The Catholic University of America
National Catholic School of Social Service, Office of Field Education
STUDENT FIELD EVALUATION: Advanced Year Clinical/Clinical Health/Clinical Military
Date: FALL:______SPRING: ______Student ID # :______
Student Name: ______Field Liaison/Seminar Instructor: ______
Field Instructor, Degree & Title:______
Agency/Program: ______
Instructions:
Submit TWO copies of the Field Evaluation and Log of Hours to your seminar instructor/liaison
GENERAL EXPLANATION OF EVALUATION FORM
This form evaluates the student’s mastery of the practice behaviors in the 10 Core Competencies established by the Council on Social Work Education (CSWE). At the end of the semester, student current progress and performance in the field placement should be reviewed by the student and field instructor. The Evaluation Form should be discussed, signed, and dated by field instructor and student, and submitted to the Seminar Instructor. The student receives a grade each semester for the 3-credit Field Instruction/Integrative Seminar. The final grade is based on Field Instruction (60%) and Seminar work (40%). Grade assignment is in accordance with the University grading system found in the CUA Student Handbook. Students must receive a grade of ‘C’ or above in Seminar and in Field in order to progress to the next semester of Field Instruction. The Seminar Instructor assigns a grade for the semester, based on seminar performance and performance in field, as evaluated by field instructor. The field evaluation makes up 60% of the grade for the course (a minimum grade of ‘C’ or above on field evaluation is equivalent to an average score of ‘3’ on field evaluation).
Note:
If a student receives ratings of No in any of the 4 Essential Professional Behaviors a Student Review will be convened. If there are 5 or more scores of 1 in Practice Behaviors, a Student Review will be convened.
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Essential Professional Behaviors
Students are expected to behave professionally in their field placements. Four Essential Professional Behaviors have been identified. Please rate and discuss with your student whether they are exhibiting all of these behaviors:
Essential Professional Behaviors / Yes(Fall) / No
(Fall) / Yes
(Spring) / No
(Spring)
1. Student reports to field on time.
2. Student attends field regularly.
3. Student is receptive and open to feedback from field instructor.
4. Student handles absences and/or unavoidable lateness responsibly.
TEN AREAS OF COMPETENCE
Please rate the student’s level of skill for each practice behavior based on the following scale:
1 = This skill has not yet emerged
2 = This skill is emerging and is demonstrated at a low and inconsistent level
3 = This skill is achieved at a consistent and acceptable level
4 = This skill is performed at an advanced level
5 = This skill is exceptional
NA = Not applicable to internship experience.
IE = Too little experience up to this point to be able to assign any rating
I. Identify as a PROFESSIONAL SOCIAL WORKER and conduct oneself accordingly.
Practice Behaviors / FALL / SPRINGSocial workers demonstrate professional use of self across all practice settings.
Develop, manage, and maintain therapeutic relationships with clients within the person-in-environment and strengths perspectives.
II. Apply social work ETHICAL PRINCIPLES to guide professional practice.
Practice Behaviors / FALL / SPRINGSocial workers recognize and manage personal biases in practice settings.
Social workers recognize and negotiatethe complexities that can arise whenorganizational policies/procedures interact with competingprofessional standards forethical social workpractice.
Social workers apply ethical principles through the use of an ethical decision making model that helps in the resolution of an ethical dilemma.
III. Apply CRITICAL THINKING to inform and communicate professional judgments.
Practice Behaviors / FALL / SPRINGSocial workers engage in reflective practice.
Social workers evaluate the strengths and weaknesses of multiple theoretical perspectives and differentially apply them to client situations.
IV. Engage DIVERSITY AND DIFFERENCE in practice.
Practice Behaviors / FALL / SPRINGSocial workers use their self-awareness to understand the influence of their personal biases and values in working with others.
Social workers practice within the context of difference in shaping the life experiences of clients, themselves, and the working alliance.
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V. Advance HUMAN RIGHTS AND SOCIAL AND ECONOMIC JUSTICE.
Social workers practice with the understanding that societal structures and values may oppress, marginalize, and alienate, or create, enhance, and privilege different cultural groups within a society.
