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Texas A&M University-Commerce
School of Social Work
MSW Concentration Field Practicum (SWK 554)
Learning Plan & Evaluation Form
This is the student’s (First)
correct choice.)
(Second)
(Third)
semester of field.
(Please circle/check
STUDENT NAME (PRINT): _____________________________________________________
SWK 554
SPRING (YEAR):
Agency:
Faculty Liaison:
Field Instructor:
On-Site Supervisor (if applicable)
SWK 554
SUMMER (YEAR):
Agency:
Faculty Liaison:
Field Instructor:
On-Site Supervisor (if applicable)
SWK 554
FALL (YEAR):
Agency:
Faculty Liaison:
Field Instructor:
On-Site Supervisor (if applicable)
Instruction for Completion: The Learning Plan is a tool to guide the field practicum experience. While
each student is expected to achieve the course objectives for the field practicum, each field experience
is unique. Therefore, the Learning Plan should incorporate the field practicum’s learning objectives, the
agency’s goals and learning opportunities, and the student’s individual learning goals and interests. If
the agency or program does not have services available to help the student meet the learning
objectives, other opportunities outside of the agency may be sought.
The Learning Plan is to be completed by field student, with the assistance of the Field Instructor (and
On-Site Supervisor, when applicable). Students may include class and portfolio assignments as a part of
the identified tasks or activities. The student should make three copies of the learning plan to be
available for: 1) the Student’s Portfolio; 2) the Field Instructor’s file; 3) the Faculty Field Liaison’s file.
Revised Summer 2014
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The Learning Plan should be used as part of the student’s weekly supervision with the Field Instructor.
Progress towards meeting objectives should be reviewed and used as an ongoing measure for the
student evaluation process.
The Advanced Generalist Field Practicum is intended to provide students with opportunities to learn and
assume AGP roles such as broker, facilitator, mediator, advocate, case manager, educator, researcher,
administrator, clinician, and program evaluator. By the final (3rd) semester of the AGP field, students
are expected to demonstrate the integration of social work values, knowledge, and skills with complex
problems and situations and reflect their ability to practice independently and autonomously. The
following are the MSW program goals:
1. Prepare MSW graduates for professional advanced generalist practice that reflects application and
integration of critical thinking, theoretical frameworks, and differential interventions.
2. Enable MSW graduates to apply ethical reasoning to advance equality, justice, and social change.
3. Promote leadership and service that is relevant to individual contexts of practice and enhances
well-being and quality of life.
Rating Scale for Evaluation of Field Placement Performance
Instructions for Rating Interns on the 10 competencies in the First Part of the Evaluation:
The 10 competencies specified in this evaluation form are those established by our national
accrediting organization (Council on Social Work Education).
5
4
3
2
1
n/a
Excellent
Good
Average
Fair
Poor
Not applicable, as the intern has not had the opportunity to demonstrate competence in this
area
Comments may be made under any competency statement, if desired. Comments are needed
for any competency statement rated under a 3. Please be sure to indicate those areas in which you
think the intern is particularly strong and those areas in which the student needs improvement.
This evaluation is intended to give the intern feedback about her or his performance. The field
instructor’s rating of these items will not directly be used to calculate the grade given to the intern. The
faculty liaison has responsibility of assigning the grade for field instruction. The grade that is assigned
will be based on: the faculty liaison’s overall evaluation of the student’s performance in field
placement in conjunction with the field instructor’s evaluation and other submitted materials such as:
intern logs, seminar participation; papers that integrate field with classroom instruction.
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UPON COMPLETION OF THE MSW ADVANCED GENERALIST FIELD PRACTICUM, STUDENTS WILL BE ABLE
TO FULLY ENGAGE IN THE ROLE OF CHANGE AGENT. The following Competencies, Practice Behaviors,
and Learning Activities are reflective of this role:
Competency 1.1: Critically analyze practice situations and communicate
judgments and reasoning through decision-making processes.
Practice Behaviors:
 Applies professional judgment and reasoning
 Synthesizes and effectively communicates relevant information to other
Mid
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Competency 1.2: Contribute to evidence-based best practice approaches
to assess and improve effectiveness.
Practice Behaviors:
 Uses research and evaluation to assess intervention, efficacy, and
effectiveness
 Develops and shares data to enhance best practices and professional
knowledge
 Uses evidence-based research findings to improve practice
Mid
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Final
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Competency 1.3: Differentially apply theories and frameworks of HBSE.
Mid
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Final
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Competency 1.4: Demonstrate autonomy in dynamic practice situations
that involve:
1. Relationship-building at all levels of systems
2. Evidence-based assessment tools and intervention approaches.
3. Effective intervention with complex problems and prevention
strategies.
