M/600/9015, Level 2). You will be required to fully complete the worksheet to achieve a pass.
Paperwork that relates to this assessment element
worksheet
8CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
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Assessment element 5 – worksheets
You will be required to complete the ‘Fundamentals of Pilates’ worksheet (level 3) and ‘The original exercises, adaptations and modi!cations’ worksheet. You will be required to fully complete the worksheets to achieve a pass.
Paperwork that relates to this assessment element
Assessment element 6 – client pro!le, progressive programme and viva
Using a real, apparently healthy individual (eg, a peer, family member, friend or partner) who does not require medical intervention, learners are required to produce and implement the following:
a) client pro!le and goal setting, including:
– short
– medium
– long
progression over the weeks according to the client’s goals, together with session outlines for weeks eight and 12, demonstrating anticipated further progression.
Sessions for weeks one to four must be implemented with the client. The detailed session plans, each for
9CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Other information An ‘apparently healthy’ adult may be:
Client goals may relate to:
Paperwork that relates to this assessment element includes:
Paperwork not included in this learner assessment record includes:
10CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
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Assessment element 7 – planning
You will be required to complete a session overview for the session you plan to deliver. The session overview should take account of:
You will also be required to prepare a detailed session plan for the Pilates session you will deliver for observed assessment (this may be one of the sessions from weeks one to four of your progressive programme). If it is not one of these sessions, then a separate detailed session plan will need to be prepared. The session plan should include the following:
Preparation phase:
– instruction of Pilates principles
– alignment
– breathing
– core activation
– concentration
– mobility and "owing movement
– posture and precision
– balance
Main phase, involving whole-body movement:
– instruction of Pilates principles
Starting positions (focus on at least four; these can feature in any of the sections):
Include all objectives/purposes listed below:
– scapular stability
– trunk stability
– pelvic stability
– spine mobility
– shoulder and hip mobility
– strength
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Include: three actions listed below:
– "exion/extension
– rotation
– circumduction
– lateral "exion
Closing phase:
– instruction of Pilates principles
– stretching
– mobility
– relaxation (active or passive)
Paperwork that relates to this assessment element:
Assessment element 8 – summative observation of practical teaching
Evidence for this assessment must be in the form of direct observation of performance. Video assessment is also permissible and must adhere to CYQ guidelines.
The session delivered must relate to the session plan in assessment element 7.
You are required to instruct a Pilates session to a group of clients/participants. The session should contain:
An appropriate preparation section that includes instruction of:
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An appropriate main section that includes instruction of:
– standing (both feet, single foot)
– seated (crook, staff/legs straight, tailor/cross legged, straddle)
– kneeling (buttocks on heels or buttocks lifted)
– prone lying ("at and elevated on elbows)
– side lying and kneeling
– on all fours
– supine lying (crook, corpse and tabletop)
– supine plank (weight between hands and feet)
Include all objectives/purposes listed below:
Include: three of the actions listed below:
An appropriate closing section that includes instruction of:
Include instruction of appropriate progressions, regressions and adaptations to accommodate different
Paperwork that relates to this assessment element:
13CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Assessment element 9 – evaluation
You are required to complete a session evaluation and re"ection based on the session taught in assessment element 8.
Paperwork that relates to this assessment element:
checklist – assessment element 8)
The remaining forms contained within this pack are explained below:
Assessment planThis document is designed to allow you and your assessor to plan your progress through the assessment components. You can use this to plan with your assessor and tutor when assessment activities will take place.
Assessor feedback sheetThis form will be used by your assessor to record any feedback that you may be given. This form may be used at any stage in your learning to record feedback.
Question and response sheetThis form will be used by your assessor to record any questions that you may be asked and any responses you may give.
Summary of achievementThis document is designed to record the outcomes of the assessment elements and any further action
also be signed by you to declare authenticity of work and by your assessor to indicate which of the units have been satisfactorily completed. This document should be kept in a safe place as it acts as evidence of your achievements.
14CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
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CYQ
Dip
lom
a in
Tea
chin
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asse
ssm
ent
plan
Ass
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elem
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Evid
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1. T
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Ana
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ysio
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for e
xerc
ise
and
heal
th(A
/600
/905
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2. W
orks
heet
:H
ealth
, saf
ety
and
wel
fare
in a
!tn
ess
envi
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(T/6
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016)
3. T
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Prin
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es o
f exe
rcis
e an
d he
alth
(A
/600
/901
7)(d
elet
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app
licab
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orks
heet
:Kn
ow h
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sup
port
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nts
who
take
pa
rt in
exe
rcis
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d ph
ysic
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ctiv
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(M/6
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015)
5. W
orks
heet
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ndam
enta
ls o
f Pila
tes
The
orig
inal
exe
rcis
es, a
dapt
atio
ns a
nd
mod
i!ca
tions
15CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012 15
Ass
essm
ent
elem
ent
Evid
ence
/ as
sess
men
t m
etho
dD
ate,
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e an
d pl
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8. S
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9. E
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Lear
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ame:
Sign
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D
ate:
Ass
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Si
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Dat
e:
Inte
rnal
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assu
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nam
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Si
gnat
ure:
Dat
e:
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Worksheet: Health, safety and welfare in a !tness environment
Learner’s name:
Health and safety
1. Identify three types of emergency that may occur in a !tness environment
1
2
3
2. Describe the responsibilities of the following individuals during an emergency
Role Responsibility
1. General manager
3. Emergency services
3. Explain the importance of following emergency procedures calmly and effectively
17CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
4. Describe how to maintain the safety of people involved in typical emergencies, including children, older people and disabled people
Children
Older people
Disabled people
5. Outline why health and safety is important in a !tness environment
6. Identify the legal and regulatory requirements for health and safety relevant to working in a !tness environment
7. Describe duty of care and professional role boundaries in relation to special population groups
Children
Older people
Disabled people
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8. Identify the typical roles of individuals responsible for health and safety in a !tness organisation
Individual Health and safety role
9. Describe three types of security procedure that you may need to follow when working in a !tness environment
1
2
3
10. Describe two key health and safety documents that are relevant in a !tness environment
1
2
19CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
11. Identify one possible hazard for each of the following aspects of working in a !tness environment
Hazard
Facilities
Equipment
Working practices (including lifting and handling of equipment)
Client behaviour
Security
Hygiene
12. Describe how to risk assess the types of hazard highlighted in question 11 above
13. Describe how to control risks associated with the types of hazard highlighted in question 11 above
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14. Identify the appropriate person/position to contact within the !tness organisation when hazards and risks cannot be controlled personally
15. Describe what is meant by safeguarding the welfare of children and vulnerable adults
16. Describe the responsibilities and limitations of a !tness instructor with regards to safeguarding children and vulnerable adults
17. List four types of abuse and their associated signs that an instructor may encounter
Types of abuse Signs of abuse
1
2
3
4
21CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
18. Describe a !tness organisation’s policies and procedures in relation to safeguarding children and vulnerable adults, including typical reporting procedures
Policies Reporting procedures
1
2
19. Describe the procedures to follow to protect yourself from accusations of abuse
20. Identify two statutory agencies responsible for safeguarding children and vulnerable adults and state when it may be necessary to contact them (contact scenario)
Statutory agency Contact scenario
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21. Describe how to maintain the con!dentiality of information relating to possible abuse
Final result: F Pass F Refer
I con!rm that the information within this worksheet is entirely my own work.
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
23CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Worksheet: Know how to support clients who take part in exercise and physical activity
Learner’s name:
1. Give two reasons why it is important to form effective working relationships with clients
1
2
2. Give two reasons why it is important to present yourself and the organisation positively to clients
1
2
3. Describe how the communication skills below can assist in client motivation
Open questions
Eye contact
Active listening
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4. Explain the importance of valuing equality and diversity when working with clients
5. List three typical barriers to exercise/physical activity that clients may experience
1
2
3
6. Explain how incorporating clients’ exercise/physical activity preferences into their programme can strengthen motivation and adherence
7. List two incentives and two rewards that can strengthen clients’ motivation and adherence
Incentives Rewards
25CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
8. List three strategies and describe how they can help clients overcome typical barriers to exercise/physical activity
Strategies How does the strategy help the client overcome the barrier?
1
2
3
9. Explain why it is important for a clients to take personal responsibility for their own !tness and motivation
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10. Explain how each of the following can assist clients to develop their own strategy for motivation and adherence
11. Identify two behaviour change approaches/strategies to encourage adherence to exercise/physical activity
1
2
12. What does SMART stand for?
S
M
A
R
T
13. Describe the process for setting short, medium and long-term goals following initial goal-setting
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14. Describe the process for revising short, medium and long-term goals
15. Explain the importance of client care:
a. From the point of view of the client
b. From the point of view of an organisation or company
16 Explain why it is important to deal with clients’ needs to their satisfaction
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17. List two ways to identify clients’ needs
1
2
18. Give two reasons for the importance of dealing with clients’ needs timely, effectively and positively
1
2
19. State two ways in which you could exceed clients’ expectations
1
2
Final result: F Pass F Refer
I con!rm that the information within this worksheet is entirely my own work.
