Department
of Sociology, Social Work and Anthropology
SOCIAL WORK PROGRAM ASSESSMENT PLAN
Practicum Assessment Instruments
SAMPLE LEARNING CONTRACT
Semester:
Name of Student:
Placement Agency:
Field Instructor:
GOAL 1: TO IMPROVE INTERVIEWING SKILLS
Objective 1: To read Cormier’s book on interviewing during the first month of practicum and discuss any questions with my field instructor.
Objective 2: To observe five interviews conducted by agency staff during the semester.
Objective 3: To videotape two interviews with clients by the end of the semester.
Objective 4: To conduct at least five interviews with clients by the end of the semester.
Method of Evaluation: I will have my Practicum Instructor view the videotapes and give me feedback on my strengths and how I can improve.
GOAL 2: TO LEARN THE COMMUNITY’S SOCIAL SERVICES RESOURCES
Objective 1: By mid-quarter visit two referral agencies and do one informational interview with a staff member about the services available.
Objective 2: To read 20 recently closed cases by the 7th week of the semester to identify referrals that were made.
Objective 3: To attend at least ten staff meetings during the semester.
Method of Evaluation: I will develop a list of resources to be utilized when referring clients.
GOAL 3: TO LEARN HOW TO CONDUCT A GROUP
Objective 1: To observe the incest survivors’ support group four times during the first month of the semester.
Objective 2: To attend the scheduled 4 hour in-service entitled “Working with Groups.”
Objective 3: To co-facilitate two of the sessions in the incest survivors’ support group.
Method of Evaluation: Ask the agency group leader for feedback on my skills of co-facilitation and take notes during the in-service.
Student _______________________________________________ Date ____________
Practicum Instructor______________________________________ Date____________
Practicum Director_______________________________________ Date ____________
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SW 4870 Self-Evaluation of Learning Goals
Discuss the accomplishments of each of your goals and objectives, as well as barriers that you experienced. Please attach your learning contract and any evidence of accomplishment from your methods of evaluation. Turn this in with your Fall evaluation.
Goal 1:
Goal 2:
Goal 3:
SW 5870 Self-Evaluation of Learning Goals
Discuss the accomplishments of each of your goals and objectives, as well as barriers that you experienced. Please attach your learning contract and any evidence of accomplishment from your methods of evaluation. Turn this in with your Fall evaluation.
Goal 1:
Goal 2:
Goal 3:
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To Document AGENCY SUPERVISORY CONFERENCE
Planning on the part of both the student, Practicum Instructor, and Practicum Director is important in supervisory conferences. This form is to help you plan for your supervisory conference meeting.
NAME:
DATE:
These are the topics or themes I want to discuss in the meeting:
Feedback received during conference:
These are the tasks I want to prepare/or accomplish for my next supervisory conference:
Next supervisory conference will be:
Date: ____________________ Time:______________
_________________________________
Student
_________________________________
Practicum Instructor Signature
_________________________________
Practicum Director
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
To Document PROGRAM SUPERVISORY CONFERENCE
NAME:
DATE:
Themes to discuss in the meeting (practicum experience, integration/relationships in the agency, assigned activities and how they relate to social work practice, learning goals, concerns, etc.).
Feedback received during conference:
_________________________________ Date: ______________
Student
______________________________________
Practicum Director or Assistant Practicum Director
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ACTIVITY SUMMARY AND REFLECTION FORM
Name:
Agency:
Date:
Please summarize your activities for the month:
Based on your experience this month, what have you learned about social work practice in the real world?:
THE REVIEW AND EVALUATION MEETING. Performance evaluation is an ongoing process throughout Practicum that begins with the student's first encounter with the Practicum Instructor in the placement interview and culminates in a final evaluation at the end of the placement. Ongoing evaluation of the student's progress is a built-in aspect of supervision. Students are also expected to develop the ability to evaluate their own practice throughout the Practicum experience.
At the end of each quarter, Practicum Instructors are asked to summarize their thoughts about the progress of students by completing structured evaluation forms that correlate with the Practicum Objectives and Mission Statement of the Social Work Program. Practicum Instructors are encouraged to be candid and direct in their evaluations.
Components of Performance Evaluation
Students are evaluated on specific educational and performance expectations which include application of social work skills, relationships with others, communication skills, emotional maturity (basic personal qualities and maturity), and professionalism. A variety of factors come under the heading of professionalism:
• Dress and Grooming. Conforming to agency standards and expectations.
