Student: _______________________________ Agency Field Instructor: _________________________
Date: _______________________________ Agency: ______________________________________
Section I LIST THE STUDENT’S KEY LEARNING EXPERIENCES AND ASSIGNMENTS THUS FAR
Section II CORE COMPETENCIES
Use the assessment tool below to rate/asses the student’s progress toward achieving each core competency. Please refer back to the learning contract for competency definitions and corresponding practice behaviors.
Core Competency
EP2.1.1- Identify as a professional social worker and conduct oneself accordingly.
Not Applicable
(Student has not had the opportunity to demonstrate skills in this area)
Concerns
Identified
(Student is struggling in this area and is in danger of not achieving competency if not improved)
Meeting
Expectations
(Student is progressing adequately & appropriately; is on target to achieve competency in this area by the end of the course)
Exceeding
Expectations
(Student excels in this area of practice)
EP2.1.2- Apply social work ethical principles to guide professional practice.
EP2.1.3- Apply critical thinking to inform and communicate professional judgments.
EP2.1.4- Engage diversity and difference in practice.
EP2.1.5- Advance human rights and social and economic justice.
EP2.1.6- Engage in research-informed practice and practice-informed research.
Mid-term Field Evaluation
Rev. 8/2015
Page 1 of 2

Core Competency
EP2.1.7- Apply knowledge of human behavior and the social environment.
EP2.1.8- Engage in policy practice to advance social and economic well-being and to deliver effective social work services.
EP2.1.9- Respond to contexts that shape practice.
EP2.1.10(a)-(d)- Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities.
Not Applicable
(Student has not had the opportunity to demonstrate skills in this area)
Concerns
Identified
(Student is struggling in this area and is in danger of not achieving competency if not improved)
Meeting
Expectations
(Student is progressing adequately & appropriately; is on target to achieve competency in this area by the end of the course)
Exceeding
Expectations
(Student excels in this area of practice)
Does the student seem to be fully engaged in this learning experience? Yes
Are there any concerns at this time that need to be corrected/addressed? Yes
If yes, please describe:
Key learning activities and assignments to still be completed:
No
No
The student must sign this evaluation.
The student's signature indicates that the student has read the evaluation. Any discrepancies in the student's and field instructor's perception of the student's performance should be noted below and discussed with the Field Director/Field Faculty during the agency site visit.
Field Instructor Date
Student Date
Student's comments (please use the back of the page if needed):
Mid-term Field Evaluation
Rev. 8/2015
Page 2 of 2