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
29CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Worksheet: Fundamentals of Pilates
1. Explain the qualities of a Pilates teacher (minimum of six qualities)
2. Explain the role of a Pilates teacher in relation to promoting long-term behavioural change (list the stages of change and appropriate interventions)
3. Explain the bene!ts of Pilates (minimum of six bene!ts)
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4. Explain the importance of effective communication and describe how to adapt communication to meet clients’ needs
5. Explain the importance of verbal and nonverbal communication when instructing clients
6. Provide a brief explanation and overview on the history of Pilates and developments within the industry (the space provided gives an indication of the amount of explanation/overview required)
31CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
7. Explain the principles (techniques) of the original Pilates exercises and how they have evolved/been adapted to meet current theories and best practice
8. Explain what is meant by the ‘holistic approach’
9. Explain the term ‘integral biology’
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10. Explain the use of suitable music within a Pilates session
11. Explain why a class without music might be bene!cial
Final result: F Pass F Refer
I can con!rm that this worksheet is all my own work
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
Exp
lain
the
34
orig
inal
Pila
tes
exer
cise
s an
d th
eir
goa
ls, i
nclu
ding
ada
ptat
ions
and
mod
i!ca
tions
for
each
exe
rcis
e
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
1. H
undr
ed
3. R
ollo
ver w
ith le
gs s
prea
d
4. R
ocki
ng w
ith o
pen
legs
33
Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
Exp
lain
the
34
orig
inal
Pila
tes
exer
cise
s an
d th
eir
goa
ls, i
nclu
ding
ada
ptat
ions
and
mod
i!ca
tions
for
each
exe
rcis
e
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
1. H
undr
ed
3. R
ollo
ver w
ith le
gs s
prea
d
4. R
ocki
ng w
ith o
pen
legs
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Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
6. R
ollin
g ba
ck li
ke a
bal
l
9. S
pine
str
etch
Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
(con
tinue
d)
35CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
10. R
ocki
ng
11. C
orks
crew
12. S
aw
13. S
wan
div
e
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Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
(con
tinue
d)
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
16. N
eck
pull
17. S
ciss
ors
18. B
icyc
le
19. S
houl
der b
ridge
20. S
pine
twis
t
37CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
21. J
ack
knife
24. T
ease
r
25. H
ip tw
ist
26.
Sw
imm
ing
Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
(con
tinue
d)
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
16. N
eck
pull
17. S
ciss
ors
18. B
icyc
le
19. S
houl
der b
ridge
20. S
pine
twis
t
38CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Wor
kshe
et: T
he o
rigin
al e
xerc
ises
, mod
i!ca
tions
an
d ad
apta
tions
(con
tinue
d)
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
27. L
eg p
ull –
pro
ne
28. L
eg p
ull –
sup
ine
29. M
erm
aid
– si
de b
end
30. B
oom
eran
g
31. S
eal
39CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Orig
inal
exe
rcis
eG
oals
/pu
rpos
e of
exe
rcis
eA
naly
sis
cons
ider
atio
ns
eg, s
kill
and
!tne
ss le
vel r
equi
red
and
pote
ntia
l con
trai
ndic
atio
ns
for s
peci
!c g
roup
s
Mod
i!ca
tions
/ada
ptat
ions
Out
com
e (p
ass/
refe
r)
32. C
rab
33. C
ontr
ol b
alan
ce
Fina
l res
ult:
F P
ass
F R
efer
I can
con
!rm
that
this
wor
kshe
et is
all
my
own
wor
k
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
40CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Physical activity readiness questionnaire
Name: Age: Male/Female:
Address:
Telephone – daytime: evening:
the amount of physical activity in your life.
For most people, physical activity should not pose a problem or hazard.
be inappropriate or for those who should seek medical advice concerning the type of activity most suitable for them. Common sense is your best guide for answering thesequestions.
Please read them carefully and circle YES or NO opposite the question, as it applies to you.
1. Has your doctor ever said that you have a heart condition and recommended only medically supervised activity?
YES/NO
2. Do you get chest pains brought on by physical activity? YES/NO
3. Have you developed chest pains in the last month? YES/NO
4. Do you tend to lose consciousness or fall over as a result of dizziness? YES/NO
5. Do you have a bone or joint problem that could be aggravated by the proposed physical activity?
YES/NO
6. Has a doctor ever recommended medication for your blood pressure or heart condition?
YES/NO
If you have answered YES to any of the above questions, then you are required to gain consent from your doctor before participating in the Pilates session.
If you have answered NO to all the above questions, you have reasonable assurance of your present suitability for:
A Pilates sessionA gradual increase in regular exercise promotes !tness and improves overall health, while minimising or eliminating discomfort. Postpone entry into the programme if you feel unwell or have a temporary illness.