• Attendance. Consistently be where you have committed to be. Report on time. Stay late. Come in on off days because you want to. Be willing to stay late for client-or-agency related crises.
• Behavior and Attitude. Be professional in your interactions. Utilize appropriate communication skills.
• Identity with social work as a profession. Understand what it means to be a social worker within your specific agency.
• Use of time. Well organized, efficient, capable in priority-setting, fast worker, and productive.
• Adherence to basic principles of social work practice. Abide by the NASW Code of Ethics. Maintain confidentiality, show respect for clients, use a nonjudgmental approach, and so on.
• Going the extra mile. Pursuing extra or non-required readings and special experiences during placement.
• Paper Work. Reports should be legible, accurate, on time, and so on.
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FALL SEMESTER PRACTICUM STUDENT EVALUATION
Student Name:
Agency Name:
It is important that the evaluation of the student be a shared process and that the Practicum Instructor and student discuss progress during the semester.
1. STUDENT ACTIVITIES
Please write a brief description of student assignments and activities during the semester.
STUDENT LEARNING GOALS
Comment on progress or lack of progress toward completing objectives of the learning contract
(ATTACH COPY OF LEARNING CONTRACT AND EVIDENCE OF GOAL COMPLETION):
Rate the overall performance in completion of learning goals.
Unsatisfactory Outstanding
1 2 3 4 5
What new experiences can the student expect to be involved in next semester?
On the scales below, with 5 being outstanding and 1 as unsatisfactory, please rate the student on the following items. Please note that you can rate the student anywhere on the scale. For example, if you rate a student as 3.5 please note the specific number next to the scale.
Overall Performance
Overall, in what manner did the student carry out and fulfill the tasks and responsibilities assigned this semester?
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Values and Diversity
Demonstrates appropriate values that are congruent with the social work profession.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates understanding of the NASW code of Ethics and can clarify ethical dilemmas which arise in their agency work.
Unsatisfactory Outstanding
1 2 3 4 5
Possesses an appreciation for human diversity.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates a sensitivity to the agency client population.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates knowledge of forms and mechanisms of oppression and discrimination and strategies of change that advance social and economic justice.
Unsatisfactory Outstanding
1 2 3 4 5
Is able to identify his/her own feelings, attitudes, and biases in the context of how they influence behavior.
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Social Work Knowledge
Demonstrates knowledge of the historical function and role of the social work profession.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates knowledge of agency policies and procedures and how these impact client systems and workers.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates an understanding of human development, social systems theory, and bio-psycho-social bases of human behavior in their work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates knowledge of the research process as it relates to the problem-solving process.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates knowledge of generalist social work practice (working with individuals, groups, and the community).
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Social Work Skills
Demonstrates the ability to problem-solve utilizing an empowerment and strengths perspective.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates an appropriate helping style and use of self.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates beginning level interviewing and interpersonal communication skills appropriate for work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to apply generalist practice with systems of all sizes.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to link clientele with resources and services.
Unsatisfactory Outstanding
1 2 3 4 5
Ability to relate and communicate clearly and concisely with written materials such as letters, memos, reports and client records.
Unsatisfactory Outstanding
1 2 3 4 5
Ability to relate to and communicate clearly and effectively with clients, supervisors, administrators, and other professional colleagues.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to evaluate their own practice.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates appropriate use of agency supervision.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to apply social work concepts in their work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Overall professional presentation of self (dress and grooming, attendance, behavior and attitude, use of time, going the extra mile):
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Practicum Instructor recommended grade:Rationale for grade:
QUALITATIVE FEEDBACK:
1. Student Strengths:
2. Suggestions for Student to improve His/Her Professional Competence:
3. Other comments:
________________________ ________
Student Signature Date
Practicum Instructor Signature
________________________
Practicum Director Signature
SPRING SEMESTER PRACTICUM STUDENT EVALUATION
Student Name:
Agency Name:
It is important that the evaluation of the student be a shared process and that the Practicum Instructor and student discuss progress during the semester.
1. STUDENT ACTIVITIES
Please write a brief description of student assignments and activities during the semester.
STUDENT LEARNING GOALS
Comment on progress or lack of progress toward completing objectives of the learning contract
(ATTACH COPY OF LEARNING CONTRACT AND EVIDENCE OF GOAL COMPLETION):
Rate the overall performance in completion of learning goals.
