SOW 4522
BSW 400-HOUR FINAL PRACTICUM
Department of Social Work
The University of West Florida
Each student must receive a minimum of one hour of regularly scheduled, uninterrupted field instruction with a University approved Social Work Field
Instructor. Please indicate the day and hour(s) scheduled for weekly field instruction with the assigned Field Instructor:
DAY _____________ HOUR ________________
__________________________
__________________________
Student’s Name
Field Instructor’s Name
__________________________
__________________________
Student’s Signature
Field Instructor’s Signature
NOTE: Signature indicates collaboration and agreement with the learning contract, which contains the broad competencies and specific practice behaviors
required of bachelor’s-level clinical social workers by the Council on Social Work Education (CSWE). The student learning contract provides a broad framework
for developing an individualized learning plan which is responsive to the needs of the student and the resources of the field agency. Please feel free to develop
creative opportunities at the agency and utilize other community resources, if necessary, to provide opportunities such as work with groups, which may not be
available in every practice setting.
This document also serves as the mid-term and final evaluation. The format for evaluation is as follows:
1 = Not Competent
2 = Developing Competency: Student performance is below the expected level; student provides inconsistent evidence of competency. This would be the rating
for most students at mid-term. By the final evaluation, we would expect improvement to a final rating of 3 or 4.
3 = Competent: Student is able to demonstrate proficiency on a consistent basis in the understanding of key concepts or acquisition of skills taught.
4 = Advanced Competence: Student exceeds basic standards for competency on a consistent basis.
N/A = No Opportunity Yet: Student performance has not yet been observed for this behavior (mid-term evaluation use only).
Note: By the end of the year, the student is expected to demonstrate overall proficiency in each competency that is evaluated, i.e., a rating of “3”. Ratings of “4”
are not expected of every student and should be reserved for truly exceptional performance. All ratings should be substantiated through specific examples.
CSWE Competencies and Practice
Behaviors
Educational Policy 2.1.1 — Student identifies as
a professional social worker and conducts
him/herself accordingly.
Agency Activities Corresponding
to Practice Behaviors
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Mid-Term
Evaluation:
Final
Evaluation:
1=Not
Competent
2=Developing
Competency
3=Competent
4=Advanced
Competence
N/A=No
Opportunity
Yet
Rate level of
achievement for
each practice
behavior
1=Not
Competent
2=Developing
Competency
3=Competent
4=Advanced
Competence
Rate level of
achievement for
each practice
behavior
A) Advocate for client access to the services
of social work. . (PB #1)
A)
A) _____
A) _____
B) Practice personal reflection and selfcorrection to assure continued professional
development. (PB #2)
B)
B) _____
B) _____
C) Attend to professional roles and
boundaries. (PB #3)
C)
C) _____
C) _____
D) Demonstrate professional demeanor in
behavior, appearance, and communication.
(PB #4)
D)
D) _____
D) _____
E) Engage in career-long learning. (PB #5)
E)
E) _____
E) _____
F) Use supervision and consultation. (PB #6)
F)
F) _____
F) _____
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Recognize and manage personal values in a
way that allows for professional values to
guide practice. (PB #7)
A)
A) _____
A) _____
B) Make ethical decisions by applying
standards of National Association of Social
Workers “Code of Ethics”. (PB #8)
B)
B) _____
B) _____
C) Tolerate ambiguity in resolving ethical
conflicts. (PB #9)
C)
C) _____
C) _____
D) Apply strategies of ethical reasoning to
arrive at principled decisions. (PB #10)
D)
D) _____
D) _____
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Distinguish, appraise, & integrate multiple
source of knowledge, including researchbased knowledge, and practice wisdom.
(PB #11)
B) Analyze models of assessment, prevention,
intervention, and evaluation. (PB #12)
A)
A) _____
A) _____
B)
B) _____
B) _____
C) Demonstrate effective oral and written
communication in working with
individuals, families, groups,
organizations, colleagues, & communities.
(PB #13)
C)
C) _____
C) _____
Educational Policy 2.1.2 — Apply social work
ethical principles to guide professional practice.
Educational Policy 2.1.3 — Apply critical
thinking to inform and communicate
professional judgments.
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Recognize the extent to which a culture’s
structures and values may oppress,
marginalize, alienate, or create or enhance
privilege and power. (PB #14)
A)
A) _____
A) _____
B) Gain sufficient self-awareness to eliminate
the influence of personal biases and values
in working with diverse groups. (PB #15)
B)
B) _____
B) _____
C) Recognize and communicate their understanding of the importance of difference in
shaping life experiences. (PB #16)
C)
C) _____
C) _____
D) View themselves as learners and engage
those with whom they work as informants.
