Senior Placement Field Experience

The Midterm evaluation should be completed following approx. 180 hours of the placement. The Final evaluation should be completed following approx. 400 hours of the placement.  

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* 1. Please indicate if this evaluation is for the Midterm (180 hours) or the Final (400 hours)

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* 2. Student's Name

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* 3. Field Instructor

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* 4. Agency 

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* 5. Time Span of Placement

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* 7. What is the current school year?

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* 8. Student's Work Assignments: Please refer to the Learning Contract and indicate which work assignments have been completed, are in process, or are being revised.

For the Performance Objective questions below, please rate the student in the following areas:
N/A = If item was not addressed
1 = Unacceptable performance
2 = Below level of expectation for student near completion of social work study
3 = At level of expectation for student near completion of social work study
4 = Above level of expectation for student near completion of social work study
5 = Exceptional level of ability for student near completion of social work study
* S = Skills, V = Values, K = Knowledge, C/A = Cognitive/Affective Processes
*For administrative purposes only

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* 9. Competency 1: Demonstrate Ethical and Professional Behavior

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Makes ethical decisions by applying the standards of the NASW Code of Ethics, relevant laws and regulations, models for ethical decision-making, ethical conduct of research, and additional codes of ethics as appropriate to context (C/A, K)*
Uses reflection and self-regulation to manage personal values and maintain professionalism in practice situations (V, C/A)*
Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication (S,V)*
Uses technology ethically and appropriately to facilitate practice outcomes (S)*
Uses supervision and consultation to guide professional judgment and behavior (C/A, V)*

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* 10. Competency 2: Engage Diversity and Difference in Practice 

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Applies and communicates understanding of the importance of diversity and differing in shaping life experiences in practice at the micro, mezzo, and macro levels *(S, C/A, V, K)
Presents themselves as learners and engage clients and constituencies as experts of their own experiences *(C/A, V)
Applies self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituencies *(C/A, V)

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* 11. Competency 3: Advance Human Rights and Social, Economic, and Environmental Justice

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Applies their understanding of social, economic, and environmental justice to advocate for human rights at the individual and system levels *(K, S, V)
Engages in practices that advance social, economic, and environmental justice *(K,S,V. C/A)

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* 12. Competency 4: Engage in Practice-informed Research and Research-informed Practice

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Uses practice experience and theory to inform scientific inquiry and research *(S,K)
Applies critical thinking to engage in analysis of quantitative and qualitative research methods and research findings *(C/A, S)
Uses and translates research evidence to inform and improve practice, policy, and service delivery *(C/A, K, S, V)

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* 13. Competency 5: Engage in Policy Practice

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Identifies social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services *(K, S, C/A)
Assesses how social welfare and economic policies impact the delivery of and access to social services *(C/A)
Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice *(C/A, S, V)

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* 14. Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Applies knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks to engage with clients and constituencies *(C/A, S)
Uses empathy, reflection, and interpersonal skills to effectively engage diverse clients and constituencies *(C/A, S, V, K)

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* 15. Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Collects and organizes data, and apply critical thinking to interpret information from clients and constituencies *(S, K)
Applies knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the analysis of assessment data from clients and constituencies *(C/A, S)
Develops mutually agreed-on intervention goals and objectives based on the critical assessment of strengths, needs, and challenges within clients and constituencies *(S,K)
Selects appropriate intervention strategies based on the assessment, research knowledge, and values and preferences of clients and constituencies *(C/A, S, K, V)

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* 16. Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Critically chooses and implements interventions to achieve practice goals and enhance capacities of clients and constituencies *(C/A)
Applies knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies *(C/A, S)
Uses inter-professional collaboration as appropriate to achieve beneficial practice outcomes *(S,C/A)
Negotiates, mediates, and advocates with and on behalf of diverse clients and constituencies *(S,V, K)
Facilitates effective transitions and endings that advance mutually agreed-on goals *(S,C/A)

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* 17. Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities

  N/A 1 - Unacceptable 2 3 4 5 - Exceptional
Selects and uses appropriate methods for evaluation of outcomes *(S, C/A)
Applies knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the evaluation of outcomes *(S, C/A, V)
Critically analyze, monitor, and evaluate intervention and program processes and outcomes *(C/A, S)
Applies evaluation findings to improve practice effectiveness at the micro, mezzo, and macro levels *(C/A, S, K)

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* 18. SUMMARY: Student's Strengths and Areas for Growth. Please include fieldwork instructor's assessment of student's readiness for beginning level of professional social work practice. 

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* 19. Student Signature: (Please type name to indicate signature)

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* 20. Date of signature:

Date / Time

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* 21. Field Instructor/Supervisor Signature: (Please type name to indicate your signature)

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* 22. Date of signature:

Date / Time

T