UMSL School of Social Work, MSW Program Advanced Social Work Practice with Individuals, Families and Groups Agency Supervisor's Final Evaluation (Revised 05/2014) Course 6800 Course 6850 Return forms: Hand-signed forms may be submitted in person or by fax to: (314) 516-6416. Forms sent as an email attachment to socialwork@umsl.edu may be signed electronically provided the document is sent from the professional email address of the practicum supervisor, and the student signer is copied. This fill form is best for a PC and Internet Explorer. Student's Name: Student ID#: Semester: Year: Agency Name: Supervisor's Name: Phone: Please complete the evaluation below by placing a check mark in the rating box that is appropriate for the student for each practice behavior identified. Please use the comment area to discuss ways in which the competency was met and to identify any areas in which you believe the student is particularly strong or those areas that need improvement. *Practice behaviors in italics are specific to advanced practice with individuals, families and groups. Professional Identification: Identifies as a professional social worker and conducts oneself accordingly (EPAS 2.1.1) Unacceptable Deficient Developing Accomplished Exemplary 1 2 3 4 5 Performance is generally unacceptable; never meets competency Rarely meets competency Advocates for client access to the services of social work Attends to professional roles and boundaries Understands and follows agency policies and procedures Demonstrates professional demeanor in behavior, appearance, and communication Uses supervision and consultation Establishes and maintains effective professional relations with clients, co-workers, representatives from other disciplines and other agencies 1 Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Organizes time and plans work accordingly Demonstrates initiative and resourcefulness in practicum Understands agency's mission, goals, function and role Understands how own behavior and values affect relationships with clients Able to use social work knowledge and skills in work with clients Uses person-in-environment and/or strengths perspectives to guide therapeutic relationships Understands challenges when using social work values and knowledge in multi-disciplinary setting Uses social work professional knowledge and skills to engage clients in problem solving that will help restore functioning Comments: . Applies social work ethical principles to guide professional practice (EPAS 2.1.2) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Demonstrates knowledge of, and abides by, the NASW Code of Ethics in practice Tolerates ambiguity in resolving ethical conflicts Applies ethical decision making skills and frameworks to issues specific to work with individuals, families and groups 2 Identifies personal biases and understands how to manage these biases Understands ethical issues in the use of technology in clinical practice and use this knowledge to manage technology to protect clients Comments: . Applies critical thinking to inform and communicate professional judgments (EPAS 2.1.3) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Demonstrates effective oral and written communication in working with individuals, families, groups, organizations, communities, and colleagues Differentiates between several theoretical perspectives and determines which are most appropriate in working with client/s Keeps professional records Presents professional understanding of clients at team meetings and in other situations in which social work knowledge is needed Comments: 3 IV. Engages diversity and difference in practice (EPAS 2.1.4) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Demonstrates awareness and sensitivity to racial, ethnic, cultural, religious, gender, disability, and sexual orientation factors in understanding clients Has sufficient self-awareness to eliminate the influence of personal biases and values in working with diverse groups Recognizes and communicates understanding of the importance of difference in shaping life experiences Views self as a learner, and engages those with whom he/she works as informants Shares with colleagues current information about best clinical practices for intervention with diverse clients Uses practitioner/client differences to identify client strengths Identifies the diverse population residing in the metropolitan region and shares information about how to respond appropriately to those who are experiencing poverty, marginalization or alienation Comments: 4 V. Advances human rights and social and economic justice (EPAS 2.1.5) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Engages in practice that advances social and economic justice Recognizes that each person, regardless of position in society, has basic human rights, such as freedom, safety, privacy, an adequate standard of living, health care and education Develops approaches to treatment that take into account client's difficulties created by social injustice, particularly in terms of inability to access services Comments: VI. Engages in research-informed practice and practice-informed research (EPAS 2.1.6) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Identifies the research base for the work done at the agency 5 Identifies and uses evidence-based practices in work with clients Evaluates own practice or that of agency Comments: VII. Applies knowledge of human behavior and the social environment (EPAS 