Field Placement Weekly Supervision Log
College of Community and Public Affairs
Department of Social Work
State University of New York
CONTACT INFORMATION
MSW Intern
Agency
Email Address
Address
Field Instructor
Agency
Task Supervisor (if applicable)
Phone #
City
State
Date
Zip
Email Address
Address
Email Address
City
Office #
Office #
Phone #
State
Field Liaison
Zip
Office #
Semester:
SW 59_
QUESTIONS
1. What went well this week? (this could be an event, occurrence, or a moment of realization or
personal learning)
2. How did you demonstrate acknowledgment of and commitment to the NASW Values and Code of
Ethics?
3. Identify aspects of diversity you encountered this week:
4. Please identify macro, micro, or mezzo level skills that you used this week:
5. Learning Plan: What practice behaviors have you been working on or accomplished since our last
supervisory session?
6. Learning Plan: What practice behaviors to focus on for next supervisory session?
7a. Which CSWE Competencies have you been exposed to in this past week?
Competency 1: Demonstrate Ethical and Professional Behavior,
Competency 2: Engage Diversity and Difference in Practice,
Competency 3: Advance Human Rights and Social, Economic, and Environmental Justice
Competency 4: Engage In Practice-informed Research and Research-informed Practice,
Competency 5: Engage in Policy Practice,
Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities,
Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities,
Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities,
Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities,
7b. What did you learn about this area of focus or about yourself in this regard?
8. Which current or previous graduate course was of value this week in field, and why?
9. Are you getting what you need from this field placement? How can your experience be improved? (If
you have any concerns and are worried about bringing it up please talk to your field liaison who can
help you complete this section).
10. Additional Comments (or agenda items, case review that you want to make sure is discussed this
week):
11. Field Instructor Comments (optional if you would like to offer feedback, affirmations and guidance):
The log is intended to help:

Challenge you to think critically about the work you are doing.

Document the knowledge and skills you are gaining.

Identify skills/knowledge that you need to address in supervision.

Help facilitate a dialogue between the student and field instructor

Help you learn how to prepare yourself for supervision

Help your field instructor organize and prepare for supervision

Help your field instructor assess areas that you may need to grow, and to clarify questions that may arise

Help document your work for both you and your field instructor to review when completing final evaluations

Document concerns that you or your field instructor have (this is a necessary step in addressing challenges in field).

Facilitate conversations around areas that are identified (or at times not identified).

Link coursework to field on a regular basis