Briar Cliff University

Department of Social Work

Learning Plan & Field Evaluation
Taylor Holmes SU/FA 20
Student: Semester /year:
Field Instructor: Tiffani McCormick Task Supervisor:
(The Social Worker
(if applicable)
supervisor)
Connections of Cumberland County (910) 630-0106
Agency: Phone:
119 N. Cool Spring St, Fayetteville, NC 28301 Tiffani.mccormick@connectionsofcc.org
Address: Email:

This Learning Plan is based on the nine competencies students are expected to demonstrate upon finishing their internship. Each competency has
identified practice behaviors specific to the competency.

The field instructor (the social worker supervisor) will help the student identify practice opportunities, including timelines, related to the competency
which will be identified and assessed during the semester. The practice behaviors are closely related to each other and may be addressed with the same
internship activities. You should refer to the Learning Plan each week in supervision and update it as field activities change.

Second document on bottom of pages:

 This evaluation presents an opportunity for the field director to evaluate the student’s growth and development of the nine competency areas
developed by the Council on Social Work Education. By the end of the practicum students demonstrate competency in each of the following
arenas of performance as a foundation level social worker.
 For students who do not demonstrate the designated benchmark in any practice behavior, please indicate, in the instructor’s comments, specific
plans to support student need for development in these areas.
 For students who are unable to meet the benchmark on practice behaviors across three or more competencies, a remedial plan may be
required. If there is a need for a remedial plan to assist the student in achieving a competency, the faculty field director will meet with the student and
field instructor to develop the plan. The Final Field Evaluation will ask you to evaluate skill development in each of these areas.
For each evaluation item, please rate the student accordingly to the following scale:

5 - Superior/Advanced Competence. Demonstrates the ability to function independently with very high levels of awareness, knowledge and/or skill;
overall work quality/task completion is exceptional, suggesting mastery of the practice behavior. Exceptional ability to conceptualize, analyze, evaluate,
and synthesize multiple sources of information generated by observation, reflection, and reasoning. Demonstrates excellent regulation of emotions to
limit influence on thinking and behavior. Superior perception and discernment of multiple sources to form an opinion.

4 - Above Average Competence. Demonstrates moderate-to-high levels of awareness, knowledge and/or skill; overall work quality/task completion
exceeds basic practice standards and the level of competence is above average, suggesting additional guidance in key areas would promote mastery.
Moderate to high ability to conceptualize, analyze, evaluate, and synthesize multiple sources of information generated by observation, reflection, and
reasoning. Demonstrates above average regulation of emotions to limit influence on thinking and behavior. Very good perception and discernment
of multiple sources to form an opinion.

3. Basic Competence. Demonstrates acceptable levels of awareness, knowledge and/or skill; overall work quality/task completion meets basic practice
standards, but the level of competence is somewhat rudimentary, suggesting additional training and guidance may be beneficial. Adequate ability to
conceptualize, analyze, evaluate, and synthesize multiple sources of information generated by observation, reflection, and reasoning. Demonstrates
average regulation of emotions to limit influence on thinking and behavior. Good capacity to perceive and discern multiple sources to form an opinion.

2. Below Average Competence. Demonstrates levels of awareness, knowledge and/or skill that are below basic practice standards; overall work
quality/task completion is below acceptable standards and the degree of competence is lacking, suggesting the need for additional training and
consideration of corrective action. Minimal ability to conceptualize, analyze, evaluate, and synthesize multiple sources of information generated by
observation, reflection, and reasoning. Below average regulation of emotions to limit influence on thinking and behavior. Insufficient perception and
discernment of multiple sources to form an opinion.

1. Poor / Unacceptable Competence. Demonstrates unacceptable levels of awareness, knowledge and/or skill; overall work quality/task completion is
exceedingly poor and the degree of competence is very seriously lacking, requiring corrective action. Negligible ability to conceptualize, analyze, evaluate,
and synthesize multiple sources of information generated by observation, reflection, and. Poor regulation of emotions to limit influence on thinking and
behavior. Deficient perception and discernment of multiple sources to form an opinion.

3.0 - Desired benchmark for first half of internship. 4.0 - Desired benchmark for second half of
internship.

Comments may be made under any competency statement, if desired. Please be sure to indicate those areas in which you think the student is particularly
strong and those areas that need improvement. This evaluation is intended to give the student feedback about her or his performance . Final scores will
contribute to the determination of final grade (A-F). The points are added into other required assignments. Please sign and return the
Learning Plan to when scoring is completed.

Practice Behaviors
 Make ethical decisions by
applying the standards of
NASW Code of Ethics,
relevant laws and
regulations, models for
ethical decision making,
ethical conduct of research
and additional codes of ethics
appropriate to context.
 Use reflection and self-
regulation to manage
personal values and maintain
professionalism in practice
situations.
 Demonstrate professional
demeanor in behavior;
appearance and oral and
written, and electronic
communication.
 Use technology
appropriately and ethically
to facilitate practice
outcomes.
 Use supervision and consultation
to guide professional judgement
and behavior
Competency 1.0 –Demonstrate Ethical and Professional Behavior.
EPAS Competency 2.1.1
Identify Use these instruments or others to
timeline measure…be specific.
with each
practice  Observation
Internship Activities behavior:  Journal
 Discussion
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
 Student will maintain agency and client confidentiality By midterm  Biweekly journal entries
 Student will uphold NASW Code of Ethics  Weekly team supervision meetings
 Student will discuss ethical dilemmas during supervision and 
demonstrate initiative in discussing ethical issues in supervision
 Student will identify potential strategies to resolve ethical dilemmas
and demonstrate emerging knowledge of ethical decision-making
models
 Student will keep a journal to record reflections
 Student will assess actions with supervisor
 Student will seek feedback and guidance and use it appropriately
 Student will identify themselves as a student intern when
communicating with clients
 Student will engage in tasks suitable for generalist practice
 Student will treat clients and staff with respect, in a nonjudgmental
manner, and demonstrate positive relationship-building communication
with staff and clients
 Student will follow agency dress code at all times
 Student will use clear and understandable language when
communicating with clients and staff
 Student will review procedures manual and attend orientation
 Student will demonstrate awareness of agency policy regarding use of
technology
 Student will use email and phone communication as outlines by agency
policy
 Student will practice healthy boundaries as outlined by agency policies
and NASW Code of Ethics
 Student will be prepared for supervision and will arrive promptly and
prepared to engage in weekly supervision
 Student will seek supervision appropriately outside of formal meetings
and seek guidance from supervisor when necessary
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Make ethical decisions by applying the
standards of NASW Code of Ethics, relevant
laws and regulations, models for ethical
1
decision making, ethical conduct of research
and additional codes of ethics appropriate to
context.
Use reflection and self-regulation to manage
2 personal values and maintain
professionalism in practice situations
Demonstrate professional demeanor in
3 behavior; appearance and oral and written,
and electronic communication.
Use technology appropriately and ethically
4
to facilitate practice outcomes..
Use supervision and consultation to guide
5
professional judgement and behavior.
TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 2.0 – Engage Diversity and Difference in Practice

EPAS Competency 2.1.2

 Instrument used to measure

Identify each practice behavior, Be
timeline specific, you may use more
With than one.
Internship Activities with Timeline each
Practice Behaviors (What do you want to learn and practice?) Observation
practice Journal
Be specific and realistic with short term and long term goals.
behavior: Discussion
By Midterm Documentation
Assignments
By Final Reading
Supervision
Apply and communicate  student will be able to describe the impact of culturally diverse factors at By final  Observation
understanding of the importance all system levels  Supervision
of diversity and difference in  student will demonstrate effective and culturally competent interviewing
shaping life experiences in practice skills
at the micro, mezzo, and macro  student will identify how agency policies and procedures affect diverse
level. populations eligible for services
 student will demonstrate cultural sensitivity when working with agency’s
diverse population and will reflect that in strength-based interactions with
clients
 Student will keep a journal to record reflections By final  Journal
Present themselves as learners and  Student will be able to work with clients of various cultural, ethnic  Supervision
engage client as experts of their and racial backgrounds and with a variety of problems and value-
own experiences. sensitive issues
 Student will be able to work with clients of various cultural, ethnic
and racial backgrounds and with a variety of problems and value-
sensitive issues
 Based on supervisory observation and student reports, student will
demonstrate culturally appropriate responsiveness
 Based on classroom and field learning, student will identify areas in
which agency could improve its responsiveness to minority groups
 Student will present suggestions for improvement at staff meeting

Apply self-awareness and self-
regulation to manage the influence
of personal biases and values in
working with diverse clients and
constituencies.
 Student will keep a journal to record reflections By final  Journal
 Observation/reflection
 Student will be able to identify personal values, beliefs and
assumptions evoked in relation to the demands of the agency
setting
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor

Apply and communicate understanding of

the importance of diversity and difference in
1
shaping life experiences in practice at the
micro, mezzo, and macro level.

Present themselves as learners and engage

2 client and constituencies as experts of their
own experiences.
Apply self-awareness and self-regulation to
manage the influence of personal biases and
3
values in working with diverse clients and
constituencies.
4 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 3.0 – Advancing Human Rights and Social Economic and Environmental Justice

EPAS Competency 2.1.3

 Instrument used to measure each

Identify practice behavior, Be specific, you
timeline with may use more than one.
Internship Activities with Timeline each practice
Observation
(What do you want to learn and practice?) behavior:
Practice Behaviors Journal
Be specific and realistic with short term and long term
Discussion
goals. By Midterm Documentation
Assignments
By Final Reading
Supervision
 Student will identify underserved needs of population By final  Observation
served by agency
Apply their understanding of
social economic and
environmental justice to advocate
for human rights at the individual
system levels.

 Utilizing client and staff communication, case record By final  Documentation

Engage in practices that advanced document review, and current demographic analyses,  Supervision
social, economic and student will engage in on-going program needs
environmental justice. assessment

 Student will report findings at staff/team meetings and

assist in the development of program enhancements
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Apply their understanding of social
economic and environmental justice to
advocate for human rights at the individual
system levels Distinguish, appraise, and
1
integrate multiple sources of knowledge,
including research-based knowledge, and
practice wisdom.

Demonstrate professional demeanor in

2 behavior; appearance and oral and written,
and electronic communication.
3 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 4.0 – Engage in Practice informed Research-informed practice and Research-informed practice
Practice Behaviors
Use practice experience and
theory to inform scientific inquiry
and research.
Apply critical thinking skills to
engage in analysis of quantitative
and qualitative research methods
and research findings.
EPAS 2.1.4
 Instrument used to measure each
Identify practice behavior, Be specific, you
timeline with may use more than one.
Internship Activities with Timeline each practice
Observation
(What do you want to learn and practice?) behavior:
Journal
Be specific and realistic with short term and long term
Discussion
goals. By Midterm Documentation
Assignments
By Final Reading
Supervision
 Student will be able, in consultation with field By final  Assignments- Change Process Model & Paper
supervisor, to identify agency problem or issue that  Observation
needs to be addressed and formulate a problem statement  Documentation
 Supervision
 Student will be able to discuss the effect of research on
agency practice and/or policy
 Student will have access to and review current data and
outcome measures
 Student will share the change process outline with
supervisor, begin to develop a potential change process
project, and outline a data collection plan
 Student will be able to verbalize how the research project
could benefit the program
 Student will be able to compare and contrast models of By final  Discuss in supervision
assessment and prevention
 Student will be able to distinguish which sources are
relevant to client population served by agency
  Student will discuss her conclusions with supervisor By final  Discuss in supervision

 Student will use supervision to discuss the development

Use and translate research of her research project and be able to form a study
evidence to inform and improve hypothesis
practice, policy and service
delivery.
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Use practice experience and theory to inform
1 scientific inquiry and research.
Apply critical thinking skills to engage in
2 analysis of quantitative and qualitative
research methods and research findings.
Use and translate research evidence to
3 inform and improve practice, policy and
service delivery.
4 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:


Practice Behaviors
Identify social policy at the
local, state and federal level
that impacts well-being,
service delivery, and access to
social services.
Assess how social welfare and
economic policies impact the
delivery of and access to social
services
Apply critical thinking to
analyze, formulate and
advocate for policies that
advance human rights and
social, economic, and
environmental justice.
Competency 5.0 – Engage in Policy Practice
EPAS Competency 2.1.5
Instrument used to measure each practice
behavior, Be specific, you may use more than
Identify
one.
timeline with
Internship Activities with Timeline each practice  Observation
(What do you want to learn and practice?) behavior:  Journal
Be specific and realistic with short term and long term goals.  Discussion
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
 Student will describe social policies, laws, practices that impact By midterm  Supervision
the client system or delivery of services  Reading- news/current events, policy, legislation
 Student will define how the agency partners with local
resources in the provision of services
 Student will describe social policies, laws, practices that impact By midterm  Observation
the client system or delivery of services  Supervision
 Reading
 Student will describe services and resources provided by the
agency to its client systems
 Student will collaborate with agency to identify tasks to help By midterm  Observation
resolve an identified social problem that is impacted by policy  Discussion
at the agency, community, local, state or federal level  Supervision
 Student will verbalize an understanding of how changes in
policy can help clients to overcome an identified social
problem
 Student will describe services and resources provided by the
agency to its client systems
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor

Identify social policy at the local, state and

1 federal level that impacts well-being, service
delivery, and access to social services.
Assess how social welfare and economic
2 policies impact the delivery of and access to
social services.
Apply critical thinking to analyze, formulate
and advocate for policies that advance
3
human rights and social, economic, and
environmental justice.
TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 6.0 – Engage with individuals, Families, Groups, Organizations and Communities.
Practice Behaviors
Apply knowledge of human
behavior and social
environment, person-in-
environment, and other
multidisciplinary theoretical
frameworks to engage with
clients and constituencies
Use empathy, reflection, and
interpersonal skills to
effectively engage diverse
clients and constituencies.
EPAS 2.1.6
Instrument used to measure each practice
behavior, Be specific, you may use more
Identify
than one.
timeline with
Internship Activities with Timeline each practice  Observation
(What do you want to learn and practice?) behavior:  Journal
Be specific and realistic with short term and long term goals.  Discussion
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
 Student will be able to identify issues related to transitions over By midterm  Supervision
 Observation
the course of the life cycle
 Discussion
 Student will be able to relate social work perspectives and  Reading
related theories
 During supervision and in staff/team meetings, student will
explain an understanding of client challenges from a life
transition perspective
 Student will observe staff conducting assessments for 1 month
and discuss with task supervisor and field instructor
 Student will be able to evaluate environmental impact upon
client’s presenting concerns
 Student utilizes eco-systems theory to assess and intervene to
address client’s presenting concerns
 Student will be able to “start where the client is” By midterm  Supervision
 Discussion
 Student will be able to establish rapport with the client system  Observation
 Student will be able to create and maintain a therapeutic
relationship with clients
 Student will demonstrate growing effectiveness in her
 relationship building and sustaining skills as observed by task
supervisor

 Student will demonstrate appropriate boundaries and engage in

strength-based partnerships with clients as observed by task
supervisor
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Apply knowledge of human behavior and
social environment, person-in-environment,
1 and other multidisciplinary theoretical
frameworks to engage with clients and
constituencies
use empathy, reflection, and interpersonal
2 skills to effectively engage diverse clients
and constituencies
3 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 7.0 – Assess Individuals Families, Groups, Organizations, and Communities.
Practice Behaviors
Collect and organize data and
apply critical thinking to
interpret information from
clients and constituencies.
Apply knowledge of human
behavior and social
environment, person-in-
environment, and other
multidisciplinary theoretical
frameworks in the analysis of
assessment data from clients
and constituencies.
EPAS Competency 2.1.7
Instrument used to measure each practice
behavior, Be specific, you may use more
Identify
than one.
timeline with
each practice  Observation
Internship Activities with Timeline
(What do you want to learn and practice?) behavior:  Journal
Be specific and realistic with short term and long term goals.  Discussion
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
 Student will be able to gather relevant data in an organized By midterm  Supervision
manner  Discussion
 Documentation
 Student obtains clients records follow agency policy
 Under supervision, student interprets client data as appropriate
 Student will complete strength-based assessments with at least 4
clients, will secure informed consent to request data from
outside sources, and will request this documentation in a timely
manner
 At team meetings, student will effectively articulate summaries
of her assessments, and auxiliary documentation to assist in the
development of a tentative treatment plan for clients
 Through the interviewing process, the student will identify at By midterm  Supervision
least three areas of strength  Discussion
 Documentation
 Through the interviewing process, the student will identify at
least three areas of challenge
 Student will be able to evaluate environmental impact upon
client’s presenting concerns
 Student utilizes eco-systems theory to assess and intervene to
address client’s presenting concerns
  After observation, student will conduct 4 assessments
successfully on her own as measured by task supervisor

Develop mutually agreed-on  Student, in concert with client system, will be able to develop By midterm  Discussion
intervention goals and clear and timely service goals  Documentation
objectives based on the  Observation
critical assessment of  Student will be able to develop measurable objectives designed
strengths, needs and to meet agreed upon goals.
challenges within clients and
constituencies.  In partnership with at least two clients, student will develop goal
plans with measurable outcomes

Select appropriate
intervention strategies
based on assessment,
research knowledge, and
values and preferences of
clients and constituencies.
 Student will be able to select from an array of intervention By midterm  Observation
strategies  Supervision
 Discussion
 Student will be able to describe selected intervention and discuss
why particular strategy has been chosen
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Collect and organize data and apply critical
1 thinking to interpret information from
clients and constituencies.
Apply knowledge of human behavior and
social environment, person-in-environment,
and other multidisciplinary theoretical
2
frameworks in the analysis of assessment
data from clients and constituencies.

Develop mutually agreed-on intervention

goals and objectives based on the critical
3 assessment of strengths, needs and
challenges within clients and constituencies.

Select appropriate intervention strategies

based on assessment, research knowledge,
4
and values and preferences of clients and
constituencies.
5 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 8.0 – Intervene with Individuals, Families, Groups, Organizations, and Communities

EPAS 2.1.8

Instrument used to measure each practice

Identify behavior, Be specific, you may use more
timeline with than one.
each practice  Observation
Internship Activities with Timeline  Journal
Practice Behaviors (What do you want to learn and practice?) behavior:
 Discussion
Be specific and realistic with short term and long term goals.
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
Critically choose and  Student will be able to implement and continually assess By final  Discussion
implement interventions to progress towards goal attainment  Observation
achieve practice goals and  Documentation
enhance capacities of clients  Student will be able to revise intervention plan accordingly
and constituencies.
 With assigned client, student will review progress on weekly
basis. If client shows no improvement, student will, in
partnership with client, adjust intervention

Apply knowledge of human  During supervision, S will describe theory that informs her By midterm  Supervision
behavior and the social treatment, and how she has partnered with client in their work  Discussion
environment, person in the together  Observation
environment, and other  Reading
multidisciplinary theoretical  Using a theoretical framework, student and client work together
frameworks in interventions toward goal attainment
with clients and
constituencies.

Use inter-professional
collaboration as appropriate
to achieve beneficial practice
outcomes.
 Student demonstrates knowledge regarding roles of inter-professional By midterm  Observation
team and benefits of working in an inter- professional setting  Discussion
 Supervision
 Student identifies ways in which inter-professional team works to
ensure ‘best practices’ for client (client system)

Negotiate, mediate and  Student connects client to appropriate resources and referrals to By midterm  Discussion
advocate with and on behalf promote goal attainment  Supervision
of diverse clients and
 constituencies.
 Student advocates for needed services for client

 Student will consult task supervisor when referrals to other

agencies are required to assist client

 Student will both prepare client for self- advocacy and intervene
when necessary (with input from task supervisor)

 Student will be able to assess successful goal attainment and By final  Discussion
Facilitate effective transitions plan termination accordingly.  Supervision
and endings that advance
 Documentation
mutually agreed upon goals.
 Student will be able to successfully terminate in the helping
process.

 When/if goal is achieved, student will end formal relationship

with a follow-up plan in place
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Critical choose and implement interventions
to achieve practice goals and enhance
1
capacities of clients and constituencies.