4. Response to the feedback process from interventions.
Mid
Final
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Practice Behaviors:
 Translates empirically-supported human behavior theories and
conceptual frameworks into practice at all levels
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Uses appropriate assessment and intervention strategies grounded
in human behavior theories and conceptual frameworks
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Uses empathy and other interpersonal skills
Builds trust with all levels of systems
Collects, organizes, and interprets client data
Assesses client system’s strengths and limitations
Selects appropriate intervention strategies
Demonstrates one’s ability to move a client system through the practice
intervention process
Assists clients to resolve problems
Negotiates, mediates, and advocates for client systems
Facilitates transitions and endings
Critically analyzes, monitors, and evaluates interventions
Assesses, intervenes, and evaluates complex problems with all systems
Revised Summer 2014
Final
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Competency 3.4: Develop leadership skills as advanced generalist
practitioner to enhance organizations and communities.
Mid
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Final
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Practice Behaviors:
 Becomes increasingly proactive in recommending constructive
change in organizations and communities.
Planned Field Activities that reflect the role of CHANGE AGENT:
Mid
Final
1.
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2.
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3.
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4.
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5.
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Midterm Comments:
Final Comments:
UPON COMPLETION OF THE MSW ADVANCED GENERALIST FIELD PRACTICUM, STUDENTS WILL BE ABLE
TO FULLY ENGAGE IN THE ROLE OF ADVOCATE. The following Competencies, Practice Behaviors, and
Learning Activities are reflective of this role:
Competency 2.1: Promote social policies to improve service delivery
systems.
Practice Behaviors:
 Interfaces with colleagues, client systems, and agencies to promote
effective use of policies (ie, policy practice)
 Identifies impact of policies from various systems on clients and advocates
on behalf of client systems
Mid
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Final
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Competency 2.2: Apply social work ethical principles to resolve
dilemmas and create positive change
Practice Behaviors:
 Articulates and advocates social work values and ethics among
interdisciplinary situations and settings
 Strategically uses supervision and consultation to address ethical
dilemmas in practice
Mid
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Final
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Competency 2.3: Demonstrate the ability to build strengths based on
mutual engagement with diverse populations.
Practice Behaviors:
 Refrains from acting upon biases and values as they relate to a diverse
group
 Modifies and adapts traditional interventions to meet needs of diverse
and oppressed populations.
 Applies strengths and empowerment strategies as with diverse groups
Mid
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Final
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Competency 2.4: Demonstrate commitment to strategies that
Mid
address discrimination, reduce disparities, and promote social and
economic justice.
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Practice Behaviors:
 Actively promotes opportunities and participation of diverse constituents ____
Final
Planned Field Activities that reflect the role of ADVOCATE:
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Mid
Final
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2.
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3.
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4.
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5.
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Midterm Comments:
Final Comments:
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UPON COMPLETION OF THE MSW ADVANCED GENERALIST FIELD PRACTICUM, STUDENTS WILL BE ABLE
TO FULLY ENGAGE IN THE ROLE OF LEADER. The following Competencies, Practice Behaviors, and
Learning Activities are reflective of this role:
Competency 3.1: Exemplify professional social work behavior and
standards.
Mid
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Final
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Practice Behaviors:
 Employs conscious use of self, self-reflection, self-monitoring, and
self-correction in practice situations
 Models professional demeanor in behavior and communications.
 Adheres to professional roles and boundaries
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Competency 3.2: Use leadership skills to respond, influence, and
and shape changing contexts.
Mid
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Final
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Practice Behaviors:
 Demonstrates leadership in changing contexts of social, organizational,
and community environments
 Knows leadership skills necessary for community decision-making
processes
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Competency 3.3: Apply innovative solutions to social and organizational
dynamics.
Mid
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Final
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Practice Behaviors:
 Demonstrates innovative problem-solving in social and organizational
systems
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Planned Field Activities that reflect the role of LEADERSHIP:
Mid
Final
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3.
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5.
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Midterm Comments:
Final Comments:
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Performance Evaluation of Professional Behaviors
Mid
Final
11. Completion of scheduled hours.
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12. Completes assigned tasks in a timely & professional manner.
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13. Interacts appropriately with agency staff.
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14. Interacts appropriately with Field Instructor (and On-Site Supervisor).
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15. Adheres to agency rules and policies.
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Field Instructor’s OVERALL RATING AT THE END OF THE SEMESTER: _______
Narrative Performance Evaluation by Field Instructor (and On-Site Supervisor-Final Evaluation
1. Identify the student’s strengths and abilities:
MIDTERM:
FINAL:
2. Identify areas for student growth and development:
MIDTERM:
FINAL:
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3. Progress in completing learning plan/activities:
MIDTERM:
FINAL:
4. What additional learning opportunities would be helpful:
MIDTERM:
FINAL
5. Other Comments:
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Student Comments, Regarding Placement and Evaluation: (Final Evaluation)
1. How would you assess your performance in the Field Practicum this semester?
2. What have you learned in this placement?
3. What future opportunities would enhance your skills and learning opportunities?
4. Comments regarding this evaluation?
_______________________________ (Mid)
MSW Field Instructor
Date
______________________________ (Final)
MSW Field Instructor
Date
_______________________________ (Mid)
Student
Date
______________________________ (Final)
Student
Date
_______________________________ (Mid)
Faculty Field Liaison
Date
______________________________ (Final)
Faculty Field Liaison
Date
_______________________________ (Mid)
On-Site Supervisor
Date
______________________________ (Final)
On-Site Supervisor
Date
Revised Summer 2014