9.7: Supervisor Evaluation of Student

STUDENT EVALUATION BY AGENCY SUPERVISOR

FIELD WORK PRACTICUM

NAME OF STUDENT____________________________________________________
AGENCY________________________________________________________________

AGENCY SUPERVISOR __________________________________________________

PERIOD COVERED BY EVALUATION FROM_____________            TO_____________

NUMBER OF HOURS WORKED   

Please evaluate the experience of the above-named student in terms of your agency or organization. This evaluation should be discussed with the student and signed by the supervisor, College Field Work instructor, and the student. In Section A, please identify the kind of work and experiences your student intern performed during his/her placement in your agency. In section C, please tell us how well your intern did in acquiring competencies.

I have read this evaluation.

DATE          Agency Supervisor_____________________________________

DATE          Student______________________________________________

DATE          College Instructor _____________________________________

SECTION A.

Describe the student's role and tasks in the agency or organization. Be specific about roles played.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B.

 

Please rate the student’s performance in the following areas using the scale below.

A Outstanding	B Good	C Average	D Needs Improvement	F Poor

 

___      1. The student understood agency operations.

___      2. The student understood the agency's purpose and role in the Human Service system.

___      3. The student accepted supervision and constructive criticism.

___      4. The student was reliable such as arriving when expected.

___      5. The student completed assignments on time.

___      6. The student participated as a member of the team.

___      7. The student related well to clients of diverse backgrounds.

___      8. The student was respectful of others' points of view.

___      9. The student demonstrated good communication skills.

___      10. The student was able to ask for help.

___      11. The student was able to keep personal information of the client confidential.

___      12. The student demonstrated an understanding of client self-determination.

___      13. The student showed respect for the client's personal values.

___      14. The student demonstrated a recognition of the client’s worth and uniqueness.

 

SECTION C. 

Please check yes or no as to whether the student completed the tasks below. If you answered yes, please rate their performance.                                                                                                                                              

DID THE STUDENT	NO	YES	Rate their performance  1         2         3         4           5 Poor                          Excellent
Complete basic intakes			1         2         3         4           5
Instruct others in Activities of Daily Living			1         2         3         4           5
Assist in case management			1         2         3         4           5
Facilitate groups			1         2         3         4           5
Maintain professional records			1         2         3         4           5
Participate in treatment/service planning			1         2         3         4           5
Participate in Goal Planning			1         2         3         4           5
Conduct interviews			1         2         3         4           5
Conduct crisis interviews			1         2         3         4           5
Make good referrals			1         2         3         4           5
Plan and implement recreational activities with clients			1         2         3         4           5
Communicate professionally with clients			1         2         3         4           5

 

SECTION D

Give a general summary of what you saw as this student's strengths and areas where you feel the student could improve (please utilize the back of this sheet if needed).