Site Supervisor Evaluation

KIN 492 / 493: Internship Site Supervisor Evaluation

Department of Kinesiology, Michigan State University

Scoring Rubric

Site Supervisor:

Please go over this evaluation with the students, and indicate to the student, and in the comments section, why the student is receiving the score that they are receiving in each category. At the mid-internship review, please indicate how the students can improve during the remainder of their internship. Please put these recommendations in the comments section of each area.

After you have discussed the evaluation with the student, please do the following:

1.Give a copy to the student for their files.

2.Pages 2-5: e-mail these pages to Keri Morrison at . In the subject header, please put in the subject line: KIN 492 / 493 Supervisor Evaluation.

3.Before you e-mail the evaluation to Keri Morrison, please change the name of the file to:

FirstName_LastName_Mid_Internship_Evaluation

OR

FirstName_LastName_Final_Internship_Evaluation

4.Page 6: Fax (517- 353-2944) or mail (135 IM Sports Circle, Michigan State University, East Lansing, MI 48824) to Keri Morrison.

Student Name: / Mid-Internship Evaluation
PID: / Final Internship Evaluation

1. Quality of work (Score 0-10 points):

Points / Completion of Tasks
5 / All assigned tasks are performed within the assigned time.
3-4 / Most assigned tasks are performed in a timely manner.
1-2 / Assigned tasks are frequently late.
0 / Assigned tasks are rarely completed.
Points / Performance of Tasks
5 / Assigned tasks are performed as instructed.
All tasks meet expectations and some exceed expectations.
3-4 / Most tasks are performed as instructed and meet expectations.
1-2 / Student usually does not meet expectations for assigned tasks.
0 / Student never meets expectations for assigned tasks.
Comments and/or Recommendations:

Student Name:

2. Application of knowledge to the work environment (Score 0-10 points):

Points / Problem Solving
5 / Student displays high-level reasoning ability when performing tasks.
3-4 / Student displays some reasoning ability when performing tasks.
1-2 / Student does not display much ability to reason when performing tasks and needs more help than normal to understand and complete tasks.
0 / Student does not display any reasoning ability and does not display any ability to understand and complete tasks.
Points / Instruction
5 / Student displays an exceptional ability to instruct patients, participants and/or clients.
3-4 / Student displays an adequate ability to instruct patients, participants, and/or clients.
1-2 / Student has difficulty in clearly instructing patients, participants, and/or clients.
0 / Student has not demonstrated any ability to instruct patients, participants, and/or clients.
Comments and/or Recommendations:

Student Name:

3. Professionalism (Score 0-10 points):

Points / Dress
5 / Student is always dressed appropriately for the work environment.
3-4 / Student is usually dressed appropriately for the work environment.
1-2 / Student is usually dressed inappropriately for the work environment.
0 / Student is never dressed appropriately for the work environment.
Points / Communication
5 / Student always interacts well with co-workers, supervisors, and participants.
3-4 / Student usually interacts well with co-workers, supervisors, and participants.
1-2 / Student has difficulties in their interactions with co-workers, supervisors, and/or participants.
0 / Student has serious difficulties in their interactions with co-workers, supervisors, and/or participants.
Comments and/or Recommendations:

Student Name:

4. Overall rating of student. Using the blank line below, please rate the overall ability of the student to succeed in this field on a scale of 0 to 10. In addition, please explain the basis for this rating in the comments.

Rating:

Comments and/or Recommendations:

Total Score (Sum of Sections 1 through 4): / 40 points possible

Site Supervisor Name:

KIN 492 / 493: Internship Site Supervisor Evaluation

Department of Kinesiology, Michigan State University

Certification of Evaluation

Mid-Internship Evaluation
Final Internship Evaluation

Please print off this page and fax or mail to Keri Morrison.

Fax: 517- 353-2944

Mail:135 IM Sports Circle

Michigan State University

East Lansing, MI 48824

By signing below, I certify that I have performed the evaluation of the above named student.

Site Supervisor Name:

Supervisor Signature: ______Date: (M/D/YY)

By signing below, I certify that I have discussed my evaluation with my supervisor and understand why I have received the evaluation that I received.

Student Name:

Student Signature: ______Date: (M/D/YY)

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