Evaluation Tool for Child Life Practicums Key: |=Not Acceptable (Student does not perform this skill at a level acceptable for a beginning child life practicum, even when provided considerable assistance by clinical supervisor) jelow Standard (Requires significant assistance in order to perform the skill or behavior. Student is given ‘multiple opportunities to build skills and is having difficulty integrating feedback and improving skills) standard Beginning Practicum (requires appropriate assistance in order to perform the skill or behavior, but is demonstrating Improvement) ‘ontinued Improvement (Requires some assistance in order to perform the skill or behavior effectively most of the time) 1ereasing Independence (Takes initiative and is gaining appropriate independence for a practicum student) Student Name: Erin Kisch Term: Summer 2018 1[2[3[4[s5[ WA Reflective Practice Recognizes and demonstrates willingness to explore how personal challenges, x learning needs, cultural and personal beliefs impact professional practice. Engages in self-reflective practice, demonstrating realistic and critical thinking x regarding own performance, and incorporates insights into practice. Areas of strength and proposed action: plan(s): Assessing body language as well as reading the room are areas that Erin has shown growth during practicum. Even more deeper critical thinking could be an area of growth as Erin continues on her journey Engagement in Supervision Readily accepts and integrates supervision and feedback from supervisor and other x members of health care team Seeks support from mentors, peers, and supervisors. x Contacts both clinical and academic supervisors in a timely manner when absences x are necessary or other concerns arise so they may be addressed. ‘Areas of strength and proposed action plan(s): Erin has shown good professionalism and timeliness during this student experience. Seeking out more information and opportunities while involved in larger medical system could be an area of growth. Initiative Is motivated to learn. Follows through on specific assignments and tasks. x ‘Accepts responsibility and demonstrates initiative in work. x ‘Areas of strength and proposed action plan(s): Towards the end of student experience Erin really displayed the ability to pick up on pertinent body language and assessments of patients and their families. Continuing to tune into pieces of conversations and interactions as well as reading the room may offer more chances for growth and learning Professional Presentation of Self Maintains a positive attitude, is tactful, and considerate. x Demonstrates adaptability and flexibility in the health care environment. Remains calm in stressful situations.Evaluation Tool for Child Life Practicums Key: jot Acceptable (Student does not perform this skill at a level acceptable for a beginning child life practicum, even when provided considerable assistance by clinical supervisor) jelow Standard (Requires significant assistance In order to perform the skill or behavior. Student is given ‘multiple opportunities to build skills and is having difficulty integrating feedback and improving skis) standard Beginning Practicum (requires appropriate assistance in order to perform the skill or behavior, but is demonstrating Improvement) 4=Continued Improvement (Requires some assistance in order to perform the skill or behavior effectively most of the time) reasing Independence (Takes initiative and Is gaining appropriate independence for a practicum student) Demonstrates respect for athers’ points of view, x Practices careful attention to verbal and written communication and to personal x appearance. ‘Maintains confidentiality of children, families, and staff in and out of the health care x setting ‘Areas of strength and proposed action plan(s): Erin displays professionalism well in the way she carries herself, showing respect to other disciplines and keying into how | her presence in the room affects pt’s and their families. 1[2[3[4/s| WA Time Management ‘Completes site assignments on time ‘Attends meetings and other scheduled responsibilities on time. ‘Adheres to work hours and schedule. “Areas of strength and proposed action plan(s): Erin exhibits great time management with turning in assignments on time while also being flexible to changes in work flow as needs arise. ‘Assessments & Interactions Prioritizes needs of patients and families Uses developmentally appropriate play asa tool. x ‘Assesses patient's developmental and emotional states accurately and interacts, x while matching the developmental level and emotional state. Formulates and implements Child Life goals. x Facilitates group process while attending to individual needs: x Provides varied activities matching patient’s condition and need. x vides techniques to help patients and families cope with hospitalization. Encourages family to advocate for patient. x Follows infection control and safety procedures and policies. x ‘Areas of strength and proposed action plans): Due to the standards of this, observational practicum experience Erin has not had the opportunity to build many of these skills independently. Conversely, Erin has been able to witness many interactions with Certified Child Life Specialists as well as other disciplines during their interactions with patients and their families. Communication & TeachingEvaluation Tool for Child Life Practicums key: lot Acceptable (Student does not perform ths skill ata level acceptable for a beginning child life practicum, even when provided considerable assistance by dlinical supervisor) jelow Standard (Requires significant assistance in order to perform the sill or behavior. Student is given multiple opportunities to build skills and is having dificulty integrating feedback and improving skills) standard Beginning Practicum (requires appropriate assistance in order to perform the skill or behavior, but is demonstrating Improvement) 4=Continued improvement (Requi creasing Independence (Takes i ‘some assistance in order to perform the skill or behavior effectively most of the time) ative and is gaining appropriate independence for a practicum student) ‘Communicates verbally with team members to obtain and or share pertinent patient x and family data ‘Takes the opportunity to educate staff/ multidisciplinary team members about Child x Life services when possible/appropriate ‘Advocates for the needs of children and families within a multidisciplinary team. x Priortizes patient needs and clearly communicates tasks to volunteers, ‘Able to model appropriate play interactions and engage volunteers during x interaction, ‘Areas of strength and proposed action plan(s): The above areas are not areas in which Erin has had opportunity to develop due to practicum being observational. student Name Print:_E, Kisch Student Signatur: Supervisor Name Print:,| ZA bveng ed supervisor signature ZUM Date: ¢ (Uf. 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