FIELD INSTRUCTION EVALUATION FORMS

Social Work Program

STUDENT’S FINAL EVALUATION OF AGENCY/FIELD PRACTICUM

Date______

Your opinions regarding your agency placement are important to us. In order to ensure that your educational needs are being met satisfactorily we have developed a list of questions asking for opinion about your placement. All information is completely confidential.

Student’s Name:______

Agency: ______

Name of Field Instructor: ______

Please respond to the following questions for the current semester: (check one)

Please Indicate:______SOWK 399 (Spring Semester – Junior)

______SOWK 490 (Fall Semester – Senior)

______SOWK 499 (Spring Semester – Senior)

AGENCY/FIELD PRACTICUM

  1. Was the overall attitude of the agency supportive of student training?

______very good______satisfactory______unsatisfactory

  1. Were the agency’s facilities (space, supplies, clerical support, etc.) adequate to allow you to carry out your responsibilities:

______very good______satisfactory______unsatisfactory

  1. Did the agency provide a useful orientation which included safety procedures for practice?

______yes______no

  1. Did your assignments call for a level of skill appropriate to your development?

______yes______no

  1. Did your experiences at the agency contribute positively to your identity as a social worker?

______yes______no

If “no”, please explain______

______

  1. Did you have a full range of social work practice assignments, i.e., individual, family, group, macro project(s)?

______yes______no

If “no”, please circle the experiences you did not have:

IndividualFamilyGroupMacro Project(s)

  1. Did your field placement provide assignments and experiences which allowed you to practice and apply concepts, principles and techniques learned in the classroom?

______yes______no

If “no”, please explain______

______

  1. Did you have opportunities to work with clients of diverse, racial, ethnic and cultural backgrounds?

______yes______no

  1. What did your supervisor do to help you to learn about yourself in regard to how you work with people?

______

______

  1. What opportunities did you have to participate in staff meetings and conferences?

______

______

______

  1. Did you have the opportunity to learn about the network of community social services?

______

______

______

  1. How would you rate the agency as a field instruction placement?

Excellent______Good______Fair______Poor______

  1. What else would you want a fellow student to know about this agency as a field placement site? Use additional paper if necessary

______

______

______

______

______

______

______

Social Work Program

STUDENT’S FINAL EVALUATION OF FIELD INSTRUCTION/FIELD INSTRUCTOR

This form is to be completed after the final semester of placement. It will not be used in any ways connected to final grading of students.

Date______

Agency______

Student’s Name______

Name of Your Field Instructor:______

Please respond to the following questions for the current semester: (check one)

Please Indicate:______SOWK 399 (Spring Semester – Junior)

______SOWK 490 (Fall Semester – Senior)

______SOWK 499 (Spring Semester – Senior)

FIELD INSTRUCTION/FIELD INSTRUCTOR

(PLEASE INCLUDE YOUR PERSONAL COMMENTS ALONG WITH THE RATING YOU CHECK)

  1. What was the quality of the working relationship with your field instructor?

______very good______satisfactory______unsatisfactory

______

______

______

  1. Did your field instructor help create an environment in which you felt you could risk questions, mistakes and disagreements?

______yes______no

If “no”, please explain______

______

  1. How well did your field instructor facilitate the learning of specific skills?

______very well ______satisfactory ______unsatisfactory

______

______

______

  1. How well did your field instructor model professional social work attitudes and values?

______very well ______satisfactory ______unsatisfactory

______

______

______

  1. Did your field instructor provide clear and consistent expectations of you during this field placement?

______yes______no

If “no”, please explain______

______

  1. Did your field instructor seem to be aware of the learning process you were going through as a developing professional?

______yes______no

If “no”, please explain______

______

  1. How well was your field instructor able to assess your strengths and limitations as the field placement progressed?

______very well______satisfactory ______unsatisfactory

______

______

______

  1. Did your field instructor give you clear and useful feedback about your practice on a regular basis?

______yes______no

If “no”, please explain______

______

  1. How well was your field instructor able to help you integrate the class and field experience?

______very well______satisfactory ______unsatisfactory

______

______

______

  1. Did your field instructor schedule and keep regular conferences with you?

______yes______no

If “no”, please explain______

______

  1. Was your field instructor available to you at times other than schedule times?

______yes______no

If “no”, please explain______

______

  1. What would you say to a fellow student who asked about having this person as a field instructor?

(Use extra sheets of paper if necessary)

______

______

______

______

Social Work Program

STUDENT’S FINAL EVALUATION OF FIELD LIAISON

This form is to be completed after the final semester of placement. It will not be used in any ways connected to final grading of students.

Date______

Agency______

Student’s Name______

Name of Your Field Instructor:______

Please respond to the following questions for the current semester: (check one)

Please Indicate:______SOWK 399 (Spring Semester – Junior)

______SOWK 490 (Fall Semester – Senior)

______SOWK 499 (Spring Semester – Senior)

FIELD SEMINAR INSTRUCTOR/LIAISON

  1. Did your liaison visit at least twice each semester?

______yes ______no

  1. Was your liaison available for extra conferences if the need arose?

_____yes ______no

  1. Did your liaison include you in conferences with your field instructor during each field visit:

______yes ______no

  1. Did your liaison make her/his expectations clear to you?

______yes ______no

If “no”, please explain______

______

  1. Did your liaison take an active role in making sure you had learning experiences at the agency which met curriculum requirements?

______yes ______no

  1. How well did your liaison create an atmosphere in which you could openly discuss all aspects of your field placement experience?

______very well ______satisfactory ______unsatisfactory

  1. How well did your liaison create an atmosphere in which you could openly discuss all aspects of your field placement experience?

______very well ______satisfactory ______unsatisfactory

Please comment:______

______

______

  1. How effective was your liaison in helping you work out whatever problems arose in relation to your field placement?

______very well ______satisfactory ______unsatisfactory

Please explain:______

______

______

  1. How useful to you as a learner were the liaison visits?

______very well ______satisfactory ______unsatisfactory

Please comment:______

______

______

  1. In what ways did field seminar aid you in integrating the themes of VSU social work program (social justice, ethics and values, diversity, human and social environment, policy, strengths, etc.)?

______

______

______

______

  1. What topics or skills covered in the seminar were of help to you in your placement?

______

______

______

______

  1. How do you view yourself now? In what ways do you see yourself differently from when you started your placement?

______

______

______

______

Social Work Program

FIELD INSTRUCTOR’S EVALUATION OF FACULTY FIELD INSTRUCTION LIAISON

Date______

Field Instructor’s Name______

Faculty Field Instruction Liaison’s Name______

Agency______

Please indicate the number of VSU students you instruct?______

  1. Did your liaison make the required number (two per semester) of visits? ______Yes ______No
  1. What do you consider an appropriate number of visits per semester? ______

PLEASE EVALUATE YOUR FIELD LIAISON USING THE SCALE PROVIDED. IN THE SPACE TO THE RIGHT OF EACH STATEMENT, INDICATE THE NUMBER FROM THE SCALE WHCH BEST REPRESENTS THE STRENGTH OF YOUR AGREEMENT OR DISAGREEMENT WITH THE STATEMENT.

1 23456 N/A

Strongly Strongly Not

Disagree Agree Applicable

  1. My liaison was available for consultation by telephone.______
  1. My liaison understood the functions and policies of my agency.______
  1. My liaison was aware of learning opportunities available for students at my agency.______
  1. My liaison shared with me the School’s expectations for students in the field.______
  1. My liaison shared with me information pertinent to the School’s curriculum ______

with the objective of helping me to teach my student.

  1. My liaison was aware of the strengths and limitations of my student and helped ______

in defining student learning needs.

  1. My liaison provided me with useful feedback on student progress based on______

review of the students’ recorded material.

  1. My liaison was effective in helping me work out problems which arose in ______

relation to my students.

  1. My liaison maintained communication with me regarding my view of the ______

student’s progress in the field placement.

  1. My liaison was flexible with regard to conference planning and would ______

include the student if that seemed appropriate.

