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University of Georgia
School of Social Work
SOWK 7055 Concentration Final Field Evaluation
FACE SHEET
Student Name:______Check One: ____Fall ____Year
Field Instructor:______Spring ____Year
Field Site:______Clinical____CEPD
Placement hours completed at time of evaluation:______
Please check all methods of evaluation used to evaluate your student’s progress:
____Direct observation
____Review of all written work
____Weekly supervision
____Feedback from task supervisors or other staff
____Feedback from other community/agency personnel
____Taped interviews/meetings
____Role-play situations in supervision
____Other:______
Grade: Please assign a letter grade that reflects the student’s performance in field placement.
You may choose to give + or – with the letter grade (e.g., A-, B+, B-, C+, C-)
The student’s recommended grade for field placement this semester is:______
Field Instructor Signature:______Date:______
Faculty Liaison’s Signature (when providing social work supervision):______
I have read this evaluation and have discussed it with my Field Instructor.
I have attached an addendum to this evaluation: ____No ____Yes
Student’s Signature:______Date:______
Field Instructor Evaluation of
Advanced Clinical Practice Competencies
Name of Student ______Date ______
Name of Field Instructor______Agency ______
Instructions for Field Instructor Evaluation
The Council on Social Work Education (CSWE) identifies 10 Practice Competencies (#2.1.1 through 2.1.10) for all MSW graduates of accredited schools of social work. In the table below each competency you will find a list ofpractice behaviors that demonstrate mastery of the broader competency. Please rate the student’s ability to perform each of the practice behaviors using the following scale. Indicate your response by circling only one number to the right of each practice behavior. A rating of 3 is equivalent to adequate competency for a beginning MSW practitioner.
1=Very Low Level of Competence
2=Low Level of Competence
3=Adequate Level of Competence
4=High Level of Competence
5=Very High Level of Competence
NA = Not applicable; no opportunity to demonstrate practice behavior
2.1.1Identify as a professional social worker and conducts oneself
accordingly
A / Identify opportunities for clinical social work involvement in the enhancement and maintenance of psychosocial functioning / 1 / 2 / 3 / 4 / 5 / NAB / Maintain professional boundaries, roles, and demeanor in clinical social work practice settings / 1 / 2 / 3 / 4 / 5 / NA
C / Utilize professional resources, i.e. supervision, self-reflection, and self developed learning plans to improve professional clinical social work practice / 1 / 2 / 3 / 4 / 5 / NA
Comments:
2.1.2 Apply social work ethical principles to guide professional practice
A / Apply ethical decision-making principles and frameworks to issues specific to clinical social work practice / 1 / 2 / 3 / 4 / 5 / NAComments:
2.1.3Apply critical thinking to inform and communicate professional judgments
A / Apply problem-solving techniques based on informed discernment within clinical social work practice / 1 / 2 / 3 / 4 / 5 / NAB / Communicate effectively with a variety of stakeholders, i.e. diverse clientele and multi-disciplinary colleagues / 1 / 2 / 3 / 4 / 5 / NA
Comments:
2.1.4 Engage diversity and difference in practice
A / Identify and apply appropriate clinical social work models with diverse client populations for engagement, assessment, intervention, and evaluation / 1 / 2 / 3 / 4 / 5 / NAComments:
2.1.5 Advance human rights and social and economic justice
A / Advocate on behalf of people to secure basic human rights, including the availability and accessibility of psychosocial services / 1 / 2 / 3 / 4 / 5 / NAB / Educate and empower people to advocate on their own behalf for their basic human rights, including the availability and accessibility of psychosocial services / 1 / 2 / 3 / 4 / 5 / NA
Comments:
2.1.6 Engage in research-informed practice and practice-informed research
A / Identify, select, and evaluate strategies for maintaining and enhancing psychosocial functioning / 1 / 2 / 3 / 4 / 5 / NAB / Work collaboratively with agency personnel or faculty member to assess and improve intervention effectiveness. / 1 / 2 / 3 / 4 / 5 / NA
Comments:
2.1.7 Apply knowledge of human behavior and the social environment
A / Relate theories, models, and evidence-based knowledge to the maintenance and enhancement of people’s psychosocial functioning / 1 / 2 / 3 / 4 / 5 / NAComments:
2.1.8 Engage in policy practice to advance social and economic well-being and to deliver
social work services
A / Apply policy practice skills, including education and advocacy to work with clients / 1 / 2 / 3 / 4 / 5 / NAComments:
2.1.9 Respond to contexts that shape practice
A / Adapt clinical social work practices in response to contextual events and advances in knowledge / 1 / 2 / 3 / 4 / 5 / NAComments:
2.1.10 Engage, assess, intervene, and evaluate with individuals, families, groups,
organizations, and communities
EngagementA / Utilize interpersonal and contracting skills to engage members of diverse groups in interventions aimed toward increased psychosocial functioning / 1 / 2 / 3 / 4 / 5 / NA
Assessment
B / Conduct a comprehensive biopsychosocial assessment of a client in the context of the clinical practice environment / 1 / 2 / 3 / 4 / 5 / NA
C / Use empathy and sensitive interviewing skills to facilitate clients’ identification of their strengths and problems / 1 / 2 / 3 / 4 / 5 / NA
D / Employ the DSM-IV-TR and/or another appropriate assessment protocol to accurately assess psychosocial needs and/or diagnose psychopathology / 1 / 2 / 3 / 4 / 5 / NA
E / Create an appropriate and mutually agreed upon treatment plan aimed at improving psychosocial needs identified through assessment / 1 / 2 / 3 / 4 / 5 / NA
Intervention
F / Select and apply strategies aimed toward effective prevention of psychosocial dysfunction adapting them for relevance to target populations / 1 / 2 / 3 / 4 / 5 / NA
G / Select and apply effective clinical social work interventions to improve clients’ psychosocial functioning / 1 / 2 / 3 / 4 / 5 / NA
Evaluation
H / Apply research skills to the evaluation of psychosocial interventions / 1 / 2 / 3 / 4 / 5 / NA
I / Communicate and disseminate evaluation results appropriate to the intended stakeholders / 1 / 2 / 3 / 4 / 5 / NA
Comments: