SALISBURY UNIVERSITY

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					                                      SALISBURY UNIVERSITY
                                   DEPARTMENT OF SOCIAL WORK

                                           FIELD INSTRUCTOR’S
                                      GRADUATE
                                 MID-TERM EVALUATION
                                   OF STUDENT’S PERFORMANCE



Period of Evaluation Covers:          to

Student:                                      SU Student ID#:

Agency:

Field Supervisor:                                     Phone:

Field Supervisor E-Mail Address:

Use of this form:
This is the evaluation form to use in the middle of the student’s 1st semester field placement. It is
important that evaluation of the student be a shared process and that you and the student discuss
variations and similarities in your assessments.

List Mid-Term Evaluation of Learning Goals (Please refer to Learning Contract):




Comment on the process of developing the LEARNING CONTRACT and any progress on the
completion of goals:
                          STUDENT’S PERFORMANCE IN FIELD INSTRUCTION
Please evaluate the behaviors you observe in the student’s performance using the following scale:
        Pass – performance meets expectations
        Needs improvement – performance below expectations
        Fail – performance well below expectations
No Opportunity – you have not had the opportunity to teach or observe this content, or the field setting does not
provide opportunity to learn this content.
                                                                                          Rate
                                                                                     Needs                   No
                                                                       Pass                       Fail
                                                                                  Improvement             Opportunity
1. Demonstrates knowledge of the agency’s programs and client
   populations served
2. Shows awareness of social work values and ethics
3. Demonstrates problem-solving skills
4. Recognizes personal changes she/he needs to make in order
   to work effectively as a social worker
5. Demonstrates awareness of human diversity
6. Demonstrates understanding of how his/her own values help
   or interfere with social work practice
7. Expresses self clearly in verbal communication
8. Expresses self clearly in written communication
9. Demonstrate acceptance of self and others
10. Seeks feedback and critique regarding own work
11. Handles work load
12. Is on time for appointments
13. Discusses classroom learning in relation to client situations
14. Organizes well
Suggestions for student in order to improve his/her professional competence: (Use additional sheets if
more space is required).




Student Comments: (Use additional sheets if more space is required).




Would you like to schedule a conference with the faculty field liaison to discuss this evaluation and the
student’s progress to date? Yes     No

                                                    Signatures
               Student:                                                                     Date:
     Field Supervisor:                                                                      Date:
 Faculty Field Liaison:                                                                     Date:

				
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posted:2/15/2013
language:Japanese
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