Unsatisfactory Outstanding
1 2 3 4 5
What new experiences can the student expect to be involved in next semester?
On the scales below, with 5 being outstanding and 1 as unsatisfactory, please rate the student on the following items. Please note that you can rate the student anywhere on the scale. For example, if you rate a student as 3.5 please note the specific number next to the scale.
Overall Performance
Overall, in what manner did the student carry out and fulfill the tasks and responsibilities assigned this semester?
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Values and Diversity
Student demonstrates values which are congruent with the social work profession (including confidentiality, respect for the dignity and uniqueness of the individual, clients right to self-determination):
Unsatisfactory Outstanding
1 2 3 4 5
Continues to display an appreciation for human diversity.
Unsatisfactory Outstanding
1 2 3 4 5
Continues to display an sensitivity to the agency client population.
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Social Work Knowledge
Continues to demonstrate knowledge of the historical function and role of the social work profession in their agency work.
Unsatisfactory Outstanding
1 2 3 4 5
Has increased and demonstrates knowledge of agency policies and procedures and how these impact client systems and workers.
Unsatisfactory Outstanding
1 2 3 4 5
Continues to demonstrate an understanding of human development, social systems theory, and bio-psycho-social bases of human behavior in their work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Continues to demonstrates knowledge of the research process as it relates to the problem-solving process and your agency.
Unsatisfactory Outstanding
1 2 3 4 5
Continues to demonstrate knowledge of generalist social work practice and how it operates in your agency.
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Social Work Skills
Demonstrates the ability to problem-solve utilizing an empowerment and strengths perspective with the agency population.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates an appropriate helping style and use of self with agency clients, staff, and colleagues.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates improved interviewing and interpersonal communication skills appropriate for work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates generalist social work practice in the context of your agency. (Generalist practice includes the ability to work with individuals, groups, and the community)
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to link clientele with resources and services.
Unsatisfactory Outstanding
1 2 3 4 5
Ability to relate and communicate clearly and concisely with written materials such as letters, memos, reports and client records.
Unsatisfactory Outstanding
1 2 3 4 5
Ability to relate to and communicate clearly and effectively with clients, supervisors, administrators, and other professional colleagues in meetings and interpersonal situations.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to evaluate their own practice with clients.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates appropriate use of agency supervision and takes initiative in seeking supervision.
Unsatisfactory Outstanding
1 2 3 4 5
Demonstrates the ability to apply social work concepts in their work with agency clientele.
Unsatisfactory Outstanding
1 2 3 4 5
Overall professional presentation of self (Dress and grooming, attendance, behavior and attitude, use of time, going the extra mile):
Unsatisfactory Outstanding
1 2 3 4 5
Assessment Skills (ability to properly identify client difficulties and concerns):
Unsatisfactory Outstanding
1 2 3 4 5
Planning and Goal Setting Skills (ability to plan effective interventions):
Unsatisfactory Outstanding
1 2 3 4 5
Implementation Skills (ability to carry out the designed intervention plan and evaluate outcomes):
Unsatisfactory Outstanding
1 2 3 4 5
Referral Skills (ability to make appropriate referrals for your agency clientele):
Unsatisfactory Outstanding
1 2 3 4 5
Termination Skills (ability to evaluate results and terminate the treatment process in an effective way):
Unsatisfactory Outstanding
1 2 3 4 5
Accountability Skills (commitment to employing agency and ethical responsibility):
Unsatisfactory Outstanding
1 2 3 4 5
Observations and Comments:
Practicum Instructor recommended grade: _______
Outstanding in almost all of the categories: A
Outstanding in a majority of the categories: A-
Excellence in a almost all of the categories: B+
Excellence in a majority of the categories: B
Meets almost all of the expectations of the agency: B-
Meets a majority of the expectations of the agency: C+
Meets expectations: C Below expectations: C- , D+, D, D-
Does not meet expectations: F
Rationale for grade:
1. Student Strengths:
2. Suggestions for Student to improve His/Her Professional Competence:
3. Other Comments:
PRACTICUM INSTRUCTOR SIGNATURE DATE
PRACTICUM DIRECTOR SIGNATURE DATE
Practicum Agency Evaluation
Student:
Placement Agency:
1. The Agency
Please list strengths of the agency in reference to your experience:
What experiences did you not receive that would have been beneficial to your social work experience:
On the scales below, with 5 being outstanding and 1 as unsatisfactory, please rate the agency on the following items.
