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Gerontology Program
Department of Sociology, Gerontology & Gender (SGG)
Practicum in Gerontology (GER 6495)
Advanced Practicum in Gerontology (GER 6496)
Student Learning Agreement (SLA)
PART I – To be completed by student (typed only)
Semester:
Fall Semester
Spring Semester
Summer Sessions
Year:
Agreement covers:
Student Name/ID#
Street Address:
City/State/Zip
Home Phone:
Email Address:
Agency Name:
Street Address:
City/State/Zip
Local Phone/Fax
Email address:
Gerontology 6495
Gerontology 6496
Both
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Agency Practicum
Supervisor:
Job Title:
Degree:
Year received:
Beginning:
Practicum Dates:
Ending:
Date/Time of
scheduled
supervision
Date:
Time:
Are you a paid
employee of the
agency?
Yes (If so, please complete and attach required paperwork.)
No
Signatures:
______________________________________________________
Student
Date
______________________________________________________
Practicum Supervisor
Date
______________________________________________________
Director of Gerontology
Date
Distribution of Copies:
Original to Director of the Gerontology Program
Copy to student
Copy to practicum instructor
Revised 5/11/16
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LEARNING OBJECTIVES
Instructions: Students in the MSG or GCG Programs are required to work 200 hours in each
their practicum placement during the enrolled semester. Some may find this requirement
difficult given family, work and other commitments. If so, discuss this with your supervisor and
Dr. Meuser; often a delayed grading arrangement can be made.
Students are required to work with their site supervisor and submit a completed learning
agreement (LA) form during the first 20 hours on site. No site is the same, and so the LA form is
designed to be flexible. Ideally, the student and supervisor should sit down and review the 7
learning areas below and consider various learning activities that may fit under each. At a
minimum, four learning areas should be targeted and completed for any given practicum. An
extra 8th objective may be developed for the specific site and student placement in question.
A learning activity should be quantifiable. For example, “read about ethics” is not a sufficient
objective. Read “x” book or “y” article about ethics and “discuss with supervisor” would be
acceptable. “Interview 5 clients concerning Z” is better than “Interview some clients.” The
more specific you can be the better.
Type into the fields, save the document, have your supervisor sign off, and then send the
original paper copy to Laura Hayes in Clark 574 (Fax 516-6366; hayeslau@umsl.edu).
1. Student will integrate theoretical knowledge about older adults and their families
in the practicum setting.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
1.
2.
3.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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2. Student will apply assessment and intervention skills for the population of older
adults and their families served in the practicum agency.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
4.
5.
6.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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3. Student will understand the organizational structure of the agency and how it
impacts on practice with older adults and families.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
7.
8.
9.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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4. Student will understand current public policy relevant to older adults and how
those policies affect the clients served by the agency.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
10.
11.
12.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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5. Student will understand and apply values and ethics relevant to gerontological
practice in the practicum agency.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
13.
14.
15.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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6. Student will understand the impact of race, class, gender, religion, sexual
orientation and ethnicity on practice with older adults and their families and the
impact of one’s own values and biases on one’s work.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
1.
2.
3.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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7. Student will learn about services relevant to work with older adults and their
families and will use these services when appropriate.
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
4.
5.
6.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
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8. Optional objective to capture unique learning opportunities at the practicum site.
_________________________________________________________________________
Activities/Observable Behaviors
Learning Outcomes
Must be specific and quantifiable. To
be completed by the student and
supervisor together.
1-2 sentences describing the essence of what will
be learned from the listed activities. To be
completed by the student and supervisor.
1.
2.
3.
Midterm Assessment
@75-125 hours between the
supervisor and student. Unsatisfactory
and Marginal ratings should be
communicated to the Gerontology
Program Director.
Date of Assessment
Final Assessment
@ 175-200 hours by supervisor,
discussed with student, and then
forwarded the Gerontology Program
Director for the grading process.
Date of Assessment
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding
Unsatisfactory
Above Average
Not Addressed
Marginal
Satisfactory
Outstanding