Fillable MSW Advanced Eval

Fill Online, Printable, Fillable, Blank MSW Advanced Eval Form

Use Fill to complete blank online WICHITA STATE UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

MSW Advanced Eval

On average this form takes 17 minutes to complete

The MSW Advanced Eval form is 17 pages long and contains:

  • 0 signatures
  • 2 check-boxes
  • 66 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Wichita State University

BROWSE WICHITA STATE UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
MSW Advanced Generalist Evaluation of Field Placement Performance
822 - Field Practicum III (MSW - Advanced) 823 - Field Practicum IV (MSW - Advanced)
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 822 & 823 (MSW Advanced) practicum student is to be compared is that of
an advanced generalist level MSW 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
advanced 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.
____________________________
1
BSRB 102-2-1a(i) – “Direct Client Contact” means a service to a client system that utilizes individual, family, or
group interventions through face-to-face interaction or the use of electronic mediums of face-to-face interaction in
which confidentiality is protected.
1
BSRB 65-6306.4(c) – “Clinical Practicum” of supervised professional experience including psychotherapy and
assessment, integrating diagnosis and treatment of mental disorders with use of American Psychiatric Association’s
diagnostic and statistical manual, with not less than 350 hours of direct client contact…
Rev 06/18
Advanced Generalist 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 advanced practice
behaviors (APB) 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
ABP 1 - Demonstrates effective leadership 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 within the advanced generalist values of
empowerment, social justice and cultural competence.
APB 2 - Understands and articulates the advanced generalist practice model of social work practice.
APB 3 - Represents agency and/or organization in a professional manner to multiple constituencies.
APB 4 - Demonstrates competency at an advanced level in verbal, written and electronic
communications in the process of managing professional duties, responsibilities, and appearance.
APB 5 - Seeks and accepts feedback, support, and constructive criticism from supervisors and
colleagues to enhance advanced generalist practice.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 6 - Recognizes and manages personal biases as they affect the client-worker relationship within
advanced generalist practice.
APB 7 - Applies evidence based knowledge of diverse cultures to advanced generalist practice.
APB 8 - Uses cognitive and affective processes that lead to culturally appropriate practice methods
that foster enhanced cultural identity and empowerment.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 9 - Apply their knowledge, skills, and ethics to social, economic and environmental justice to
advocate for human rights at the individual and system levels through cultural competency and
empowerment.
APB 10 - Actively participates with others in creating new, modifies, or improved services,
resourses, and opportunities for client systems.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist Field Placement Performance Evaluation – Page 5
Core Competency #4:
Engages in Practice-informed Research and Research-informed Practice.
Please evaluate the student’s level of competency by rating each of the following advanced practice
behaviors (APB) 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
APB 11 - Using an advanced rationale, critically assesses and chooses a tailored approach to one
intervention over another.
APB 12 - Participates in the generation of new advanced generalist practice knowledge through
practice and research.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 13 - Analyzes organizational policies, procedures, resources, through cultural competency to
empower clients at all levels of the system’s well-being, service delivery, and access to services.
APB 14 - Uses cognitive and affective processes to advocate to support policy change on behalf of a
specific group or organization.
APB 15 - Analyzes organizational policies, resources, and client characteristics to advocate for
services or change policies on behalf of a specific group or organization.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist Field Placement Performance Evaluation – Page 7
Core Competency #6:
Engages with Individuals, Families, Groups, Organizations, and Communities.
Please evaluate the student’s level of competency by rating each of the following advanced practice
behaviors (APB) 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
APB 16 - Engages with clients and constituencies using an advanced generalist framework that
incorporates a holistic and complex view of client situations.
APB 17 - Connects with clients and constituencies using respectful, empathetic, and culturally
competent approaches.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 18 - Conducts a multidimensional and comprehensive assessment that is appropriate to the
agency and community context.
APB 19 - Critically chooses and utilizes relevant theories, assessments, and diagnostic tools
appropriate to the practice setting.
APB 20 - Manages transitions and change in complex client interactions.
APB 21 - Selects and modifies evidence based intervention strategies based on continuous
multidimensional assessment.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 22 - Provide leadership to identify and achieve individual, group, organization, or community
goals.
APB 23 - Uses an advanced generalist multi-systemic view to incorporate a holistic and complex
view of tailored intervention in working with clients and constituencies.
ABP 24 - Develops successful intervention through fluid professional boundaries to maximize
effective and efficient client constituencies outcomes.
APB 25 - Uses management and planning skills to enhance agency and program capacities.
APB 26 - Facilitates ethical and culturally competent transitions and endings in interactions with
clients and constituencies.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 advanced practice
behaviors (APB) 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
APB 27 - Use culturally competent understanding of research methodologies to tailor an evaluation
to the complexities of practice settings.
APB 28 - Uses an advanced generalist assessment process that incorporates a holistic and complex
view of client situations.
APB 29 - Evaluates the implementation, impacts, and outcomes of practices, programs and policies,
and makes recommendations for improvement.
APB 30 - Applies evaluation of practice to the knowledge base to advance the social work
profession.
Field Instructor Comments:
On-Site Supervisor (if applicable) Comments:
Student Comments:
Advanced Generalist 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 or practice level.
TOTAL SEMESTER HOURS COMPLETED: /350
Field Instructor Signature:
Date:
On-Site Supervisor Signature (if applicable):
Date:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

MSW Advanced Eval

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 February 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document