Provides sufficient exposure to professional social work practice:
Unsatisfactory Outstanding
1 2 3 4 5
Provides sufficient opportunity for contact with clients, client groups, or community:
Unsatisfactory Outstanding
1 2 3 4 5
Provides adequate work space for the accomplishment of assigned tasks:
Unsatisfactory Outstanding
1 2 3 4 5
What was your experience with individual and group supervision in the agency:
Provides an appropriate orientation at the beginning of your practicum experience:
Unsatisfactory Outstanding
1 2 3 4 5
Provides opportunity for the development of an awareness of self in the process of intervention:
Unsatisfactory Outstanding
1 2 3 4 5
Opportunities for use of oral and written professional communications that are consistent with the language of the practicum setting and of the profession:
Unsatisfactory Outstanding
1 2 3 4 5
Opportunities to experience critical assessment, implementation, and evaluation of agency policy within ethical guidelines:
Unsatisfactory Outstanding
1 2 3 4 5
2. The Agency Practicum Instructor
Please list strengths of the practicum instructor:
Please list areas needing improvement:
On the scales below, with 5 being outstanding and 1 as unsatisfactory, please rate the agency practicum instructor on the following items.
Is available when needed:
Unsatisfactory Outstanding
1 2 3 4 5
Provides weekly or bi-weekly supervision meetings:
Unsatisfactory Outstanding
1 2 3 4 5
Is generally supportive:Unsatisfactory Outstanding
1 2 3 4 5
Assigns tasks that are meaningful and educationally directed:
Unsatisfactory Outstanding
1 2 3 4 5
Is knowledgeable about both theory and practice:
Unsatisfactory Outstanding
1 2 3 4 5
Overall experience with the Practicum Instructor:
Unsatisfactory Outstanding
1 2 3 4 5
3. The Program Practicum Director (Give feedback concerning either Dr. Calloway-Graham or Professor Browne, depending on who was your faculty supervisor.)
Please list strengths of your program faculty supervisor
Please list areas needing improvement:
On the scales below, with 5 being outstanding and 1 as unsatisfactory, please rate the program practicum director on the following items.
Is generally supportive:
Unsatisfactory Outstanding
1 2 3 4 5
Provides feedback to the student regarding both their social work skills and learning needs:
Unsatisfactory Outstanding
1 2 3 4 5
Is available to student as a resource person:
Unsatisfactory Outstanding
1 2 3 4 5
Serves as a positive professional role model:
Unsatisfactory Outstanding
1 2 3 4 5
Overall experience with Program Practicum Director:
Unsatisfactory Outstanding
1 2 3 4 5
Senior Self-Efficacy Assessment
Name:
Practicum Agency:
Please rate your professional competencies utilizing the following scale (circle your response):
1- Strongly Disagree
2- Disagree
3- Neutral
4- Agree
5- Strongly Agree
1. I am able to apply critical thinking skills (e.g. the ability to solve problems, evaluate theories, policies, and organizational practices) within the context of professional social work practice.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
2. I am able to understand the value base of the profession and its ethical standards and principles, and behave accordingly.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
3. I am able to understand and respect people from diverse backgrounds: age, class, color, culture, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, sex, and sexual orientation.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
4. I am able to understand the forms and mechanisms of oppression and discrimination and strategies of advocacy and social change that advance social and economic justice.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
5. I am able to understand and interpret the history of the social work profession and its contemporary structures and issues.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
6. I am able to apply the knowledge and skills of generalist practice with systems of all sizes (e.g. individual, families, groups, organizations, and communities).
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
7. I am able to use theoretical frameworks supported by empirical evidence to understand individual development and behavior across the lifespan and the interactions among individuals and between individuals and families, groups, organizations, and communities.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
8. I am able to analyze, formulate, and understand mechanisms of influence when responding to agency, state, andStrongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
9. I am able to evaluate research studies and understand their applicability to generalist social work practice.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
10. I am able to use communication skills differentially (distinguishing the appropriate response) across client populations, colleagues, and communities.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
11. I am able to use supervision and consultation appropriate to social work practice.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5
12. I am able to function within the structure of organizations and service delivery systems.
Strongly Disagree Disagree Neutral Agree Strongly Agree
1 2 3 4 5