SW 701 MSW Foundation Field Practicum Evaluation

SW 701 MSW Foundation Field Practicum Evaluation

Student: Click here to enter text.KU ID#: Click here to enter text.Field Instructor: Click here to enter text.

Field Liaison: Click here to enter text.Agency Name and Address: Click here to enter text.

Number of Practicum clock hours completed at mid-year evaluation: Click here to enter text.

Total number of Practicum hours completed in both semesters: Click here to enter text.

Percentage of Student time in direct client contact (should be at least 50%): Click here to enter text.

Field Instructor's grade recommendation: Midyear

☐ P (progress) ☐ U (unsatisfactory)

Field Instructor's grade recommendation: End-year

☐ S (satisfactory) ☐ U (unsatisfactory)

For End of the Year Evaluation:

Field Instructor’s Signature: Date: Click here to enter a date.

Student Signature: Date: Click here to enter a date.

☐ I have read the evaluation and I am in agreement with it.

☐ I have read the evaluation and I am attaching my written addendum.

Field Liaison's Grade Assignment: Click here to enter text.

Field Liaison's Signature: Date: Click here to enter a date.

Field Instructor Instructions: Please complete a rating for each practice behavior based on this scale:

5 =Consistently excels in implementing the practice behavior

4 = Above average performance of the practice behavior

3= Dependably implements the basic elements of the practice behavior

2 = Inconsistently performs the basic elements of the practice behavior

1= Fails to perform the basic elements of the practice behavior

N/A= No Assignment/activity to assess practice behavior (Mid-year evaluation only)

***You will be asked for your comments (both mid-year and final) at the end of this document.

***Ratings of N/A at the Mid-Year Evaluation indicate a need for planned assignments to provide experience with the particular practice behavior. It is important to write a brief narrative about next steps for creating opportunities for completing assignments.

Competency 1: Identify as a professional social worker and conduct oneself accordingly.
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Advocate for client access to the services of social work.
Choose an item. / Choose an item. / Practice personal reflection and self-correction to assure continual professional development.
Choose an item. / Choose an item. / Attend to professional roles & boundaries.
Choose an item. / Choose an item. / Demonstrate professional demeanor in behavior, appearance, and communication.
Choose an item. / Choose an item. / Engage in career-long learning.
Choose an item. / Choose an item. / Use supervision and consultation.
Competency 2: Apply social work ethical principles to guide professional practice.
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Recognize and manage personal values in a way that allows professional values to guide practice.
Choose an item. / Choose an item. / Make ethical decisions by applying standards of the NASW Code of Ethics and, as applicable, of the IFSW/IASSW Ethics in Social Work, Statement of Principles.
Choose an item. / Choose an item. / Tolerate ambiguity in resolving ethical conflicts.
Choose an item. / Choose an item. / Apply strategies of ethical reasoning to arrive at principled decisions.
Competency 3: Apply critical thinking to inform and communicate professional judgments
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Distinguish, appraise, and integrate multiple sources of knowledge, including research-based knowledge, and practice wisdom.
Choose an item. / Choose an item. / Analyze models of assessment, prevention, intervention, and evaluation.
Choose an item. / Choose an item. / Demonstrate effective oral and written communication in working with individuals, families, groups, organizations, communities, and colleagues.
Competency 4: Engage in diversity and difference in practice
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Recognize the extent to which a culture’s structures and values may oppress, marginalize, alienate, or create or enhance privilege and power.
Choose an item. / Choose an item. / Gain sufficient self-awareness to eliminate the influence of personal biases and values in working with diverse groups.
Choose an item. / Choose an item. / Recognize and communicate their understanding of the importance of difference in shaping life experiences.
Choose an item. / Choose an item. / View themselves as learners and engage those with whom they work as informants.
Competency 5: Advance human rights and social and economic justice
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Understand the forms and mechanisms of oppression and discrimination.
Choose an item. / Choose an item. / Advocate for human rights and social and economic justice.
Choose an item. / Choose an item. / Engage in practices that advance social and economic justice.
Competency 6: Engage in research-informed practice and practice-informed research
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Use practice experience to inform scientific inquiry.
Choose an item. / Choose an item. / Use research evidence to inform practice.
Competency 7: Apply knowledge of human behavior and the social environment
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Utilize conceptual frameworks to guide the processes of assessment, intervention, and evaluation.
Choose an item. / Choose an item. / Critique and apply knowledge to understand person and environment.
Competency 8: Engage in policy practice to advance social and economic well-being and to deliver effective social work services
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Analyze, formulate, and advocate for policies that advance social well-being.
Choose an item. / Choose an item. / Collaborate with colleagues and clients for effective policy action.
Competency 9: Respond to contexts that shape practice
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Continuously discover, appraise, and attend to changing locales, populations, scientific and technological developments, and emerging societal trends to provide relevant services.
Choose an item. / Choose an item. / Provide leadership in promoting sustainable changes in service delivery and practice to improve the quality of social services.
Competency 10a: ENGAGE
Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Substantively and effectively prepare for action with individuals, families, groups, organizations, and communities.
Choose an item. / Choose an item. / Use empathy and other interpersonal skills.
Choose an item. / Choose an item. / Develop a mutually agreed-on focus of work and desired outcomes.
Competency 10b: ASSESS
Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Collect, organize, and interpret client data.
Choose an item. / Choose an item. / Assess client strengths and limitations.
Choose an item. / Choose an item. / Develop mutually agreed-upon goal & objectives.
Choose an item. / Choose an item. / Select appropriate intervention strategies.
Competency 10c: INTERVENTION
Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Initiate actions to achieve organizational goals.
Choose an item. / Choose an item. / Implement prevention interventions that enhance client capacities.
Choose an item. / Choose an item. / Help clients resolve problems.
Choose an item. / Choose an item. / Negotiate, mediate, and advocate for clients.
Choose an item. / Choose an item. / Facilitate transitions and endings.
Competency 10d: EVALUATE
Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities
Mid- year evaluation
(1-5) / Final evaluation
(1-5) / KUSSWBSW Level Practice Behaviors
Choose an item. / Choose an item. / Critically analyze, monitor and evaluate interventions.