  1. My liaison was responsive to my needs and concerns as a field instructor.______
  1. My liaison gave weights to my view of the student’s growth and learning______

needs in assigning grades.

  1. Please comment on the climate of the relationship and the quality of the

contact you have experienced with your liaison.

______

______

______

______

  1. Is the role of the faculty field liaison clear to you? ______Yes ______No

Please explain.______

______

______

______

VIRGINIASTATEUNIVERSITY

SOCIAL WORK PROGRAM

Mid-Semester Evaluation Format

Mid-semester evaluation of the student is an informal narrative process written in summary format by the Field Instructor and discussed with the student. It represents an assessment of such items as:

  • What projects and activities have been undertaken, what the envisioned outcomes are, and what is the current status
  • The impact of field learning experiences upon the student, i.e., what skills or knowledge have been acquired or changed (as referenced through identification of specific behavior).
  • What the effect of field experience had been upon the student’s value system
  • An assessment of student’s strengths and areas needing further work.
  • Planned new directions for remainder of semester (activities, skills and behaviors target for change or modification, learning experiences, etc.)
  • The expected outcomes of activities, in terms of effect on student’s skills, values, and knowledge.

In addition to the above items:

  1. A review of the Mid-Term/Final Evaluation Form may be discussed between the instructor and student, and referred to in the written mid-semester evaluation.
  1. While the mid-semester evaluation is viewed as a “check point” for progress, it also represents an opportune time for the Field Instructor and student to review, evaluate, and adjust original competencies/practice behaviors and learning activities/tasks for the remainder of the semester.

The Field Instructor, of course, may modify this format as he or she wishes, based on the particular setting, since these are general guidelines and suggested areas for discussion, and are not considered to be exhaustive for all settings.

The VSU Field Instruction Liaison will also confer with the student and Field Instructor at mid-semester so that the three parties may further refine and coordinate agency competencies, program competencies, and specific student needs. This is to ensure the best possible “fit” between classroom experience and the world of actual work with client systems.

Revised – 6/20/2011 gbt

Social Work Program

Field Evaluation Instrument

Field Evaluation Instrument – Adopted from Charles Zastrow (Feb. 2009). “An Interpretation for Incorporating EPAS 2008 into Social Work

Baccalaureate and Masters Curriculum In CSWE –Accredited Programs: Recommendations from the Field

Rating Scale for Evaluation of Field Placement Performance

MidtermFinal

Name of Intern ______Date ______

Instructions for Rating Interns on the 10 Competencies in the First Part of the Evaluation:

The standard by which an intern is to be compared is that of a new beginning-level social worker. The 10 competencies specified in this evaluation form are those established by our national accrediting organization (the Council on Social Work Education). Under each competency statement are several items that we ask that you rate according to the following criteria

5 / The intern has excelled in this area
4 / The intern is functioning above expectations for interns in this area
3 / The intern has met the expectations for interns in this area
2 / The intern has not as yet met the expectations in this area, but the gives indication s/he will do so in the near future
1 / The intern has not met the expectations in this area, and does not give indications s/he will do so in the near future
n/a / Not applicable, as the intern has not had the opportunity to demonstrate competence in this area

Comments may be made under any competency statement, if desired. Please be sure to indicate those areas in which you think the intern is particularly strong and those areas in which the student need improvement.

This evaluation is intended to give the intern feedback about her or his performance. The field instructor’s rating of these items will not directly be used to calculate the grade given to the intern. The faculty liaison has responsibility of assigning the grade for field instruction. The grade that is assigned will be based on: the faculty liaison’s overall evaluation of the student’s performance in field placement in conjunction with the field instructors evaluation and other submitted materials such as: intern logs; seminar participation; papers that integrate field with classroom instruction.

If you prefer to use another evaluation system in addition to this form to evaluate a student’s performance, please discuss this with the faculty supervisor.

Competence #1: Intern identifies as a professional social worker and conducts himself/herself accordingly.