(PB #17)
D)
D) _____
D) _____
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Understand the forms and mechanisms of
oppression and discrimination. (PB #18)
A)
A) _____
A) _____
B) Advocate for human rights and social and
economic justice. (PB #19)
B)
B) _____
B) _____
C) Engage in practices that advance social and
economic justice. (PB #20)
C)
C) _____
C) _____
Educational Policy 2.1.4 — Engage diversity and
difference in practice.
Educational Policy 2.1.5 — Advance human
rights and social and economic justice.
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Use practice experience to inform
scientific inquiry. (PB #21)
A)
A) _____
A) _____
B) Use research evidence to inform practice.
(PB #22)
B)
B) _____
B) _____
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Utilize conceptual frameworks to guide the
processes of assessment, intervention, and
evaluation. (PB #23)
A)
A) _____
A) _____
B) Critique and apply knowledge to
understand person and environment.
(PB #24)
B)
B) _____
B) _____
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Analyze, formulate, and advocate for
policies that advance social well-being.
(PB #25)
A)
A) _____
A) _____
B) Collaborate with colleagues and clients for
effective policy action. (PB #26)
B)
B) _____
B) _____
Educational Policy 2.1.6 — Engage in researchinformed practice and practice-informed
research.
Educational Policy 2.1.7 — Apply knowledge of
human behavior and the social environment.
Educational Policy 2.1.8 — Engage in policy
practice to advance social and economic wellbeing and to deliver effective social work
services.
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Continuously discover, appraise, and
attend to changing locales, populations,
scientific and technological developments,
and emerging societal trends to provide
relevant services with an emphasis on rural
and small communities. (PB #27)
A)
A) _____
A) _____
B) _____
B) _____
B) Provide leadership in promoting
sustainable changes in service delivery and
practice to improve the quality of social
services. (PB #28)
B)
Fill in an activity that you will engage in at field placement to
demonstrate mastery of each competency
Rate level of
achievement for
each practice
behavior
Rate level of
achievement for
each practice
behavior
A) Substantively and effectively prepare for
action with individuals, families, groups,
organizations, and communities. (PB #29)
A)
A) _____
A) _____
B) Use empathy and other interpersonal skills.
(PB #30)
B)
B) _____
B) _____
C) Develop a mutually agreed-on focus of
work and desired outcomes. (PB #31)
C)
C) _____
C) _____
D)
D) _____
D) _____
Educational Policy 2.1.9 — Respond to contexts
that shape practice.
Educational Policy 2.1.10(a)–(d) — Engage,
assess, intervene, and evaluate with individuals,
families, groups, organizations, and
communities.
Educational Policy 2.1.10(a)—Engagement
Educational Policy 2.1.10(b)—Assessment
D) Collect, organize, and interpret client data.
(PB #32)
E) Assess client strengths and limitations.
(PB #33)
E)
E) _____
E) _____
F) Develop mutually agreed-on intervention
goals and objectives. (PB #34)
F)
F) _____
F) _____
G) Select appropriate intervention strategies.
(PB #35)
Educational Policy 2.1.10(c)—Intervention
G)
G) _____
G) _____
H) Initiate actions to achieve organizational
goals. (PB #36)
H)
H) _____
H) _____
I)
Implement prevention interventions that
enhance client capacities. (PB #37)
I)
I) _____
I) _____
J)
Help clients resolve problems. (PB #38)
J)
J) _____
J) _____
K) Negotiate, mediate, and advocate for
clients. (PB #39)
K)
K) _____
K) _____
L) Facilitate transitions and endings. (PB #40)
L)
L) _____
L) _____
M)
M) _____
M) _____
Educational Policy 2.1.10(d)—Evaluation
M) Critically analyze, monitor, and evaluate
interventions. (PB #41)
FIELD INSTRUCTOR’S MID-TERM EVALUATION COMMENTS:
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STUDENT’S MID-TERM EVALUATION COMMENTS:
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Student’s Printed Name
Student’s Signature / Date Signed
MSW Field Instructor’s Printed Name
MSW Field Instructor’s Signature / Date Signed
Task Supervisor’s Printed Name
Task Supervisor’s Signature / Date Signed
FIELD INSTRUCTOR’S FINAL EVALUATION COMMENTS:
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STUDENT’S FINAL EVALUATION COMMENTS:
________________________________________________________________________________
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________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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Student’s Printed Name
Student’s Signature / Date Signed
MSW Field Instructor’s Printed Name
MSW Field Instructor’s Signature / Date Signed
Task Supervisor’s Printed Name
Task Supervisor’s Signature / Date Signed