P BAG 9055 Telephone: (263) 54 260404 ext 2156

GWERU Fax: (263) 54 260233/260311

FACULTY OF SOCIAL SCIENCES

DEPARTMENT OF PSYCHOLOGY

WORK RELATED LEARNING: ACADEMIC SUPERVISOR’S FORM (PSY302)

NAME OF STUDENT :……………………………………....................................................

REGISTRATION NUMBER : ……………………………………………………………………...
MODE OF ENTRY : ……………………………………………………………………...
PLACEMENT INSTITUTION : ……………………………………………………………………...
DEPARTMENT IN THE ORGANISATION : …………………...…………………………………………………
DATE OF PLACEMENT : …………………………………….………………………………..
DATE OF CONTRACT EXPIRY :……………………………………………………………………….
NAME OF WORK SUPERVISOR : ……………………………………………........................................
NAME OF VISITING LECTURER : ………………………………………………………………………
DATE : .………………...……………………………………………………

ATTRIBUTE TO BE ASSESSED LECTURER’S COMMENTS MARK

Nature of work
 What is the mission of the
institution you work for? [3] /5
 What is the institution’s main
objective or line of work? [2]

Main Tasks and Duties

What are your main tasks and duties
on a
/25
 Daily basis
[5]
 Weekly basis [5]
 Monthly basis? [15]

Relevance of your main tasks and

duties to your field of study
 How applicable are your
main tasks and duties to
Psychology? [10] /20
 What are some of the
Psychological theories,
principles, concepts, tools
and/or techniques that you
use in the course of your
work?
[10]
Status of Logbook
An up-to-date logbook indicating:
 Clear placement program [5]
 Clearly articulated daily,
weekly and/or monthly work
plans, with respective
objectives and key /25
performance indicators [5]
 Comments on how each work
plan went on: Explanations
of success and/or failure
[5]
 Recommendations based on
outcomes of work plans
[5]
 Work supervisor’s comments
on the student’s work plans,
comments and
recommendations [5]
Innovation and contribution to the
institution
 What value, new initiatives or
contributions have you added
to the institution?
[5] /15
 Did you make any creative
and/or resourceful
improvements to existing
systems in a bid to enhance
operational efficiency in the
institution?
[5]
 How have you enhanced the
institution’s existing
operational systems?
[5]
Work Related Challenges faced
 What operational or other
challenges have you
encountered that might have
hampered your ability to
perform tasks and duties? [5] /10
  Describe the design, plan,
implementation and
evaluation of intervention
strategies you used to
alleviate these challenges [5]

OVERALL MARK
/100

Company/Organization Stamp

Signature of Visiting Lecturer ………………...…………… Date ………………………

Signature of Workplace Supervisor ……………………............... Date ………………………