Fillable BSW MSW Foundation Eval

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BSW MSW Foundation Eval

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BSW & MSW Foundation Field Placement Performance Evaluation – Page 1
BSW / MSW Foundation Evaluation of Field Placement Performance
402 - Practicum I (BSW) 404 - Practicum II (BSW)
720 - Field Practicum I (MSW - Foundation) 721 - Field Practicum II (MSW - Foundation)
Practicum Student
Date
Field Instructor
Agency
On-Site Supervisor
The Performance Evaluation must be completed and signed by the Field Instructor, On-Site Supervisor (if
applicable), and the Student.
The standard by which a Social Work 402/404 (BSW student) and Social Work 720/721 (MSW Foundation)
practicum student is to be compared is that of a generalist student. The Core Competencies are those established by
our national accrediting organization, the Council on Social Work Education (CSWE). We are asking you to rate
each of the practicum behaviors based on the following scale:
0
Not Observed: No opportunity for these skills to be performed by the practicum student in this semester.
1
Questionable Practice: Consistently demonstrates competency far below (less than 50% of the time) for this
behavior.
2
Beginner Practice: Consistently demonstrates competency below (at least 50% of the time) for this behavior.
3
Acceptable Practice: Consistently demonstrates competency at the level (at least 70% of the time) for this
behavior.
4
Good Practice: Consistently demonstrates competency above (at least 80% of the time) for this behavior.
5
Advanced Practice: Consistently demonstrates competency far above (at least 90% of the time) for this
behavior.
This practicum evaluation will be used as a significant portion of the practicum seminar grade each semester.
Narrative Section:
Please use the brief assessment narrative section of each core competency to individualize the student’s evaluation.
The assessment is an important and necessary part of the evaluation. Your comments personalize and clarify for
your students the essence of your evaluation of their work. It is important to comment on areas that need work, as
well as areas in which the student excels or has shown significant growth or accomplishment. If possible, give
examples of strengths or weaknesses. If a student is having problems in a certain area, please document thoroughly
the examples of concerns in that area. It is essential for the student and the School to have this section completed on
all students.
____________________________
Rev 06/18
BSW & MSW Foundation Field Placement Performance Evaluation – Page 2
Core Competency #1:
Demonstrate Ethical and Professional Behavior
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 1 - Makes ethical decisions by applying the standards of the NASW Code of Ethics, relevant
laws and regulations, models for ethical decision-making, ethical conduct of research, and
additional codes of ethics as appropriate to context.
PB 2 - Uses reflection and self-regulation to manage personal values and maintain professionalism
in practice situations.
PB 3 - Demonstrates professional demeanor in behavior; appearance; and oral, written, and
electronic communication.
PB 4 - Uses technology ethically and appropriately to facilitate practice outcomes.
PB 5 - Uses supervision and consultation to guide professional judgement and behavior.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 3
Core Competency #2:
Engage Diversity and Difference in Practice
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 6 - Applies and communicates understanding of the importance of diversity and difference in
shaping life experiences in practice at the micro, mezzo, and macro levels.
PB 7 - Presents themselves as learners and engages clients and constituencies as experts of their
own experiences.
PB 8 - Applies self-awareness and self-regulation to manage the influence of personal biases and
values in working with diverse clients and constituencies.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 4
Core Competency #3:
Advance Human Rights and Social, Economic, and Environmental Justice
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 9 - Applies their understanding of social, economic, and environmental justice to advocate for
human rights at the individual and system levels.
PB 10 - Engages in practices that advance social, economic, and environmental justice.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 5
Core Competency #4:
Engage in Practice-Informed Research and Research-Informed Practice
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 11 - Uses practice experience and theory to inform scientific inquiry and research.
PB 12 - Applies critical thinking to engage in analysis of quantitative and qualitative research
methods and research findings.
PB 13 - Uses and translates research evidence to inform and improve practice, policy, and service
delivery.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 6
Core Competency #5:
Engage in Policy Practice
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 14 - Identifies social policy at the local, state, and federal level that impacts well-being, service
delivery, and access to social services.
PB 15 - Assesses how social welfare and economic policies impact the delivery of and access to
social services.
PB 16 - Applies critical thinking to analyze, formulate, and advocate for policies that advance human
rights and social, economic, and environmental justice.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 7
Core Competency #6:
Engage with Individuals, Families, Groups, Organizations, and Communities
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 17 - Applies knowledge of human behavior and the social environment, person-in-environment,
and other multidisciplinary theoretical frameworks to engage with clients and constituencies.
PB 18 - Uses empathy, reflection, and interpersonal skills to effectively engage diverse clients and
constituencies.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 8
Core Competency #7:
Assess Individuals, Families, Groups, Organizations, and Communities
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 19 - Collects and organizes data, and applies critical thinking to interpret information from
clients and constituencies.
PB 20 - Applies knowledge of human behavior and the social environment, person-in-environment,
and other multidisciplinary theoretical frameworks in the analysis of assessment data from
clients and constituencies.
PB 21 - Develops mutually agreed-on intervention goals and objectives based on the critical
assessment of strengths, needs, and challenges within clients and constituencies.
PB 22 - Selects appropriate intervention strategies based on the assessment, research knowledge, and
values and preferences of clients and constituencies.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 9
Core Competency #8:
Intervene with Individuals, Families, Groups, Organizations, and Communities
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 23 - Critically chooses and implements interventions to achieve practice goals and enhances
capacities of clients and constituencies.
PB 24 - Applies knowledge of human behavior in the social environment, person-in-environment,
and other multidisciplinary theoretical frameworks in interventions with clients and
constituencies.
PB 25 - Uses inter-professional collaboration as appropriate to achieve beneficial practice outcomes.
PB 26 - Negotiates, mediates, and advocates with and on behalf of diverse clients and constituencies.
PB 27 - Facilitates effective transitions and endings that advance mutually agreed-on goals.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 10
Core Competency #9:
Evaluates Practice with Individuals, Families, Groups, Organizations, and Communities
Please evaluate the student’s level of competency by rating each of the following practice behaviors
(PB) using the specified rating scale below. You will write in your rating score in the right-hand
column beside each practice behavior. Space provided at the end of the page for you to provide
additional comments and feedback.
0
1
2
3
4
5
Practice Behaviors
RATING
0 to 5
PB 28 - Selects and uses appropriate methods for evaluation of outcomes.
PB 29 - Applies knowledge of human behavior and the social environment, person-in-environment,
and other multidisciplinary theoretical frameworks in the evaluation of outcomes.
PB 30 - Critically analyzes, monitors, and evaluates intervention and program processes and
outcomes.
PB 31 - Applies evaluation findings to improve practice effectiveness at the micro, mezzo and macro
levels.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
BSW & MSW Foundation Field Placement Performance Evaluation – Page 11
I have been given the opportunity to participate in this evaluation with the field instructor.
Student Signature:
Date:
This student has been assessed ready to advance to the next practicum semester.
TOTAL SEMESTER HOURS COMPLETED: /240
Field Instructor Signature:
Date:
On-Site Supervisor Signature (if applicable):
Date:
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BSW MSW Foundation Eval

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Completed 16 February 2020

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