BSW Program
School of Social Work
University of North Carolina at Wilmington
Student Name: _____________________________________
Field Instructor: __________________________________________
Semester/Year : ____________________________________
Agency Phone: ___________________________________________
Agency Name: _____________________________________ Faculty Liaison: __________________________________________
Student Work Schedule: _____________________________ Schedule of Supervision: ___________________________________
Names of Additional Staff Supervising Placement Assignments:
Instructions for Completing the Learning Contract:
The Learning Contract is composed of ten goals. Following each goal are several objectives that need to be addressed to acquire the skills
necessary for successful practice of generalist social work practice at the BSW level; these goals and objectives are applicable to all practicum
sites. Each student is responsible, in collaboration with his/her agency field instructor, for articulating the learning activities, evaluation criteria,
and target dates needed to achieve the identified goals and objectives. In addition, each student must identify a goal of personal interest to pursue
within the practicum. If there are additional areas of interest students are encouraged to include them in the Learning Contract as well. This
Learning Contract will guide the practicum learning experience for two semesters and may be revised with the approval of the field instructor and
faculty liaison.
Instructions for completing the Student Performance Evaluation Form
The goals and objectives delineated in the learning contract are also the basis for evaluation of student progress in the learning process. The
evaluation tool will assess student performance suitable for beginning generalist practice. Both the student and the field instructor will evaluate
the student's performance independently, discuss their evaluation with each other, and clarify expectations collaboratively. The following rating
scale is provided to guide the evaluation process:
NO - not observed
3 - satisfactory*
1 - unsatisfactory
4 - more than satisfactory
2 - needs strengthening
5 – exceptional
* A ""3"" denotes a satisfactory performance at the placement. After rating each objective, please provide written comments to explain ratings that
are higher or lower than satisfactory as well as suggestions for strengthening work performance.
Goal 1: Identify as a professional social worker and conduct one's self accordingly.
Student Learning Objectives
A. Articulate roles of
beginning generalist practice
as they pertain to practice with
client systems of all sizes
(advocacy, facilitator, etc.).
B. Identify social work roles
and boundaries as practiced
within the agency.
C. Develop a professional
relationship with the FI to
facilitate successful use of
supervision.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
Comments
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
D. Demonstrate professional
work habits/demeanor
including planning, managing
time, setting priorities,
accountability, etc.
E. Demonstrate a willingness
to pursue continued
professional development.
F. Articulate personal
stressors associated with
practice to enhance selfawareness.
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Goal 2: Apply social work ethical principles to guide professional practice.
Student Learning Objectives
A. Distinguish between
personal and professional
values and their impact on
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
Comments
practice.
B. Identify ethical concerns
and their implications for
ethical practice.
NO 1 2 3 4 5
C. Demonstrate a commitment
to and the application of the
NASW Code of Ethics to
identified concerns that arise in
agency practice.
D. Demonstrate an ability to
recognize and tolerate
ambiguity.
NO 1 2 3 4 5
NO 1 2 3 4 5
E. Apply strategies of ethical
reasoning to arrive at
principled decisions to
address ethical dilemmas.
NO 1 2 3 4 5
Goal 3: Apply critical thinking to inform and communicate professional judgments.
Student Learning Objectives
A. Distinguish and appraise
multiple sources of information,
including both practice
experience and research-based
resources.
B. Analyze styles of assessment,
prevention, intervention, and
evaluation for strengths suitable
for generalist practice.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
C. Analyze suitability of
developmental theories that are
relevant to the agency
practice and client populations
served.
D. Demonstrate effective oral
and written communication in
working with client systems of
all sizes as well as co-workers
and colleagues.
E. Assume responsibility for
own workload as a member of
agency team.
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Goal 4: Engage clients who represent diversity and difference to enhance understanding and inclusiveness in practice.
Student Learning Objectives
A. Explore the extent of
oppression, alienation, and
power imbalances as
promoted by cultural structures
and values.
B. Gain self-awareness
regarding one's personal
biases toward diverse groups
and cultures which hinder
practice effectiveness.
C. Communicate appreciation
of difference as it shapes life
experiences of both clients and
colleagues by gaining practice
experience with diverse client
populations, conditions and
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
cultures. (Age, religion, race,
ethnicity, learning ability, etc..)
D. Demonstrate an ability to
work collaboratively with
clients and co-workers,
coming from that place of
"not-knowing" that recognizes
clients as experts.
E. Demonstrate ability to
communicate with cultural
sensitivity with diverse
populations.
NO 1 2 3 4 5
NO 1 2 3 4 5
Goal 5: Advance human rights and social and economic justice.
Student Learning Objectives
A. Articulate community and
regional factors/beliefs that
impact client rights and access to
services.
B. Identify a minimum of one
social problem that impacts
community perception of the
client population served by the
agency.
C. Explore the history of the
social problem selected to
determine extent of the problem.
D. Advocate for human rights
and social justice in the agency.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
E. Demonstrate practice skills
that advocate for social and
economic justice in
the larger community.
NO 1 2 3 4 5
Goal 6: Engage in research-informed practice and practice-informed research.
Student Learning Objectives
A. Gain experience measuring
agency's service effectiveness in
meeting client needs.
B. Review literature to identify
resources to serve client
population.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
Comments
NO 1 2 3 4 5
NO 1 2 3 4 5
C. Demonstrate techniques for
evaluating one's own practice
effectiveness.