2.1.7) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Utilizes conceptual frameworks to guide the processes of assessment, intervention, and evaluation Demonstrates an understanding of how biological, psychological, and cultural factors influence human behavior Demonstrates an understanding about the ways in which social systems promote or deter people in maintaining or achieving health and well-being Differentiates among theories and determines which are most appropriate for use with targeted client group 6 Uses bio-psycho-socialspiritual theories and/or multi-axial diagnostic classification systems in formulation of assessments Understands when to consult with others to confirm diagnoses and/or monitor interventions Comments: VIII. Engages in policy practice to advance social and economic well-being and to deliver effective social work services (EPAS 2.1.8) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Identifies the role of policy in service delivery Collaborates with colleagues and clients for effective policy action Communicates with stakeholders or others the implications of policy and/or policy changes for clients Comments: 7 IX. Responds to the contexts that shape practice (EPAS 2.1.9) Unacceptable 1 Deficient 2 Developing 3 Accomplished 4 Exemplary 5 Performance is generally unacceptable; never meets competency Rarely meets competency Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Identifies and analyzes factors that impact the agency's mission and service delivery system (i.e., organizational structure, operation, policies, funding, scientific developments, economy, etc.) Recognizes that the context of practice is dynamic and has the knowledge and skills to respond proactively Assesses clients' interactions with social contexts to understand how changes in the clients' environments may affect their ability to engage in and/or use intervention Works collaboratively with clients or others to plan/and or bring about systemic change Recognizes knowledge, skills and values needed to provide leadership in agency Comments: 8 X. Engages, assesses, intervenes, and evaluates with individuals, families, groups, organizations and communities (EPAS 2.1.10) Unacceptable Deficient Developing Accomplished Exemplary 1 2 3 4 5 Performance is generally unacceptable; never meets competency Rarely meets competency Engagement Substantively and affectively prepares for action with individuals, families or groups Embodies the concept of starting where the client is Conveys respect for the client Uses empathy and other interpersonal skills Develops a culturally responsive therapeutic relationship with a client Encourages clients to be equal partners in the establishment of treatment goals and/or expected outcomes Assessment Collects, organizes, and interprets client data Assesses client strengths and limitations Uses multi-dimensional assessment tools or approaches to plan interventions that take into account clients' coping strategies and willingness to change Selects and, when appropriate, modifies interventions based on continuous assessment of client progress Intervention Utilizes agency services and community resources on behalf of client Helps clients resolve problems 9 Inconsistently meets competency Consistently meets competency Consistently exhibits mastery of competency Facilitates transitions and endings Critically evaluates, selects and applies best practices and/or evidence-based practice Collaborates with other professionals to coordinate interventions Evaluation Applies research skills to evaluate practice Uses practice evaluation to determine best interventions for a range of conditions Comments: Please describe the student’s primary strengths and areas for growth. Strengths: Growth Areas: In what ways could the social work faculty have been more helpful to the agency or the student during the course of the practicum? Is your organization planning any changes (such as in staffing, programming, etc.) of which the University should be aware? Please describe. Please place a check mark next to the number that reflects your response to the following questions. How would you rank this student’s effort in completing practicum tasks? 1. Consistent and outstanding 2. Consistent and above average 3. Consistent and average 4. Inconsistent and average 5. Inconsistent and below average 10 How would you rank this student’s level of knowledge and skill compared to a typical advanced-practice level MSW student? 1. Outstanding 2. Above average 3. Average 4. Below average 5. Poor If this is the student’s final semester in field placement, please provide your assessment of this student’s readiness for entry level social work practice. 1. 2. 3. Surpasses expectations for entry level social work practice Meets expectations for entry level social work practice Meets expectations for entry level social work practice with the following exceptions: 4. Does not meet expectations for entry level social work practice. Please explain: 5. Does not apply. This student is not in his/her final semester of field placement Please check to verify that the student has completed 300 practicum hours Supervisor Signature Date Student Signature Date Return forms: Hand-signed forms may be submitted in person or by fax to: (314) 516-6416. Forms submitted as an email attachment to socialwork@umsl.edu may use an electronic signature (any format) provided the document is sent from the professional email address of the practicum supervisor, and the student signer is copied. 11