1.1 / Knows the profession’s history / 5 / 4 / 3 / 2 / 1 / na
1.2 / Has a commitment to enhancing the profession / 5 / 4 / 3 / 2 / 1 / na
1.3 / Has a commitment to conducting himself/herself as a professional
social worker / 5 / 4 / 3 / 2 / 1 / na
1.4 / Has a commitment to career-long learning and growth / 5 / 4 / 3 / 2 / 1 / na
1.5 / Advocates well for client access to the services of social work / 5 / 4 / 3 / 2 / 1 / na
1.6 / Practices personal reflection and self-correction to assure continual
professional development / 5 / 4 / 3 / 2 / 1 / na
1.7 / Attends well to professional roles and boundaries / 5 / 4 / 3 / 2 / 1 / na
1.8 / Demonstrates professional demeanor in appearance / 5 / 4 / 3 / 2 / 1 / na
1.9 / Demonstrates professional demeanor in communication / 5 / 4 / 3 / 2 / 1 / na
1.10 / Uses supervision and consultation effectively / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #2: Intern applies social work ethical principles to guide his or her professional practice.

2.1 / Is knowledgeable about the value base of the profession / 5 / 4 / 3 / 2 / 1 / na
2.2 / Is knowledgeable of, and abides by, the ethical standards of
the profession / 5 / 4 / 3 / 2 / 1 / na
2.3 / Is knowledgeable, and abides by, laws relevant to social work / 5 / 4 / 3 / 2 / 1 / na
2.4 / Recognizes and manages personal values in a way that allows
Professional values to guide practice (e.g., on such issues as
Abortion and gay rights) / 5 / 4 / 3 / 2 / 1 / na
2.5 / Tolerates well ambiguity in resolving ethical conflicts / 5 / 4 / 3 / 2 / 1 / na
2.6 / Is able to apply strategies of ethical reasoning to arrive at principled decisions / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #3: Intern applies critical thinking to inform and communicate professional judgments.

3.1 / Is knowledgeable about the principles of logic and scientific inquiry / 5 / 4 / 3 / 2 / 1 / na
3.2 / Is able to grasp and comprehend what is obscure / 5 / 4 / 3 / 2 / 1 / na
3.3 / Is skilled in using critical thinking augmented by creativity and curiosity / 5 / 4 / 3 / 2 / 1 / na
3.4 / Has good assessment skills / 5 / 4 / 3 / 2 / 1 / na
3.5 / Has good problem-solving skills / 5 / 4 / 3 / 2 / 1 / na
3.6 / Has good data gathering skills / 5 / 4 / 3 / 2 / 1 / na
3.7 / Analyzes complex material well / 5 / 4 / 3 / 2 / 1 / na
3.8 / Is skilled at appraising and integrating multiple sources of knowledge; including research-based knowledge and practice wisdom / 5 / 4 / 3 / 2 / 1 / na
3.9 / Is skilled at analyzing models of assessment, prevention, intervention, and evaluation / 5 / 4 / 3 / 2 / 1 / na
3.10 / Demonstrates effective oral communication in working with individuals, families, groups, organizations, communities, and colleagues / 5 / 4 / 3 / 2 / 1 / na
3.11 / Demonstrates effective written communication in working with individuals, families, groups, organizations, communities, and colleagues / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #4: Intern engages diversity and difference in practice.

4.1 / Treats diverse clients with dignity and respect / 5 / 4 / 3 / 2 / 1 / na
4.2 / Is knowledgeable and respectful of clients who differ by such factors as age, class, color, culture, disability, ethnicity, gender identity and expression, immigration status, political ideology, race, religion, sex, and sexual orientation / 5 / 4 / 3 / 2 / 1 / na
4.3 / Recognizes the extent to which a culture’s structures and values may oppress, marginalize, alienate, or create or enhance privilege and power / 5 / 4 / 3 / 2 / 1 / na
4.4 / Has sufficient self-awareness to eliminate the influence of personal biases and values in working with diverse groups / 5 / 4 / 3 / 2 / 1 / na
4.5 / Recognizes and communicates her or his understanding of the importance of difference in shaping life experiences / 5 / 4 / 3 / 2 / 1 / na
4.6 / Views herself or himself as a learner and engages those he or she works with as informants / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #5: Intern advances human rights and social and economic justice.