NO 1 2 3 4 5
Goal 7: Apply knowledge of human behavior and the social environment.
Student Learning Objectives
A. Recognize the relevance of
social systems theory for generalist
practice.
B. Identify conceptual frameworks
that guide the processes of
assessment, intervention, and
evaluation in the agency.
C. Ability to apply theories that are
useful for the placement setting.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
Goal 8: Engage in policy practice to advance social and economic well-being and to deliver effective social work services.
Student Learning Objectives
A. Identify gaps in community
services.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
Comments
NO 1 2 3 4 5
B. Demonstrate ability to
analyze agency policies to
determine effectiveness.
NO 1 2 3 4 5
C. Assess social policy to
identify target areas for change.
NO 1 2 3 4 5
D. Actively participate in
advocating for policy change at
the agency, community or
societal level.
NO 1 2 3 4 5
Goal 9: Respond to contexts that shape practice.
Student Learning Objectives
A. Identify agency mission,
history and focus for the agency.
B. Identify
agency/administrative structure
for lines of authority for
effective decision-making.
C. Identify sources and
adequacy of funding for agency
services.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
D. Articulate demographics of
client population served by the
agency.
NO 1 2 3 4 5
E. Demonstrate knowledge of
basic community resources.
NO 1 2 3 4 5
F. Gain knowledge of agency's
basic rules of safety.
NO 1 2 3 4 5
Goal 10A: Engage, assess, intervene, transition and evaluate with individuals, families and groups.
Student Learning Objectives
A. ENGAGEMENT:
-Determine how to effectively
engage clients served by the
agency.
-Demonstrate ability to use
empathy and effective listening
in interpersonal skills.
-Engage clients in trusting
supportive relationships.
-Develop mutually agreed-on
focus, with the client, for
interventions and outcomes.
B. ASSESSMENT:
-Collect, organize and
understand client data, including
strengths and concerns, meeting
with client and collateral
contacts.
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
-Select appropriate intervention
strategies.
-Use supervision to gain
awareness of techniques of
practice and reflect on personal
learning needed to enhance
practice proficiency.
C. INTERVENTIONS:
-Assist clients in identifying
solutions.
-Demonstrate skill in creating
and facilitating client groups.
-Determine ways to negotiate,
mediate and advocate for clients.
-Demonstrate knowledge and
ability to link clients to
community resources.
-Demonstrate professional
collaboration (networking).
D. TRANSITIONS:
-Identify client readiness for
endings/transitions.
-Plan and facilitate transition to
next level of service.
-Demonstrate ability to
transition at close of placement.
E. EVALUATION:
-Demonstrate skill in written
documentation.
-Gain knowledge of agency
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
evaluation methods.
-Demonstrate ability to evaluate
one's practice.
Goal 10B: Engage, assess, intervene, transition and evaluate with communities and organizations.
Student Learning Objectives
A. ENGAGEMENT:
-Demonstrate ability to use
empathy and effective listening
in interpersonal skills.
-Engage co-workers and
community professionals in
trusting work relationships.
-Develop mutually agreed-on
focus for interventions and
outcomes.
B ASSESSMENT:
-Collaborate, organize, and
understand client data, including
strengths and concerns.
-Determine appropriate
planning/organizing strategies.
C. INTERVENTIONS:
-Identify relevant
organizational/community
resources to facilitate change.
-Participate in interagency
meetings.
-Determine ways to negotiate,
Student Learning Activities
Evaluation Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
NO 1 2 3 4 5
NO 1 2 3 4 5
Comments
mediate and advocate for groups
of clients and organizational
systems.
-Collaborate with community
professionals to implement a
community outreach project.
D. TRANSITIONS:
-Identify client readiness for
endings/transitions.
-Plan and facilitate transition to
next level of service.
-Demonstrate ability to
transition at close of project(s).
NO 1 2 3 4 5
E. EVALUATION:
-Demonstrate skill in
maintaining agency statistics,
etc.
-Gain knowledge of agency
evaluation methods.
-Demonstrate ability to evaluate
an aspect of agency service
delivery.
NO 1 2 3 4 5
Goal 11: Design a personal learning goal and articulate in this space, including the learning tasks and the evaluation criteria.
Student Learning Objective
A.
Student Learning
Activities
Evaluation
Criteria
Target Date
Rating Scale
NO 1 2 3 4 5
Comments
Learning Contract Signatures: (to be signed when learning contract is submitted to field faculty liaison)
Signature of Student________________________________ Date_________________
Signature of Field Instructor__________________________ Date_________________
Signature of Faculty Liaison__________________________ Date_________________
******************************************************************************************************************
End of Semester Performance Evaluation
I. Identify Student Strengths
II. Identify Areas for Student Improvement.
III. Please Rate the Student's Overall Performance in Field Practice:
Unsatisfactory
Needs Improvement
Satisfactory
More than Satisfactory
Exceptional
1
2
3
4
5
IV. Student Comments
Performance Evaluation Signatures: (to be signed when end-of-semester field evaluation site visit is completed)
Signature of Student________________________________________________ Date_________________
Signature of Field Instructor__________________________________________ Date_________________
Signature of Faculty Liaison__________________________________________ Date_________________
Revised 9/5/11