Participant’s signature: Date:
Witness’s signature: Date: Clie
nt p
ro!l
e an
d go
al s
ettin
g
Lear
ner’s
nam
e:
D
ate:
Clie
nt’s
per
sona
l det
ails
Age
Gen
der
Hei
ght
Wei
ght
Oth
er
Med
ical
scr
eeni
ng (P
AR-
Q) o
utco
mes
(inc
lude
a c
opy
of P
AR-
Q a
nd in
form
ed c
onse
nt d
ocum
ents
)
Out
com
e of
PA
R-Q
and
adv
ice
give
nIn
form
ed c
onse
nt in
form
atio
n
Life
styl
e an
d fa
ctor
s th
at m
ay a
ffect
pos
ture
and
!tn
ess
Wor
kH
ome
and
fam
ilyD
iet
and
habi
ts (a
lcoh
ol, s
mok
ing,
etc
)A
ctiv
ity le
vels
41
Clie
nt p
ro!l
e an
d go
al s
ettin
g
Lear
ner’s
nam
e:
D
ate:
Clie
nt’s
per
sona
l det
ails
Age
Gen
der
Hei
ght
Wei
ght
Oth
er
Med
ical
scr
eeni
ng (P
AR-
Q) o
utco
mes
(inc
lude
a c
opy
of P
AR-
Q a
nd in
form
ed c
onse
nt d
ocum
ents
)
Out
com
e of
PA
R-Q
and
adv
ice
give
nIn
form
ed c
onse
nt in
form
atio
n
Life
styl
e an
d fa
ctor
s th
at m
ay a
ffect
pos
ture
and
!tn
ess
Wor
kH
ome
and
fam
ilyD
iet
and
habi
ts (a
lcoh
ol, s
mok
ing,
etc
)A
ctiv
ity le
vels
42CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Clie
nt p
ro!l
e an
d go
al s
ettin
g (c
ontin
ued)
Post
ural
ass
essm
ent
note
s an
d sc
reen
ing
(incl
ude
a co
py o
f pos
tura
l ass
essm
ent
reco
rds)
Ass
essm
ent
Obj
ectiv
e –
targ
etEx
erci
se fo
cus
exam
ples
Hea
d an
d ce
rvic
al s
pine
Shou
lder
s, s
capu
lar a
nd
thor
acic
spi
ne
Pelv
is a
nd lu
mba
r spi
ne
Knee
s, fe
et a
nd a
nkle
s
43CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Read
ines
s to
par
ticip
ate
in P
ilate
s an
d re
ason
s fo
r pa
rtic
ipat
ion,
incl
udin
g m
otiv
atio
n an
d at
titud
e
Clie
nt’s
goa
ls (p
roce
ss o
r ou
tcom
e) –
SM
ART
, to
incl
ude:
sho
rt t
erm
(4 w
eeks
) med
ium
ter
m (8
–12
wee
ks) a
nd lo
ng t
erm
(6 m
onth
s+),
eg, w
hat i
mpr
ovem
ents
/ch
ange
s w
ould
the
clie
nt li
ke to
see
/dis
cuss
how
pro
gres
s lin
ks to
goa
ls
Bar
riers
to
achi
evin
g go
als
Stra
tegi
es t
o ov
erco
me
barr
iers
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
Clie
nt p
ro!l
e an
d go
al s
ettin
g (c
ontin
ued)
Post
ural
ass
essm
ent
note
s an
d sc
reen
ing
(incl
ude
a co
py o
f pos
tura
l ass
essm
ent
reco
rds)
Ass
essm
ent
Obj
ectiv
e –
targ
etEx
erci
se fo
cus
exam
ples
Hea
d an
d ce
rvic
al s
pine
Shou
lder
s, s
capu
lar a
nd
thor
acic
spi
ne
Pelv
is a
nd lu
mba
r spi
ne
Knee
s, fe
et a
nd a
nkle
s
44CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Prog
ress
ive
prog
ram
me
– pr
epar
atio
n ph
ase
This
pro
gres
sive
pro
gram
me
is d
esig
ned
to p
rogr
ess
on fr
om w
eek
four
(for
det
ails
of w
eeks
one
to fo
ur, s
ee th
e de
taile
d se
ssio
n pl
ans)
.
Lear
ner’s
nam
e:
D
ate:
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
45CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
46CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Prog
ress
ive
prog
ram
me
– m
ain
phas
e
This
pro
gres
sive
pro
gram
me
is d
esig
ned
to p
rogr
ess
on fr
om w
eek
four
(for
det
ails
of w
eeks
one
to fo
ur, s
ee th
e de
taile
d se
ssio
n pl
ans)
.
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
47CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
48CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Prog
ress
ive
prog
ram
me
– cl
osin
g ph
ase
This
pro
gres
sive
pro
gram
me
is d
esig
ned
to p
rogr
ess
on fr
om w
eek
four
(for
det
ails
of w
eeks
one
to fo
ur, s
ee th
e de
taile
d se
ssio
n pl
ans)
.
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
49CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Prog
ress
ion
Wee
k 8
(out
line)
Wee
k 12
(out
line)
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
50CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Client pro!le, progressive programme and viva checklist
Learner’s name:
Assessor’s name:
The learner requires a " in every box to pass. Questioning can be used and should be indicated by Q and then " or R, depending on the outcome.
Client pro!le The learner produced a client pro!le that:demonstrated methods of consultation, to include:
OutcomePass = "Refer = R
the client’s personal details
informed content
the client’s lifestyle and factors that may affect posture and !tness
a postural assessment and screening
past and present physical activity
The learner demonstrated understanding of the client pro!le in the viva
Client’s goal settingThe learner:explained the importance of a Pilates teacher working together with clients to agree goals, objectives, programme and adaptations, to include:
OutcomePass = "Refer = R
the client’s readiness to participate in Pilates (to change/improve posture)
the client’s attitude and motivation to exercise
the client’s goals (process or outcome goals) SMART, short, medium and
barriers to achieving goals
strategies to overcome barriers
The learner demonstrated understanding of client goal setting in the viva
51CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
progressive programmeThe learner produced a progressive programme that:
OutcomePass = "Refer = R
contained four detailed session plans relating to the !rst four weeks
contained an outline of logical progressions for week 8
contained an outline of logical progressions for week 12
clearly related to the client’s current readiness, motivation and physical capabilities
progressed appropriately for the client’s needs and barriers (physically and psychologically)
Listed appropriate preparation exercises and progressions and included
Listed appropriate main section exercise and progression and included:
and:
and:
The learner demonstrated understanding of the progressive programme in the viva
52CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
evaluationThe learner:
OutcomePass = "Refer = R
evaluated the Pilates programme
explained how to review the Pilates programme
The learner demonstrated understanding of evaluation in the viva
Assessor’s feedback:
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
Client pro!le, progressive programme and viva checklist (continued)
53
Progressive programme evaluation
To be completed after the four implemented sessions
Learner’s name: Date:
After my sessions, I received the following feedback from the client:
My session met the client’s needs in the following ways: (comment on the effectiveness of your exercises, relationship with the client, how you motivated the client and how well your instruction style matched the client’s needs)
With the information gathered from your client and your own evaluation of the progressive programme, explain how you will review your Pilates programme.
54CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Progressive programme evaluation (continued)
Assessor’s comments:
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
55CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Session overview – planning
Learner’s name: Venue: Date:
Name of quali!ed !rst aid personnel:
Location of telephone: Duration of session:
Session aim:
Session objectives – to achieve this aim, I will:
Anticipated !tness level: Anticipated skill level:
Checks made to participant (please tick):
1. Appropriate clothing 2. No accessories (jewellery, etc)
3. Injuries (if YES, list considerations below) 4. Postural screening (list issue below)
State any speci!c considerations relating to participant needs (eg, injuries/posture)
56CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Organisation of equipment:
Equipment requirements are: List checks made regarding equipment:
Arrangements for equipment made with:
Describe the health and safety checks made to the following:
Environment:
Fire exits:
Temperature/ventilation:
Water availability:
Floor:
Obstacles:
Other:
PAR-Q and informed consent form received for each participant: YES/NO
Why is it important to have the above for each participant?
Session overview (continued)
57CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Justify the reasons for the instances when you would temporarily defer a participant?
Have any participants been deferred? YES/NO
How and when would you refer a participant to another professional?
Have any participants been referred? YES/NO
Explain factors (based on the information in this session overview) that affect safe exercise participation OR give an example of how client screening may affect safe exercise participation.
Explain how you would inform participants of the purpose and value of cool-down activities and how you would justify why suf!cient time is required in the closing phase of the session.
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
58CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Sess
ion
plan
– P
ilate
sLe
arne
r’s n
ame:
Dat
e:
W
eek
No:
Prep
arat
ion
phas
e
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
59CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
Prep
arat
ion
phas
e (c
ontin
ued)
60CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Sess
ion
plan
– P
ilate
s
Mai
n ph
ase
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
61CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
Mai
n ph
ase
(con
tinue
d)
62CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Sess
ion
plan
– P
ilate
s
Clo
sing
pha
se
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
63CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Exer
cise
nam
e
and
repe
titio
nsPu
rpos
eTe
achi
ng p
oint
s Vi
sual
isat
ions
/im
ager
y Re
gres
sion
(e
asie
r)Pr
ogre
ssio
n (h
arde
r) A
dapt
atio
n (a
ltern
ativ
e ex
erci
se
or p
ositi
on c
hang
e)
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
Clo
sing
pha
se (c
ontin
ued)
64CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Planning checklist Level 3 Diploma in Teaching Pilates
Learner’s name:
Assessor’s name:
The learner requires a " in every box to pass. Questioning can be used and should be indicated by Q and then " or R, depending on the outcome
The learner produced a session overview that: OutcomePass = "Refer = R
explained the health and safety precautions that must be checked prior to a Pilates session
explained when it may be necessary to adapt planned exercises to meet clients’ needs
justi!ed the reasons for temporary deferral
explained how and when Pilates teachers should refer participants to other professionals
explained the factors, based on client screening, that affect safe exercise participation
justi!ed why suf!cient time must be allowed for the closing phase of the session
explained how they would inform participants of the purpose and
The learner produced a session plan to instruct a Pilates teaching session that:
OutcomePass = "Refer = R
Included:
– instruction of Pilates principles – alignment– breathing – core engagement – mobility and "owing movement– posture and precision – balance
65CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
The learner produced a session plan to instruct a Pilates teaching session that:
OutcomePass = "Refer = R
Included:
– instruction of Pilates principles Start positions (at least four they can feature in other sections of the plan)
– prone lying and/or kneeling– side lying and/or kneeling– supine lying and/or kneeling– seated
and:
– scapular stability
– trunk stability – spine mobility – shoulder and hip mobility– strength
and any three of the actions listed:
– "exion/extension
– rotation– circumduction– lateral "exion
– instruction of Pilates principles – stretching – mobility – relaxation
Included appropriate progressions, regressions and adaptations to accommodate different needs
completed after the session
Assessor’s feedback:
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
66CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Session evaluation and re"ection
Learner’s name: Date:
Review the outcomes of the Pilates session
After my Pilates teaching session, I gave the following feedback and positive reinforcement to the participants:
After my Pilates teaching session, I received the following feedback from the participants:
Explain the importance of giving feedback to the clients.
Explain how to deal with negative feedback.
67CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Evaluating the Pilates session
Identify how well the exercises met participants’ needs, how effective and motivational the relationship with the participants was and how well the instructing style matched the participants’ needs.
