University of Nebraska Kearney

Communication Disorders Evaluation of Student Practicum Competencies

Student: _________________________________ Client Name: (First name, last initial) _____________________________ Total clock hrs. with supervisor: _____________ Average for this Rating:________ Grade:______

Semester/Year: ___________ Clinical Instructor: _____________________________ Practicum Level: __________ Date of Rating:___________

1. General Requirements: The ratings in these areas are computed with the overall average for the term.

   			U			S
   	–5	–4	–3	–2	–1
   1. Observed clinical rules as stated in the CLINIC HANDBOOK
   2. Missed no clinicians' meetings
   3. Prepared for and attended supervisory conferences
   4. Met deadlines for submission of lesson plans
   5. Met deadlines for submission of initial and end of semester reports
   6. Met deadlines for returning clinic materials
   7. Maintained accurate logs of clinical contact (exact time of contact)
   8. First therapy session was conducted by deadline
   9. Sessions canceled by clinician were made-up
   10. Conducted end of semester conference with supervisor present
   11. Clarified final conference agenda with supervisor prior to conference

2. Interacting with Clients

   	0	1	2	3	4	5	6	7	8	9
   1. Sensitive and responsive to client reactions, developing good rapport
   2. Set limits quickly and skillfully, in a non-threatening, non-rejecting way
   3. Appeared confident and at ease in the clinical situation
   4. Focused effectively on the needs of the client
   5. Used time to elicit the maximum number of responses from client
   6. Structured session to work toward therapy goals
   7. Made goals clear to the client
   8. Effectively motivated client when appropriate

3. Report Writing (diagnostic and/or therapeutic)

   	0	1	2	3	4	5	6	7	8	9
   1. Integrated clinical data to clearly summarize client status
   2. Adhered to established guidelines for professional writing
   3. Proofread reports to correct errors
   4. Included clear goals and objectives in initial report
   5. End of semester report reflected work accomplished
   6. Summarized parent conference
   7. Developed appropriate recommendations
   8. Described activities clearly in lesson plans
   9. Documented daily and weekly results
   10. Stated recipients of copies

4. Treatment Process

   	0	1	2	3	4	5	6	7	8	9
   1. Demonstrated understanding of applicable theory
   2. Determined appropriate type and level of therapy
   3. Carried out probes/baselines appropriately
   4. Predicted pace and amount of work to be accomplished
   5. Defined goals in terms of specific behavioral objectives
   6. Developed lesson plans with realistic objectives
   7. Modified procedures for following sessions based on effectiveness
   8. Utilized suggestions for modifying goals or techniques
   9. Took initiative to discuss unclear procedures
   10. Became adept with materials and equipment prior to therapy
   11. Resourceful in obtaining appropriate materials
   12. Devised or adapted techniques creatively to fit specific needs of client
   13. Maintained accurate treatment records
   14. Evaluated responses correctly
   15. Demonstrated flexibility within sessions to modify tasks as needed
   16. Used modeling, specific feedback, and guidance as needed
   17. Used reinforcers effectively, including both type and schedule
   18. Encouraged client to self-evaluate when appropriate

5. Professional Qualities

   	0	1	2	3	4	5	6	7	8	9
   1. Completed assignments thoroughly and on time
   2. Notified others promptly of any schedule changes
   3. Displayed an enthusiastic, positive, concerned attitude
   4. Kept personal issues from interfering with clinical responsibilities
   5. Took initiative to maintain mutually helpful communication with colleagues
   6. Accepted supervisory evaluation in an open, non- defensive manner
   7. Acted constructively to improve own clinical performance
   8. Developed self-evaluation skills
   9. Practiced punctuality with clinical sessions and clinic meetings
   10. Followed ethical guidelines, especially relating to confidentiality
   11. Followed universal precautions