Apply knowledge of human behavior and the

social environment, person in the
2 environment, and other multidisciplinary
theoretical frameworks in interventions with
clients and constituencies.
Use inter-professional collaboration as
3 appropriate to achieve beneficial practice
outcomes.
Negotiate, mediate and advocate with and on
4 behalf of diverse clients and constituencies.

Facilitated effective transitions and endings

5
that advance mutually agreed upon goals.
6 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 Competency 9.0 – Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities

EPAS Competency 2.1.9

Instrument used to measure each practice

Identify behavior, Be specific, you may use more
timeline with than one.
each practice  Observation
Internship Activities with Timeline  Journal
Practice Behaviors (What do you want to learn and practice?) behavior:
 Discussion
Be specific and realistic with short term and long term goals.
By Midterm  Documentation
 Assignments
By Final  Reading
 Supervision
Select and use appropriate  Student will identify various approaches to best evaluate outcomes By final  Observation
methods for evaluation  Supervision
outcomes.  Student will demonstrate knowledge of evaluation practices

 Student will collaborate with field instructor to identify the best

evaluation approach for clients and for their final service-learning
project

Apply knowledge of human
behavior and the social
environment, person –in-
environment, and other
multidisciplinary, theoretical
frameworks in the evaluation
of outcomes.
 Student will identify variables in the social context that could By final  Observation
potentially impact evaluation process or outcomes  Discussion
 Student will demonstrate knowledge of self-determination and various
aspects of human behavior on evaluation and outcome measures
 Student will demonstrate knowledge of the impact of theory and
context on evaluation process

Critically, analyze, monitor,  Student will be able to continuously evaluate intervention, not only at By final  Discussion
and evaluate interventions termination, but throughout process  Observation
and program process and  Supervision
outcomes  With client, student will continuously review plan to assess progress
toward goal

 Student will utilize bi-weekly sessions to assist client measure progress

 toward goal and modify intervention when warranted

Apply evaluation findings, to  Student will identify strengths and potential future changes with By final  Supervision
improve practice evaluation process at the agency that could lead to improved outcomes  Observation
effectiveness at the micro, for clients and client systems
mezzo and macro levels.
 EVALUATION Mid-Term Evaluation Final Evaluation
See Front Page for Scoring Student Field Instructor Task Supervisor Student Field Instructor Task Supervisor
Select and use appropriate methods for
1
evaluation outcomes.
Apply knowledge of human behavior and the
social environment, person –in-
2 environment, and other multidisciplinary,
theoretical frameworks in the evaluation of
outcomes.
Critically, analyze, monitor, and evaluate
3 interventions and program process and
outcomes
Apply evaluation findings, to improve
4 practice effectiveness at the micro, mezzo
and macro levels.
6 TOTAL
Field Instructor’s/Task Supervisor Mid-Term Comments:

Field Instructor’s/ask Supervisor Final Comments:

 MID-TERM EVALUATION
MIDTERM EVALUATION SCORES (2.0 Benchmark)
Student Self-Report:
Social Work Supervisor/Task Supervisor :
Average of two scores:

Mid-Term Comments
Student’s strengths:

Student’s areas for improvement:

Signatures
Student Date:

Field Instructor / Task Supervisor Date:

Director of Field Education / Designated Field Liaison Date

All signatures are REQUIRED before you hand in. Always keep a copy of this Learning Plan & Field Evaluation
FINAL EVALUATION
Final Evaluation Scores (3.5Benchmark)
Student Self-Report: Social Work Supervisor/Task supervisor (if applicable): Average of two scores:

Final Comments
Student’s strengths:
 Student’s areas for improvement:

My field instructor has discussed this final evaluation with me and I have received a copy. My agreement or disagreement is as follows:

*If the student disagrees with this evaluation, she/he should attach an explanation of their disagreement.

Signatures
Student: Date:

Field Instructor/Task Supervisor Date:

Director of Field Education / Designated Field Liaison Date

All signatures are REQUIRED before you hand in. Always keep a copy of this Learning Plan & Field Evaluation

Authorization of Release

I___________________________________authorize Briar Cliff University to release the contents of this Learning Plan & Field Evaluation upon request for post-secondary
graduate program admission purposes.

Student Signature:____________________________________________________ Date:______________________