Exercises
Relationship (effectiveness/motivational)
Instructing style
Identify how to improve personal practice.
Explain the value of re"ective practice.
Explain why the environment must be left in a condition suitable for future use.
68CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Assessor’s feedback:
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
Session evaluation and re"ection (continued)
69
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t Le
vel 3
Dip
lom
a in
Tea
chin
g Pi
late
sLe
arne
r’s n
ame:
Dat
e:
Prep
arin
g –
the
lear
ner
requ
ires
a "
in e
very
box
to
pass
. Que
stio
ning
can
be
used
on
the
prep
arin
g cr
iteria
and
sho
uld
be in
dica
ted
by Q
and
the
n "
or R
, de
pend
ing
on t
he o
utco
me.
Prep
arin
g to
tea
chin
g a
Pila
tes
sess
ion
– th
e le
arne
r:O
utco
me
P1. p
repa
red
the
envi
ronm
ent a
nd ra
nge
of re
sour
ces
requ
ired
to d
eliv
er a
Pila
tes
teac
hing
ses
sion
Resu
lt fo
r pr
epar
ing
Pass
/Ref
er
Teac
hing
– t
he le
arne
r re
quire
s a
" in
eve
ry b
ox t
o pa
ss. Q
uest
ioni
ng is
not
per
mitt
ed o
n th
e te
achi
ng c
riter
ia
Teac
hing
– t
he le
arne
r:
Prep
arat
ion
phas
eM
ain
sect
ion
Clo
sing
ph
ase
Out
com
e
T1. e
xpla
ined
the
conc
epts
and
vita
l ele
men
ts o
f the
prin
cipl
es o
f Pila
tes
with
in e
ach
exer
cise
of t
he
Pila
tes
met
hod
T2. e
xpla
ined
and
dem
onst
rate
d th
e br
eath
ing
enga
gem
ent c
once
pt
T3. e
xpla
ined
and
dem
onst
rate
d th
e te
chni
ques
of P
ilate
s w
ithin
eac
h ex
erci
se o
f the
Pila
tes
met
hod
T4. e
xpla
ined
and
dem
onst
rate
d ho
w to
ada
pt P
ilate
s ex
erci
ses
for d
iffer
ent c
lient
s/pa
rtic
ipan
ts in
the
clas
s
T5. e
xpla
ined
and
dem
onst
rate
d he
alth
and
saf
ety
prec
autio
ns w
hen
perfo
rmin
g Pi
late
s m
ovem
ents
T6. d
emon
stra
ted
how
to in
stru
ct a
Pila
tes
teac
hing
ses
sion
(in
rela
tion
to th
e de
tail
requ
ired
for e
ach
phas
e of
the
sess
ion
– se
e ov
erle
af)
T7. d
emon
stra
ted
appr
opria
te m
etho
ds o
f voi
ce p
roje
ctio
n
T8. e
xpla
ined
the
impo
rtan
ce o
f cor
rect
ing
tech
niqu
e
Resu
lt fo
r te
achi
ngPa
ss/R
efer
70CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
71
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t Le
vel 3
Dip
lom
a in
Tea
chin
g Pi
late
sPr
epar
atio
n ph
ase
Mai
n se
ctio
nC
losi
ng p
hase
To in
clud
e:
regr
essi
ons
and
adap
tatio
ns to
acc
omm
odat
e di
ffere
nt n
eeds
mon
itorin
g cl
ient
’s pe
rform
ance
To in
clud
e:
can
feat
ure
in a
ny o
f the
sec
tions
, not
just
the
mai
n ph
ase)
sta
ndin
g (b
oth
feet
, sin
gle
foot
) s
eate
d (c
rook
, sta
ff/le
gs s
trai
ght,
tailo
r/cr
oss
legg
ed,
stra
ddle
) k
neel
ing
(but
tock
s on
hee
ls o
r but
tock
s lif
ted)
pro
ne ly
ing
("at
and
ele
vate
d on
elb
ows)
sid
e ly
ing
and
knee
ling
on
all f
ours
sup
ine
lyin
g (c
rook
, cor
pse
and
tabl
etop
) s
upin
e pl
ank
(wei
ght b
etw
een
hand
s an
d fe
et)
Incl
ude
all o
bjec
tives
/pur
pose
s lis
ted
belo
w:
Incl
ude
thre
e of
the
actio
ns li
sted
bel
ow (p
leas
e tic
k):
"ex
ion/
exte
nsio
n r
otat
ion
circ
umdu
ctio
n l
ater
al "
exio
n
incl
usio
n of
app
ropr
iate
pro
gres
sion
s, re
gres
sion
s an
d ad
apta
tions
to a
ccom
mod
ate
diffe
rent
nee
ds
To in
clud
e:
regr
essi
ons
and
adap
tatio
ns to
acc
omm
odat
e di
ffere
nt n
eeds
mon
itorin
g cl
ient
’s pe
rform
ance
72CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t (c
ontin
ued)
Leve
l 3 D
iplo
ma
in T
each
ing
Pila
tes
Eval
uatin
g an
d en
ding
the
ses
sion
– t
he le
arne
r re
quire
s a
" in
eve
ry b
ox t
o pa
ss. Q
uest
ioni
ng c
an b
e us
ed o
n th
e ev
alua
ting,
end
ing
a se
ssio
n an
d ga
inin
g fe
edba
ck
crite
ria E
3 to
E9
(ON
LY) a
nd s
houl
d be
indi
cate
d by
Q a
nd t
hen
" or
R, d
epen
ding
on
the
outc
ome.
Prep
arin
g to
tea
chin
g a
Pila
tes
sess
ion
– th
e le
arne
r:O
utco
me
E1. p
rovi
ded
clie
nts/
part
icip
ants
with
feed
back
and
pos
itive
rein
forc
emen
t at t
he e
nd o
f the
ses
sion
E2. e
xpla
ined
the
info
rmat
ion
requ
ired
for f
utur
e se
ssio
ns
E3. r
evie
wed
the
outc
omes
of t
he P
ilate
s se
ssio
n
E4. i
dent
i!ed
how
wel
l the
exe
rcis
es m
et p
artic
ipan
ts’ n
eeds
, how
effe
ctiv
e an
d m
otiv
atio
nal t
he re
latio
nshi
p w
ith th
e pa
rtic
ipan
ts w
as a
nd h
ow w
ell
the
inst
ruct
ing
styl
e m
atch
ed th
e pa
rtic
ipan
ts’ n
eeds
E5. i
dent
i!ed
how
to im
prov
e pe
rson
al p
ract
ice
E6. e
xpla
ined
the
valu
e of
re"e
ctiv
e pr
actic
e
E7. e
xpla
ined
the
impo
rtan
ce o
f giv
ing
feed
back
to c
lient
s
E8. e
xpla
ined
how
to d
eal w
ith n
egat
ive
feed
back
E9. j
usti!
ed w
hy th
e en
viro
nmen
t mus
t be
left
in a
con
ditio
n su
itabl
e fo
r fut
ure
use
Eval
uatin
g an
d en
ding
a s
essi
on re
sult
Pass
/Ref
er
73
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t (c
ontin
ued)
Leve
l 3 D
iplo
ma
in T
each
ing
Pila
tes
Eval
uatin
g an
d en
ding
the
ses
sion
– t
he le
arne
r re
quire
s a
" in
eve
ry b
ox t
o pa
ss. Q
uest
ioni
ng c
an b
e us
ed o
n th
e ev
alua
ting,
end
ing
a se
ssio
n an
d ga
inin
g fe
edba
ck
crite
ria E
3 to
E9
(ON
LY) a
nd s
houl
d be
indi
cate
d by
Q a
nd t
hen
" or
R, d
epen
ding
on
the
outc
ome.
Prep
arin
g to
tea
chin
g a
Pila
tes
sess
ion
– th
e le
arne
r:O
utco
me
E1. p
rovi
ded
clie
nts/
part
icip
ants
with
feed
back
and
pos
itive
rein
forc
emen
t at t
he e
nd o
f the
ses
sion
E2. e
xpla
ined
the
info
rmat
ion
requ
ired
for f
utur
e se
ssio
ns
E3. r
evie
wed
the
outc
omes
of t
he P
ilate
s se
ssio
n
E4. i
dent
i!ed
how
wel
l the
exe
rcis
es m
et p
artic
ipan
ts’ n
eeds
, how
effe
ctiv
e an
d m
otiv
atio
nal t
he re
latio
nshi
p w
ith th
e pa
rtic
ipan
ts w
as a
nd h
ow w
ell
the
inst
ruct
ing
styl
e m
atch
ed th
e pa
rtic
ipan
ts’ n
eeds
E5. i
dent
i!ed
how
to im
prov
e pe
rson
al p
ract
ice
E6. e
xpla
ined
the
valu
e of
re"e
ctiv
e pr
actic
e
E7. e
xpla
ined
the
impo
rtan
ce o
f giv
ing
feed
back
to c
lient
s
E8. e
xpla
ined
how
to d
eal w
ith n
egat
ive
feed
back
E9. j
usti!
ed w
hy th
e en
viro
nmen
t mus
t be
left
in a
con
ditio
n su
itabl
e fo
r fut
ure
use
Eval
uatin
g an
d en
ding
a s
essi
on re
sult
Pass
/Ref
er
74CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t (c
ontin
ued)
Leve
l 3 D
iplo
ma
in T
each
ing
Pila
tes
Ass
esso
r’s c
omm
ent/
actio
n pl
an (i
f all
elem
ents
are
a ‘P
ass’
, the
n no
act
ion
plan
is re
quire
d).
Prep
arin
g
Teac
hing
Eval
uatin
g, e
ndin
g a
sess
ion
and
gain
ing
feed
back
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
75
Obs
erva
tion
of p
ract
ical
tea
chin
g –
chec
klis
t (c
ontin
ued)
Leve
l 3 D
iplo
ma
in T
each
ing
Pila
tes
Ass
esso
r’s c
omm
ent/
actio
n pl
an (i
f all
elem
ents
are
a ‘P
ass’
, the
n no
act
ion
plan
is re
quire
d).
