LSU-Shreveport
Student Evaluation
Practicum ~ COUN 783
Student: ______Semester: ______
Practicum Site: ______
Site Supervisor: ______Date of Evaluation:______
Scoring Key: 5=95(Excellent) 4=85(Good) 3=75(Average) 2=65(Poor) 1=55(Very Poor)
Area
/ Score (Circle One)1. Basic Work Requirements (attendance, timeless, task completion, etc.) / 5 4 3 2 1
2. Ethical Awareness and Conduct (knowledge of general/specific ethical
guidelines; ethical sensitivity; use of consultation, etc.) / 5 4 3 2 1
3. Knowledge (understanding of client population before/after practicum
experience, knowledge of treatment/assessment approaches before/ after
practicum experience, etc.) / 5 4 3 2 1
4. Learning (receptiveness to learning opportunities, actively seeks new
information from staff or supervisor; ability to incorporate new information,
understanding of concepts, theories, etc.) / 5 4 3 2 1
5. Response to Supervision (receptiveness to feedback, understanding of
information provided, awareness of areas of needed improvement, willingness
to explore strengths and weaknesses, etc.) / 5 4 3 2 1
6. Interaction with clients (initiates contacts appropriately; communicates with
clients effectively; builds rapport quickly and deliberately, demonstrates
respect for clients, sensitivity to cultural/gender differences, possesses an
effective repertoire of rapport-building/intervention strategies, etc.) / 5 4 3 2 1
7. Interactions with Coworkers (interactions with staff members; effectively
conveys information and own opinions, effectively receives information and
opinions from others, etc.) / 5 4 3 2 1
8. Clinical Practice Skills (creativity in individualizing interventions,
appropriateness of recommendations, case conceptualization, assessment,
thoroughness of task completion, notes/reports clinical and/or
administratively useful; accurate, well-formulated and articulated, etc.) / 5 4 3 2 1
9. Overall level of involvement with practicum experience (time,
initiative toward meeting goals, concern for clients, etc.) / 5 4 3 2 1
10. Potential for further development in the field. / 5 4 3 2 1
Comments: (Please provide a narrative description of your rationale for the ratings given on the front of this evaluation. It is helpful to provide concrete examples, as well as overall trends/tendencies in the intern’s performance. It should specifically address strength and weaknesses and focus on areas of growth, both within the practicum experience and as envisioned for the intern’s future in the counseling profession.)