5.1 / Recognizes that each person, regardless of position in society, has basic human rights, such as freedom, safety, privacy, an adequate standard of living, health care and education / 5 / 4 / 3 / 2 / 1 / na
5.2 / Recognizes the global interconnections of oppression and is knowledgeable about theories of justice and strategies to promote human and civil rights / 5 / 4 / 3 / 2 / 1 / na
5.3 / Understands the forms and mechanisms of oppression and discrimination / 5 / 4 / 3 / 2 / 1 / na
5.4 / Is skilled at advocating for human rights and social and economic justice / 5 / 4 / 3 / 2 / 1 / na
5.5 / Is skilled at engaging in practices that advance social and economic justice / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #6: Intern engages in research-informed practice and practice-informed research.

6.1 / Is skilled at using practice experience to inform research / 5 / 4 / 3 / 2 / 1 / na
6.2 / Is skilled at employing evidence-based interventions / 5 / 4 / 3 / 2 / 1 / na
6.3 / Is skilled at evaluating her or his practice / 5 / 4 / 3 / 2 / 1 / na
6.4 / Is skilled at using research findings to improve practice, policy, and social service delivery / 5 / 4 / 3 / 2 / 1 / na
6.5 / Comprehends quantitative research / 5 / 4 / 3 / 2 / 1 / na
6.6 / Comprehends qualitative research / 5 / 4 / 3 / 2 / 1 / na
6.7 / Understands scientific and ethical approaches to building knowledge / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #7: Intern applies knowledge of human behavior and the social environment.

7.1 / Is knowledgeable about human behavior across the life course / 5 / 4 / 3 / 2 / 1 / na
7.2 / Is knowledgeable about the range of social systems in which people live / 5 / 4 / 3 / 2 / 1 / na
7.3 / Is knowledgeable about the ways social systems promote or deter people in maintaining or achieving health and well-being / 5 / 4 / 3 / 2 / 1 / na
7.4 / Is skilled at applying theories and knowledge about biological variables, social variables, cultural variables, psychological variables, and spiritual development / 5 / 4 / 3 / 2 / 1 / na
7.5 / Is skilled at utilizing conceptual frameworks to guide the processes of assessment, intervention, and evaluation / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #8: Intern engages in policy practice to advance social and economic well-being and to deliver effective social work services.

8.1 / Understands that policy affects service delivery / 5 / 4 / 3 / 2 / 1 / na
8.2 / Actively engages in policy practice / 5 / 4 / 3 / 2 / 1 / na
8.3 / Is knowledgeable about the history of social policies and services / 5 / 4 / 3 / 2 / 1 / na
8.4 / Is knowledgeable about current social policies and services / 5 / 4 / 3 / 2 / 1 / na
8.5 / Is knowledgeable about the role of practice in policy development / 5 / 4 / 3 / 2 / 1 / na
8.6 / Is skilled at analyzing, formulating, and advocating for policies that advance social well-being / 5 / 4 / 3 / 2 / 1 / na
8.7 / Is skilled at collaborating with colleagues and clients for effective policy action / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #9: Intern responds to contexts that shape practice.

9.1 / Is informed, resourceful, and proactive in responding to evolving organizational, community, and societal contexts at all levels of practice / 5 / 4 / 3 / 2 / 1 / na
9.2 / Recognizes that the context of practice is dynamic, and has the knowledge and skills to respond proactively / 5 / 4 / 3 / 2 / 1 / na
9.3 / Is skilled at continuously discovering, appraising, and attending to changing locales, populations, scientific and technological developments, and emerging societal trends in order to provide relevant services / 5 / 4 / 3 / 2 / 1 / na
9.4 / Is skilled at providing leadership in promoting sustainable changes in service delivery and practice to improve the quality of social services / 5 / 4 / 3 / 2 / 1 / na

Comments:

Competence #10: Intern engages, assesses, intervenes and evaluates with individuals, families, groups, organizations, and communities.