Bethel College - SWK472 Senior Practicum Instruction Evaluation

Senior Practicum Instruction Evaluation

Thank you for completing this evaluation of your field student!

The Midterm evaluation should be completed following 200 hours of the placement. The Final evaluation should be completed when nearing 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)

Midterm

Final

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* 2. Student's Name

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* 3. Practicum Instructor

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* 4. Agency

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* 5. 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

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* 6. 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	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 N/A	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 1 - Unacceptable	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 2	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 3	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 4	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 5 - Exceptional
Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication N/A	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication 1 - Unacceptable	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication 2	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication 3	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication 4	Demonstrates professional demeanor in behavior; appearance; and oral, written, and electronic communication 5 - Exceptional
Uses technology ethically and appropriately to facilitate practice outcomes	Uses technology ethically and appropriately to facilitate practice outcomes N/A	Uses technology ethically and appropriately to facilitate practice outcomes 1 - Unacceptable	Uses technology ethically and appropriately to facilitate practice outcomes 2	Uses technology ethically and appropriately to facilitate practice outcomes 3	Uses technology ethically and appropriately to facilitate practice outcomes 4	Uses technology ethically and appropriately to facilitate practice outcomes 5 - Exceptional
Uses supervision and consultation to guide professional judgment and behavior	Uses supervision and consultation to guide professional judgment and behavior N/A	Uses supervision and consultation to guide professional judgment and behavior 1 - Unacceptable	Uses supervision and consultation to guide professional judgment and behavior 2	Uses supervision and consultation to guide professional judgment and behavior 3	Uses supervision and consultation to guide professional judgment and behavior 4	Uses supervision and consultation to guide professional judgment and behavior 5 - Exceptional

Other comments

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* 7. Competency 2: Advance Human Rights and Social, Racial, Economic, and Environmental Justice

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Advocates for human rights at the individual, family, group, organizational, and community system levels	Advocates for human rights at the individual, family, group, organizational, and community system levels N/A	Advocates for human rights at the individual, family, group, organizational, and community system levels 1 - Unacceptable	Advocates for human rights at the individual, family, group, organizational, and community system levels 2	Advocates for human rights at the individual, family, group, organizational, and community system levels 3	Advocates for human rights at the individual, family, group, organizational, and community system levels 4	Advocates for human rights at the individual, family, group, organizational, and community system levels 5 - Exceptional
Engages in practices that advance human rights to promote social, racial, economic, and environmental justice	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice N/A	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice 1 - Unacceptable	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice 2	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice 3	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice 4	Engages in practices that advance human rights to promote social, racial, economic, and environmental justice 5 - Exceptional

Other comments

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* 8. Competency 3: Engage Anti-Racism, Diversity, Equity, and Inclusion (ADEI) in Practice

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels N/A	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels 1 - Unacceptable	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels 2	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels 3	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels 4	Demonstrates anti-racist and anti-oppressive social work practice at the individual, family, group, organizational, community, research, and policy levels 5 - Exceptional
Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences.	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. N/A	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. 1 - Unacceptable	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. 2	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. 3	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. 4	Demonstrates cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the influence of bias, power, privilege, and values in working with clients and constituencies, acknowledging them as experts of their own lived experiences. 5 - Exceptional

Other comments

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

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Applies research findings to inform and improve practice, policy, and programs	Applies research findings to inform and improve practice, policy, and programs N/A	Applies research findings to inform and improve practice, policy, and programs 1 - Unacceptable	Applies research findings to inform and improve practice, policy, and programs 2	Applies research findings to inform and improve practice, policy, and programs 3	Applies research findings to inform and improve practice, policy, and programs 4	Applies research findings to inform and improve practice, policy, and programs 5 - Exceptional
Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work.	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. N/A	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. 1 - Unacceptable	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. 2	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. 3	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. 4	Identifies ethical, culturally informed, anti-racist, and anti-oppressive strategies that address inherent biases for use in quantitative and qualitative research methods to advance the purposes of social work. 5 - Exceptional

Other comments

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* 10. Competency 5: Engage in Policy Practice

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services N/A	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services 1 - Unacceptable	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services 2	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services 3	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services 4	Uses social justice, anti-racist, and anti-oppressive lenses to assess how social welfare policies affect the delivery of and access to social services 5 - Exceptional
Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice.	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. N/A	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. 1 - Unacceptable	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. 2	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. 3	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. 4	Applies critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice. 5 - Exceptional

Other comments

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* 11. 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 person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies.	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. N/A	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. 1 - Unacceptable	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. 2	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. 3	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. 4	Applies knowledge of human behavior and person-in-environment, and other interprofessional conceptual frameworks to engage with clients and constituencies. 5 - Exceptional
Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies.	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. N/A	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. 1 - Unacceptable	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. 2	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. 3	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. 4	Uses empathy, reflection, and interpersonal skills to engage in culturally responsive practice with clients and constituencies. 5 - Exceptional

Other comments

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

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies.	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. N/A	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. 1 - Unacceptable	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. 2	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. 3	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. 4	Applies theories of human behavior and person-in-environment, as well as other culturally responsive and interprofessional conceptual frameworks, when assessing clients and constituencies. 5 - Exceptional
Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan.	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. N/A	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. 1 - Unacceptable	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. 2	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. 3	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. 4	Demonstrates respect for client self-determination during the assessment process by collaborating with clients and constituencies in developing a mutually agreed-upon plan. 5 - Exceptional

Other comments

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

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals.	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. N/A	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. 1 - Unacceptable	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. 2	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. 3	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. 4	Engages with clients and constituencies to critically choose and implement culturally responsive, evidence-informed interventions to achieve client and constituency goals. 5 - Exceptional
Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies.	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. N/A	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. 1 - Unacceptable	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. 2	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. 3	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. 4	Incorporates culturally responsive methods to negotiate, mediate, and advocate with and on behalf of clients and constituencies. 5 - Exceptional

Other comments

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

	N/A	1 - Unacceptable	2	3	4	5 - Exceptional
Selects and uses culturally responsive methods for evaluation of outcomes.	Selects and uses culturally responsive methods for evaluation of outcomes. N/A	Selects and uses culturally responsive methods for evaluation of outcomes. 1 - Unacceptable	Selects and uses culturally responsive methods for evaluation of outcomes. 2	Selects and uses culturally responsive methods for evaluation of outcomes. 3	Selects and uses culturally responsive methods for evaluation of outcomes. 4	Selects and uses culturally responsive methods for evaluation of outcomes. 5 - Exceptional
Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities.	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. N/A	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. 1 - Unacceptable	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. 2	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. 3	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. 4	Critically analyzes outcomes and apply evaluation findings to improve practice effectiveness with individuals, families, groups, organizations and communities. 5 - Exceptional

Other comments

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

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* 16. Practicum Instructor/Supervisor Signature: (Please type name to indicate your signature. Field Liaison will confirm with you that you have completed this evaluation.)

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* 17. Date of signature:

Date / Time

Date