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This form is to be completed by the Field Instructor and discussed with student.

will automatically be sent to the Faculty Advisor once it is completed online.


Heather Workman


Restorations Towers

Agency Field Instructor(s):

Faculty Advisor:

Gladys J. Murphy, LMSW

Glenn Whitlaw

Please Check One:


MSW Foundation Year
MSW Advance Year

Q3 Please check and complete all that apply.


Student has received agency orientation and work space has been assigned.

Student has completed 64 hours to date.

Student is actively engaged in weekly supervision.

Learning Plan has been completed and submitted to the Field Instructor and
Faculty Advisor.
Process Recordings or PRACSIS have been reviewed by Field Instructor and
submitted to the Faculty Advisor (students should check with assigned Faculty
Advisor to find out the number of Process Recordings or PRACSIS required).
Please describe any areas of strength or concern in regard to the students
performance and/or the availability of required learning assignments.

Heather was very professional in approaching the residents, was able to engage
them in completing an Intake, Assessment and ADL Assessment and helping the
resident determine what services they need to remain independent. She had a good
understanding of what services were available and how to help the resident access

Instructions for completing the mid-term evaluation: Please evaluate students

performance halfway through the semester by indicating Progress, No Progress, or
No Opportunity. Please reference the students Learning Plan specific practice
outcomes to determine the rating.

Performance rating scale based on the (11) competencies:

PROGRESS Student met performance expectation and/or is exhibiting progression

to meet expectations

NO PROGRESS Student did not meet performance expectations

NO OPPORTUNITY There was not an opportunity to meet expectations

Identify as a professional social worker and conduct oneself accordingly.
Apply social work ethical principles to guide professional practice.


Apply critical thinking to inform and communicate professional judgments.

Engage diversity and difference in practice.


Advance human rights and social and economic justice.


Engage in research-informed practice and practice-informed research. PROGRESS

Apply knowledge of human behavior and the social environment.PROGRESS
Engage in policy practice to advance social and economic well-being and to deliver
effective social work services. PROGRESS
Respond to contexts that shape practice.


Engage, assess, intervene, and evaluate with individuals, families, groups,

organizations, and communities.PROGRESS
Analyze the impact of the urban context on a range of client systems, including
practice implications.
If there is a Competency Area in which the student has not met minimum
performance expectations to date, a plan of action must be noted below. If there will
not be an opportunity to address a competency area, please state that.

There has not been an opportunity for the student to advance human rights and
social and economic justice. Monthly newsletters such as AARP maganines and

other peridicals have been available for the student to review and learn more about
issues that affect the senior population. Heather, along with my other students was
encouraged to visit either the Arab-American or African-American Museum to learn
more about these populations and what issues affect them.

In the section below, please provide an Overall Rating of Progress or No Progress for
the students performance, as indicated by the rating that is most frequent of the
eleven (11) competencies. All parties are required to sign the midterm evaluation to
indicate that they have discussed the evaluation, even if the student does not agree
with the evaluation.





Heather was able to do a complete Assessment, Intake, and ADL Assessment and
help the resident determine wbat services they might need to remain independent.
She had a good knowledge of services available to this population and how to
access them. She preformed her duties in a ethical, professional manner. She easily
engaged the resident and showed appropriate empathy when needed.

**Please note: By typing my name below, I certify that I have reviewed the
document, completed my portion and agree with the content.

(Murphy, Gladys): Gladys J. Murphy, LMSW Feb 23, 2015 11:18 AM

Field Instructor (agency-based supervisor)


Agree with the evaluation.



**Please note: By typing my name below, I certify that I have reviewed the
document, completed my portion and agree with the content.

By signing you will submit Midterm FIASC information to the assigned faculty
advisor from the Wayne State University School of Social Work. Once the form is
completed you will not be able to modify your responses.

(Workman, Heather): Heather Workman Feb 27, 2015 10:04 PM


(Glenn Whitelaw): Glenn D.C. Whitelaw LMSW Mar 1, 2015 2:46 PM

Faculty Advisor