Social workers advocate at multiple levels for the human rights of marginalized populations.
VI. Engage in RESEARCH-INFORMED PRACTICE and PRACTICE-INFORMED RESEARCH.
Practice Behaviors / FALL / SPRINGSocial workers critically evaluate and utilize theoretical models and empirical research methods for the purpose of informing and evaluating social work practice and programs.
VII. Apply KNOWLEDGE OF HUMAN BEHAVIOR and the social environment.
Practice Behaviors / FALL / SPRINGSocial workers differentially apply theories of human behavior that address the bio-psycho-social-spiritual nature of clients and the social environment to guide social work practice.
VIII. Engage in POLICY PRACTICE to advance social and economic well-being and to deliver effective social work services.
Practice Behaviors / FALL / SPRINGAdvocate with and inform administrators and legislators to influence policies that affect clients and services.
IX. Respond to CONTEXTS THAT SHAPE PRACTICE.
Practice Behaviors / FALL / SPRINGSocial workers assess the current political, economic, social, and cultural climate as it affects the most vulnerable members of society.
Social workers intervene through advocacy to serve the most vulnerable persons within the political, economic, social, and cultural contexts.
X. ENGAGE, ASSESS, INTERVENE, AND EVALUATE individuals, families, groups, organizations, and communities.
Practice Behaviors / FALL / SPRINGEngagement
Use empathy, active listening, and other clinical skills to establish rapport in order to set treatment goals with clients.
Develop culturally responsive therapeutic relationships.
Attend to the interpersonal dynamics and contextual factors that both strengthen and potentially threaten the therapeutic alliance.
Assessment
Use multi-dimensional assessment tools that include bio-psycho-social-spiritual data to assess client’s strengths, capacities, and readiness for change.
Use differential diagnostic processes.
Intervention FALL SPRING
Develop, with clients, an intervention plan that incorporates client strengths, capacities, and protective factors.
Use culturally appropriate clinical techniques for a range of presenting concerns identified in the assessment.
Adapt appropriate intervention strategies based on continuous clinical assessment.
Evaluation
Critically analyze, monitor, and evaluate interventions and program implementation and outcomes.
Revise intervention and program implementation plans based on ongoing process and outcome evaluation.
To be completed by field instructor:
FALL SEMESTER NARRATIVE (Feel free to attach page)
I. Briefly describe the most clearly demonstrated areas of strength and demonstrated areas of ability and development this semester.
II. Briefly describe areas where student should focus on for continued growth and development. Specifically discuss any areas of concern.
III. Fall semester only: Please describe areas of focus in the 2nd semester.
Please check one of the following:
o Intern is functioning well above midyear expectations of competence for interns.
o Intern is functioning above the midyear expectations of competence for interns.
o Intern is functioning at the midyear expectations of competence for interns.
o Intern is functioning below the midyear expectations of competence for interns.
Grade for fall semester (Pass/Fail): ______
______
Field instructor signature Date
______
Student’s Signature Date Agree w/Evaluation: q *Disagree: q
*In the event that student does not agree with any aspect of this evaluation, he/she may append a statement describing specific disagreements and reasons for them.
To be completed by field instructor:
SPRING SEMESTER NARRATIVE (Feel free to attach page)
I. Briefly describe the most clearly demonstrated areas of strength and demonstrated areas of ability and development this semester.
II. Briefly describe areas where student should focus on for continued growth and development. Specifically discuss any areas of concern.
FINAL OVERALL EVALUATION:
Please check one of the following at the end of the spring semester:
o Intern has excelled in field placement by performing well above expectations.
o Intern has exceeded field placement performance expectations.
o Intern has met field placement expectations.
o Intern has demonstrated significant problems in performance in key areas of the foundation year placement.
Grade for spring semester (Pass/Fail): ______
______
Field instructor signature Date
______
Student’s Signature Date Agree w/Evaluation: q *Disagree: q
*In the event that student does not agree with any aspect of this evaluation, he/she may append a statement describing specific disagreements and reasons for them.
Rev. 9/2/2014
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