Student Name:
Field Agency:
Agency Supervisor's Name:
Describe differences between the learning contract and the actual assignment:
Please check whether the student was involved in these activities in the agency setting:
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Work with community agencies |
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Data gathering related to policy analysis/formulation |
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Identifying gaps or obstacles in meeting needs |
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Collaborative work with agency staff as a team member |
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Developing a new program or procedure |
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Direct service delivery to individuals |
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Case presentations and/or public speaking |
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Observation/work with formed group |
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Work with family as a group (two or more members of the family) |
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Observe/participate in agency administration |
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Direct service to rural populations |
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Work with diverse client population |
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Participate in writing research proposal, grant request |
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Attending inter-agency conferences, workshops |
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Attending inter-agency conferences, workshops |
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Other (Please specify):
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Students are expected to demonstrate readiness for professional employment. Please rate the student for the following categories:
| Rating Scale: |
| 1. |
Poor |
| 2. |
Fair |
| 3. |
Average |
| 4. |
Above Average |
| 5. |
Outstanding |
| N/A. |
Not Applicable |
PRACTICE SKILLS
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1.0 |
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Demonstrates the ability to assess clients needs using different sources of information including nonverbal data, client's support system and agency contacts, |
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1.1 |
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Recognize and help clients utilize the social work process of assessment, intervention, planning, goal setting and termination based on the problem definition. |
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1.2 |
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Keep goal planning within the constraints of the agency's function |
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1.3 |
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Identify various groups and the purpose for the groups |
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1.4 |
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Demonstrates skills in case management |
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1.5 |
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Appropriately uses the roles of broker, mediator, enabler, and advocate in carrying out her/his part of the plan. |
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1.6 |
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Determine when to terminate intervention. |
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1.7 |
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Gains cooperation from relevant agencies to meet clients needs. |
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1.8 |
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Ability to address client's problem/functioning level, starting where client is, responding to what clients sees as needs. |
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1.9 |
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Establishes, maintains and manages an effective helping relationship |
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1.10 |
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Demonstrates ability to understand concept of confidentiality and apply it appropriately in practice. |
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1.11 |
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Demonstrate the ability to accept in non-judgmental manner those of different life style, economic, or cultural/racial background. |
COMMUNICATION SKILLS
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2.0 |
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Communicates clearly and directly with clients/client system. |
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2.1 |
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Communicates clearly with staff and others. |
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2.2 |
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Recognizes and responds appropriately to clients verbal and non-verbal communication |
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2.3 |
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Uses effective verbal and non-verbal communication. |
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2.4 |
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Demonstrates active listening. |
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2.5 |
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Demonstrates ability to record with clarity, promptness and in good standard English, client narratives, reports and agency paperwork. |
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2.6 |
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Has the ability to make clear presentation to groups. |
SUPERVISION
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3.0 |
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Develops a balance of dependence and independence in relationship with supervisors. |
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3.1 |
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Has the ability to accept supervision from the Agency Supervisor. |
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3.2 |
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Appropriate use of supervision throughout Field Placement. |
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3.3 |
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Has the ability to work as a team member with other professionals. |
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3.4 |
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Demonstrates ability to be self-critical and identified areas where improvement is needed. |
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3.5 |
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Seeks and responds non-defensively to feedback and reflects upon the information. |
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3.6 |
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Participates actively in and utilizes learning from supervisory conferences. |
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3.7 |
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Demonstrates ability to evaluate progress towards the goals of the learning contract and initiates appropriate adjustment or activities designed to achieve those goals. |
PROFESSIONAL PERFORMANCE
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4.1 |
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Demonstrates behaviors that reflect awareness of ethical standards accepted in the profession. |
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4.2 |
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Shows flexibility in adapting to changes in programs, policies, etc. |
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4.3 |
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Shows ability to work within agency guidelines. |
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4.4 |
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Can distinguish the role and activities of social workers from other professionals and seeks to work cooperatively with them. |
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4.5 |
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Is able to risk self in unfamiliar situations. |
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4.6 |
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Works cooperatively with professional and non-professional staff. |
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4.7 |
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Is able to distinguish between personal values, and professional attitudes and their affect on her/his practice behavior, |
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4.8 |
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Regular attendance and demonstration of punctuality. |
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4.9 |
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Takes responsibility and completes paperwork in a timely manner. |
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4.10 |
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Work load is realistically planned and priorities are set for good use of time. |
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4.11 |
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Acts professionally and responsibly in matters of appearance and presentation of self. |
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4.12 |
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Willing to do assigned work. |
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4.13 |
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Seeks out new learning experiences and additional responsibilities |
KNOWLEDGE OF THE AGENCY AND COMMUNITY
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5.0 |
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Understands that each agency has structure and gives services as defined by its policies. |
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5.1 |
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Has the ability to interpret the function of her/his agency to others in the community. |
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5.2 |
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Demonstrates an understanding of local agencies, their functions and services as they pertain to the needs of agency clients. |
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5.3 |
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Has the ability to use community resources and the referral process where appropriate. |
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5.4 |
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Can critically examine agency, recognize necessary limitations and work for change when appropriate. |
Please respond, in narrative form to the following questions:
A. Assess the students' growth, looking as his/her strengths. Please identify these areas.
B. Assess the student's growth, looking at his/her limitations. Please identify these areas.