Dissertation Proposal Evaluation Form

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1. Student’s Name: (Required.)

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2. Chair's Name:

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3. Faculty Member’s Name: (Required.)

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4. Faculty Member’s Role: (Required.)

Chair

Committee

Reader

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5. Date of Proposal Hearing:

Date:

Date

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6. Date IRB Approved Study: (for Chair only)

Date:

Date

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7. Date of CITI Certification: (for Chair only)

Date:

Date

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8. Date Proposal Approval Expires (four years from today): (for Chair only)

Date:

Date

Instructions: All members of the dissertation committee (chair, committee members, and readers)
should complete this survey by the end of the proposal hearing.

NOTE: Ratings of “3” represent a student who is performing as would be expected and is on target.
Ratings of “4” or above should be reserved for a student who is doing better than expectable or is
excelling, while ratings below “3” indicate a need for concern.

QUALITY OF DOCUMENT

Question Title

9. The proposal conveys a clear picture of the problem to be studied. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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10. The proposal conveys the history of related conceptual and theoretical ideas in the literature review. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

11. The proposal conveys the history of research findings in the literature review. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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12. The proposal conveys the student’s understanding of the integration between psychodynamic theory and research. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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13. The proposal demonstrates the student’s ability to summarize theoretical and research perspectives related to the question under study (Required.)

0 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

14. The proposal demonstrates the student’s ability to convey research methodology. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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15. The proposal demonstrates the student’s ability to convey sampling (subject/participant recruitment) strategies. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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16. The proposal demonstrates the student’s understanding of threats to the study’s validity (Required.)

0 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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17. The proposal is a well written, coherent summary of the problem, question or hypothesis and methodology. (Required.)

1 (fails)

3 (meets)

5 (Exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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18. The proposal meets the Institute’s writing and style standards for the dissertation. (Required.)

0 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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19. Total Score for Quality of Document: (Required.)

QUALITY OF ORAL PRESENTATION

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20. The student demonstrates the ability to verbally convey essential features of the study (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

21. The student demonstrates the ability to specifically convey the problem being studied. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

22. The student demonstrates the ability to specifically convey the question or hypothesis being studied. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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23. The student demonstrates the ability to locate the problem/question/hypothesis and value of the research in the literature. (Required.)

0 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

24. The student’s verbal presentation, in conjunction with the written proposal, leads to a meaningful discussion with the committee. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

25. The student responds openly and thoughtfully to the committee’s questions and feedback. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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26. Total Score for Quality of Oral Presentation: (Required.)

ETHICAL CONSIDERATIONS

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27. The student demonstrates the ability to identify potential risks to human subjects. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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28. The student demonstrates the ability to convey the scope of study and risks to participants in the Consent Forms. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

29. The student demonstrates the ability to construct an acceptable IRB application. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

30. The student demonstrates a general respect for and awareness of human subjects. (Required.)

1 (fails)

3 (meets)

5 (exceeds)

Clear

i We adjusted the number you entered based on the slider’s scale.

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31. Total Score for Ethical Considerations: (Required.)

ADDITIONAL COMMENTS AND OVERALL SCORE

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32. Note any problems in learning that need to be addressed prior to final approval of the dissertation. Comment:

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33. Overall Score (subtotal of all scored domains above): (Required.)

Score Interpretation:
Below 60 = significant practicum concerns exist and should be reported to the Practicum Chair
60 – 80 = meeting expectations, on target, progressing as expected
Above 80 = exceptional, beyond expectations

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34. Decision (Required.)

Pass

Conditional Pass

Fail

Dissertation Proposal Evaluation Form

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* 1. Student’s Name: (Required.)

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* 2. Chair's Name:

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* 3. Faculty Member’s Name: (Required.)

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* 4. Faculty Member’s Role: (Required.)

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* 5. Date of Proposal Hearing:

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* 6. Date IRB Approved Study: (for Chair only)

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* 7. Date of CITI Certification: (for Chair only)

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* 8. Date Proposal Approval Expires (four years from today): (for Chair only)

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* 9. The proposal conveys a clear picture of the problem to be studied. (Required.)

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* 10. The proposal conveys the history of related conceptual and theoretical ideas in the literature review. (Required.)

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* 11. The proposal conveys the history of research findings in the literature review. (Required.)

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* 12. The proposal conveys the student’s understanding of the integration between psychodynamic theory and research. (Required.)

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* 13. The proposal demonstrates the student’s ability to summarize theoretical and research perspectives related to the question under study (Required.)

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* 14. The proposal demonstrates the student’s ability to convey research methodology. (Required.)

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* 15. The proposal demonstrates the student’s ability to convey sampling (subject/participant recruitment) strategies. (Required.)