Prep
arin
g
Teac
hing
Eval
uatin
g, e
ndin
g a
sess
ion
and
gain
ing
feed
back
Lear
ner’s
sig
natu
re:
D
ate:
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
76CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Assessor’s feedback
Learner’s name: Date:
Criterion number Feedback
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
77
Assessor question and response sheet
Learner’s name:
Assessor’s name:
Assessor’s question Learner’s response
Learner’s signature: Date:
Assessor’s signature: Date:
Internal quality assurer’s signature: Date:
78CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Sum
mar
y of
ach
ieve
men
t C
YQ L
evel
3 D
iplo
ma
in P
ilate
s
Lear
ner’s
nam
e:
D
ate:
Cen
tre
nam
e:
Ass
esso
r’s n
ame:
IQA’
s na
me:
Ass
essm
ent
elem
ent
Ass
essm
ent
outc
ome
Ass
esso
r’s
sign
atur
e
and
date
Act
ion
plan
for
achi
evem
ent
and
evid
ence
pro
duce
d fo
r ex
empt
ion
Reas
sess
men
t ou
tcom
eA
sses
sor’s
si
gnat
ure
and
date
Ass
esso
r’s
sign
-off
IQA
’s s
igna
ture
(if
sam
pled
)EQ
A’s
si
gnat
ure
(if
sam
pled
)
1.Th
eory
pap
er:
Ana
tom
y an
d ph
ysio
logy
for
exer
cise
and
he
alth
Pass
%
Refe
r
Exem
ptio
n
2. W
orks
heet
: H
ealth
, saf
ety
and
wel
fare
in
a !
tnes
s en
viro
nmen
t
Pass
Refe
r
Exem
ptio
n
3.Th
eory
pap
er:
Prin
cipl
es o
f ex
erci
se a
nd
heal
th
Pass
%
Refe
r
%
Exem
ptio
n
79CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0© YMCA Qualifications 2012
Ass
essm
ent
elem
ent
Ass
essm
ent
outc
ome
Ass
esso
r’s
sign
atur
e
and
date
Act
ion
plan
for
achi
evem
ent
and
evid
ence
pro
duce
d fo
r ex
empt
ion
Reas
sess
men
t ou
tcom
eA
sses
sor’s
si
gnat
ure
and
date
Ass
esso
r’s
sign
-off
IQA
’s s
igna
ture
(if
sam
pled
)EQ
A’s
si
gnat
ure
(if
sam
pled
)
4. W
orks
heet
: Kn
ow h
ow to
su
ppor
t cl
ient
s w
ho ta
ke p
art
in e
xerc
ise
and
phys
ical
act
ivity
Pass
Refe
r
Exem
ptio
n
5. W
orks
heet
s:
of P
ilate
s
exer
cise
s,
adap
tatio
ns
and
mod
i!ca
tions
Pass
Refe
r
Exem
ptio
n
6. C
lient
pro
!le,
pr
ogre
ssiv
e pr
ogra
mm
e an
d vi
va
Pass
Refe
r
Exem
ptio
n
7. P
lann
ing
Pass
Refe
r
Exem
ptio
n
80CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
Lear
ner
auth
entic
ity s
tate
men
t:I c
on!r
m th
at th
e ev
iden
ce p
rovi
ded
for t
his
qual
i!ca
tion
is e
ntire
ly m
y ow
n w
ork.
Lea
rner
’s si
gnat
ure:
Dat
e:
Ass
esso
r’s s
ign-
off s
tate
men
tI c
on!r
m th
at I
am s
atis
!ed
that
the
lear
ner n
amed
abo
ve h
as p
rovi
ded
evid
ence
that
is v
alid
, aut
hent
ic, r
elia
ble,
cur
rent
and
suf
!cie
nt to
dem
onst
rate
the
requ
ired
know
ledg
e, u
nder
stan
ding
and
/or s
kills
for t
he u
nits
sig
ned
off h
ere.
Ass
esso
r’s s
igna
ture
:
Dat
e:
Inte
rnal
qua
lity
assu
rer’s
sig
natu
re:
D
ate:
Sum
mar
y of
ach
ieve
men
t (c
ontin
ued)
Ass
essm
ent
elem
ent
Ass
essm
ent
outc
ome
Ass
esso
r’s
sign
atur
e
and
date
Act
ion
plan
for
achi
evem
ent
and
evid
ence
pro
duce
d fo
r ex
empt
ion
Reas
sess
men
t ou
tcom
eA
sses
sor’s
si
gnat
ure
and
date
Ass
esso
r’s
sign
-off
IQA
’s s
igna
ture
(if
sam
pled
)EQ
A’s
si
gnat
ure
(if
sam
pled
)
8. S
umm
ativ
e ob
serv
atio
n of
pra
ctic
al
teac
hing
Pass
Refe
r
Exem
ptio
n
9. E
valu
atio
nPa
ss
Refe
r
Exem
ptio
n
82CYQ Level 3 Diploma in Teaching Pilates (600/4015/4) | Learner Assessment Record | Version 1.0
© YMCA Qualifications 2012
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