Field Practicum Midterm Eval - Fall 2020
The standard by which an intern is to be compared is that of a new beginning-level social worker. The 9 competencies specified in this evaluation form are those established by our national accrediting organization (the Council on Social Work Education). Under each competency statement are several items that we ask you to rate according to the following criteria.

4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area

Comments may be made under any competency statement, if desired. Please be sure to indicate those areas in which you think the intern is particularly strong and those areas in which the student needs improvement.

This evaluation is intended to give the student feedback about their performance. Please rate the student on any given item as it is appropriate to YOUR  field setting. The field supervisor's rating of these items will not directly be used to calculate the grade given to the student. The field coordinator has responsibility of assigning the grade for field instruction.

The grade assigned will be based on:
The faculty field coordinator's overall evaluation of the student's performance in field placement in conjunction with the field supervisor's evaluation and other submitted materials such as: intern logs, seminar participation, papers that integrate field with classroom instruction.

If you prefer to use another evaluation system in addition to this form to evaluate the student's performance please discuss this with the field coordinator.

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Email *
Student Name *
Competency #1 Demonstrate Ethical and Professional Behavior *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
1.1 make 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;
1.2 use reflection and self-regulation to manage personal values and maintain professionalism in practice situations;
1.3 demonstrate professional demeanor in behavior; appearance; and oral, written, and electronic communications;
1.4 use technology ethically and appropriately to facilitate practice outcomes; and
1.5 use supervision and consultation to guide professional judgment and behavior.
Comments
Competency #2 Engage Diversity and Difference in Practice *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
2.6 apply and communicate understanding of the importance of diversity and difference in shaping life experiences in practice at the micro, mezzo, and macro levels;
2.7 present themselves as learners and engage clients and constituencies as experts of their own experiences; and
2.8 apply self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituencies.
Comments
Competency #3 Advance Human Rights and Social, Economic, and Environmental Justice *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
3.9 apply their understanding of social, economic, and environmental justice to advocate for human rights at the individual and system levels; and
3.10 engage in practices that advance social, economic, and environmental justice.
Comments
Competency #4 Engage In Practice-informed Research and Research-informed Practice *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
4.11 use practice experience and theory to inform scientific inquiry and research;
4.12 apply critical thinking to engage in analysis of quantitative and qualitative research methods and research findings; and
4.13 use and translate research evidence to inform and improve practice, policy, and service delivery.
Comments
Competency #5 Engage in Policy Practice *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
5.14 identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services;
5.15 assess how social welfare and economic policies impact the delivery of and access to social services;
5.16 apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic and environmental justice.
Comments
Competency #6 Engage with Individuals, Families, Groups, Organizations, and Communities *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
6.17 apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks to engage with clients and constituencies; and
6.18 use empathy, reflection, and interpersonal skills to effectively engage diverse clients and constituencies.
Comments
Competency #7 Assess Individuals, Families, Groups, Organizations, and Communities *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
7.19 collect and organize data, and apply critical thinking to interpret information from clients and constituencies;
7.20 apply 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;
7.21 develop mutually agreed-on intervention goals and objectives based on the critical assessment of strengths, needs, and challenges within clients and constituencies; and
7.22 select appropriate intervention strategies based on the assessment, research knowledge, and values and preferences of clients and constituencies.
Comments
Competency #8 Intervene with Individuals, Families, Groups, Organizations, and Communities *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
8.23 critically choose and implement interventions to achieve practice goals and enhance capacities of clients and constituencies;
8.24 apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies;
8.25 use inter-professional collaboration as appropriate to achieve beneficial practice outcomes;
8.26 negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies; and
8.27 facilitate effective transitions and endings that advance mutually agreed-on goals.
Comments
Competency #9 Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities *
4 - Exemplary: the intern has excelled in this area
3 - Very good: the intern is functioning above expectations for interns in this area
2 - Proficient: the intern has met the expectations for interns in this area
1 - Emerging: the intern has not as yet met the expectations in this area
0 - The intern has not met the expectations in this area
N/A - Not applicable, as the intern has not had the opportunity to demonstrate competence in this area
9.28 select and use appropriate methods for evaluation of outcomes;
9.29 apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the evaluation of outcomes;
9.30 critically analyze, monitor, and evaluate intervention and program processes and outcomes; and
9.31 apply evaluation findings to improve practice effectiveness at the micro, mezzo, and macro levels.
Comments
Overall Evaluation at Midterm
Comments
Signature of Agency Field Supervisor *
Agency *
Date *
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A copy of your responses will be emailed to the address you provided.
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