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* 16. The proposal demonstrates the student’s understanding of threats to the study’s validity (Required.)

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* 17. The proposal is a well written, coherent summary of the problem, question or hypothesis and methodology. (Required.)

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* 18. The proposal meets the Institute’s writing and style standards for the dissertation. (Required.)

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* 19. Total Score for Quality of Document: (Required.)

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* 20. The student demonstrates the ability to verbally convey essential features of the study (Required.)

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* 21. The student demonstrates the ability to specifically convey the problem being studied. (Required.)

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* 22. The student demonstrates the ability to specifically convey the question or hypothesis being studied. (Required.)

Question Title

* 23. The student demonstrates the ability to locate the problem/question/hypothesis and value of the research in the literature. (Required.)

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* 24. The student’s verbal presentation, in conjunction with the written proposal, leads to a meaningful discussion with the committee. (Required.)

Question Title

* 25. The student responds openly and thoughtfully to the committee’s questions and feedback. (Required.)

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* 26. Total Score for Quality of Oral Presentation: (Required.)

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* 27. The student demonstrates the ability to identify potential risks to human subjects. (Required.)

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* 28. The student demonstrates the ability to convey the scope of study and risks to participants in the Consent Forms. (Required.)

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* 29. The student demonstrates the ability to construct an acceptable IRB application. (Required.)

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* 30. The student demonstrates a general respect for and awareness of human subjects. (Required.)

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* 31. Total Score for Ethical Considerations: (Required.)

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* 32. Note any problems in learning that need to be addressed prior to final approval of the dissertation. Comment:

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* 33. Overall Score (subtotal of all scored domains above): (Required.)

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* 34. Decision (Required.)

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* 35. Recommendations for Passing Student:

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* 36. Recommendations for Conditional Passing Student:

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* 37. If Conditional Pass, what are the conditions? (to be filled out by chair only)

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* 38. Recommendations for Failing Student:

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* 39. Faculty Electronic Signature (please type out your name): (Required.)

1. Student’s Name: (Required.)

2. Chair's Name:

3. Faculty Member’s Name: (Required.)

4. Faculty Member’s Role: (Required.)

5. Date of Proposal Hearing:

6. Date IRB Approved Study: (for Chair only)

7. Date of CITI Certification: (for Chair only)

8. Date Proposal Approval Expires (four years from today): (for Chair only)

9. The proposal conveys a clear picture of the problem to be studied. (Required.)

10. The proposal conveys the history of related conceptual and theoretical ideas in the literature review. (Required.)

11. The proposal conveys the history of research findings in the literature review. (Required.)

12. The proposal conveys the student’s understanding of the integration between psychodynamic theory and research. (Required.)

13. The proposal demonstrates the student’s ability to summarize theoretical and research perspectives related to the question under study (Required.)

14. The proposal demonstrates the student’s ability to convey research methodology. (Required.)

15. The proposal demonstrates the student’s ability to convey sampling (subject/participant recruitment) strategies. (Required.)

16. The proposal demonstrates the student’s understanding of threats to the study’s validity (Required.)

17. The proposal is a well written, coherent summary of the problem, question or hypothesis and methodology. (Required.)

18. The proposal meets the Institute’s writing and style standards for the dissertation. (Required.)

19. Total Score for Quality of Document: (Required.)

20. The student demonstrates the ability to verbally convey essential features of the study (Required.)

21. The student demonstrates the ability to specifically convey the problem being studied. (Required.)

22. The student demonstrates the ability to specifically convey the question or hypothesis being studied. (Required.)

23. The student demonstrates the ability to locate the problem/question/hypothesis and value of the research in the literature. (Required.)

24. The student’s verbal presentation, in conjunction with the written proposal, leads to a meaningful discussion with the committee. (Required.)

25. The student responds openly and thoughtfully to the committee’s questions and feedback. (Required.)

26. Total Score for Quality of Oral Presentation: (Required.)

27. The student demonstrates the ability to identify potential risks to human subjects. (Required.)

28. The student demonstrates the ability to convey the scope of study and risks to participants in the Consent Forms. (Required.)

29. The student demonstrates the ability to construct an acceptable IRB application. (Required.)

30. The student demonstrates a general respect for and awareness of human subjects. (Required.)

31. Total Score for Ethical Considerations: (Required.)

32. Note any problems in learning that need to be addressed prior to final approval of the dissertation. Comment:

33. Overall Score (subtotal of all scored domains above): (Required.)

34. Decision (Required.)

35. Recommendations for Passing Student:

36. Recommendations for Conditional Passing Student:

37. If Conditional Pass, what are the conditions? (to be filled out by chair only)

38. Recommendations for Failing Student:

39. Faculty Electronic Signature (please type out your name): (Required.)