FIELD INSTRUCTOR EVALUATION OF STUDENTRATING SCALE
Internship Placement Program
Michigan Department of Human Services
Ratings are distinct for each semester; they are not cumulative. Under each competency, specific practice behaviors are listed, along with specific measures for evaluating student performance.
This form may be personalized with comments after each section. If any intern within a section has been rated Minimally Competent or Not Competent a specific comment must be included regarding that item in the area provided. In addition, strengths, achievements and initiatives shown by the student in the performance of his/her assignments and work contact should be noted in the comment sections or narrative summary.
The Rating Scale is:
- Fully Competent: The student demonstrates both knowledge and ability which completely meets and/or exceeds the criteria set for the practice behavior.
- Mostly Competent: The student demonstrates both knowledge and ability which meets a majority of the basic expectations for the practice behavior.
- Moderately Competent: The student demonstrates both knowledge and ability which meets the basic expectations for the practice behavior.
- Minimally Competent: The student requires intensive redirection. The student demonstrates effort but has difficulty in achieving required expectations for the practice behavior.
- Not Competent: The student is unable to perform even minimal tasks and does not demonstrate an understanding of the theoretical base of materials.
- Not Applicable: Student has little or no opportunity to engage in task.
DHS-1308 (2-13) MS Word1
FIELD INSTRUCTOR EVALUATION OF STUDENTRATING SCALE
Internship Placement Program
Michigan Department of Human Services
Student Name / Student ID NumberCollege/University / Degree Program
Field Placement Site / Field Instructor Name
Evaluation Period / Year / Total Hours
Mid-Term Final
5-Fully Competent, 4-Mostly Competent, 3-Moderately Competent, 2-Minimally Competent, 1-Not Competent, N/A-Not Applicable
Competency / 1 / 2 / 3 / 4 / 5 / N/A
Competency 1 – Identify as a professional social worker and conduct oneself accordingly
Displays appropriate behavior with staff and clients – professional demeanor
Demonstrates the importance of appearance and appropriateness in dress
Demonstrates effective communication
Utilizes professional supervision and consultation
Maintains client confidentiality, professional roles and boundaries
Demonstrates ability to access services for clients
Is punctual and adheres to agree upon attendance schedule
Recognizes the need to manage personal values and opinions in order to assist clients or client systems
Comments
Competency 2 – Apply social work ethical principles to guide professional practice
Read and demonstrates an understanding of the NASW Code of Professional Values and Ethics
Recognizes the importance of considering ethical behavior in decision making by applying the NASW Code to clients and systems
Displays ability to distinguish differences among self-reflection, self-monitoring, and self-correction
Comments
Competency / 1 / 2 / 3 / 4 / 5 / N/A
Competency 3 – Apply critical thinking to inform and communication professional judgments
Demonstrates purposeful oral and written communication in working with clients and systems
Displays the ability to organize information in an appropriate format
Identifies and distinguishes different assessment tools
Demonstrates awareness of the importance of using different sources of information
Demonstrates familiarity and how research-based knowledge affects the client or target population
Demonstrates effective oral and writing skills when working with different populations
Comments
Competency 4 – Engage diversity and difference in practice
Communicates the importance of difference in shaping life experiences
Utilizes diversity sensitive interviewing skills
Recognizes and describes the extent to which a particular group’s values and structures may oppress, marginalize, alienate, or enhance the privilege and power of clients and systems
Demonstrates awareness of the importance of knowing personal biases and values related to different groups
Recognizes the importance of fostering a respect for diversity
Demonstrates awareness of appropriate life experiences to share with clients, groups and other individuals
Views and utilizes staff as helpful sources of information
Comments
Competency 5 – Advance human rights and social and economic justice
Describes the forms and mechanisms of oppression and discrimination related to the clients and systems of the agency
Distinguishes the difference between oppress-sion and discrimination
Differentiates case and cause advocacy regarding human rights and social and economic justice
Comments
Competency 6 – Engage in research-informed practice and practice-informed research
Uses research evidence to inform practice
Recognizes why research evidence is used
Acknowledges how research affects the tasks performed at the agency
Recognizes the need for ongoing and existing or evidence-based research and evidence related to the field
Recognizes the importance of practice experience
Comments
Competency 7 – Apply knowledge of human behavior and the social environment
Demonstrates an understanding of major social work theoretical frameworks
Articulates the connection between develop-mental stages and appropriate intervention
Demonstrates familiarity with the processes of assessment, intervention, and evaluation
Recognizes the importance of understanding others in their own environment
Demonstrates familiarity with how to gain information about others in their own environment
Comments
Competency 8 – Engage in policy practice to advance social and economic well-being and to deliver effective social work services
Demonstrates an understanding of social policies
Identifies how particular policies influence practice
Identifies the role of practice in policy development
Acknowledges ways to advocate for effective policy change
Comments
Competency 9 – Respond to contexts that shape practice
Identify organization change that impacts clients and systems
Recognizes the need to make changes to service delivery to provide effective services (i.e. different location, different population, etc.)
Recognizes the role of social workers in providing leadership to support effective changes
Demonstrates awareness of the profession’s history and commitment to improving the lives of those served or their communities
Comments
Competency 10 – Engage with individuals, families, groups, organizations, and communities
Recognize and distinguish between verbal and non-verbal communication as expressed by clients, colleagues, etc.
Recognizes the role he/she plays with clients/groups/organizations/communities
Acknowledges that all participants enter the agency at different stages with different needs
Recognizes and employs the appropriate uses of empathy
Acknowledges why work goals and desired outcomes are created and used during field work
Recognizes and understands methods for collecting, organizing, and interpreting client data from a variety of sources
Recognizes and employs the different types of intervention strategies
Identifies the special engagement needs of diverse clients across systems and the life span
Assesses strengths and challenges of clients and systems in working toward case conceptualization
Develop mutually agreed-upon client and system goals
Identifies major social work interventions to help clients and systems solve problems
Initiates culturally sensitive and developmentally appropriate actions to achieve client/system goals
Considers prevention strategies as an integral part of the intervention process
Assesses personal and professional strengths and challenges
Remains open to self-reflection and feedback
Comments
Additional Competencies
Comments
Would the DHS Field Instructor recommend the intern for a position with the Department of Human Services?
Yes No (If no, why not?)
Additional Feedback
I have reviewed the above evaluation and acknowledge receipt:
Student Signature / Date
Field Instructor Signature / Date
Field Liaison Signature / Date
Recommended Grade (based on college/university grading scale, i.e. 4.0 scale, Pass/Fail or letter grade)
Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area.
DHS-1308 (2-13) MS Word1