Field Placement Information Form The information on this form is collected under the authority of the Ryerson University Act and is needed to consider your interest in providing a learning experience to one or more students in a social work degree program at Ryerson University. The information will be used in connection with placement negotiations, communication with students, as well as reports required for accreditation from the Canadian Association for Social Work Education (CASWE). The information you provide will also be used to keep you informed and up-to-date on the School of Social Work’s activities, such as workshops and events for Field Instructors. If you have any questions about the collection, use and disclosure of this information by the School of Social Work, please contact the Field Education Manager at swfield@ryerson.ca or 416-979-5000, ext. 7241. Please complete this form as follows: 1. Save a copy of this form on your computer. 2. Complete the form. 3. Email your completed form to swfield@ryerson.ca A. Placement Setting Name of your organization / agency: B. Field Instructor The Field Instructor is the person at your organization / agency who will be working directly with the student(s). The Field Instructor is also the person who will be working with the student(s) to develop a learning plan and submit mid-term and final evaluations. The information you provide will be used to keep the Field Instructor informed and up-to-date on the activities of the School of Social Work, including workshops for Field Instructors. If you Field Placement Information Form | 1 have questions about the collection, use and disclosure of this information by the School of Social Work, please contact the Field Education Manager at swfield@ryerson.ca or 416-9795000, ext. 7241. Name: Title: Program: Address: Email: Telephone number: Other number: C. About the Field Instructor Accredited by the Canadian Association for Social Work Education (CASWE), the School of Social Work is required to collect certain information about the people who will be supervising our students. The reason we ask for this information is for reports required for accreditation and to allow the School of Social Work to understand the experience that each Field Instructor brings to the placement. If you have questions about the collection, use and disclosure of this information by the School of Social Work, please contact the Field Education Manager at swfield@ryerson.ca or 416-979-5000, ext. 7241. Experiential background: 0-2 years in the social work field 2-5 years in the social work field 5-10 years in the social work field 10+ years in the social work field Educational background: BSW MSW PhD in social work Not applicable Other: Has the Field Instructor supervised students before? Select all that apply: BSW student(s) from Ryerson MSW student(s) from Ryerson Students from other programs / institutions (please list the program and institution): Field Placement Information Form | 2 This will be the first time supervising students D. Education Coordinator Our school refers to the person who coordinates student placements within an organization / agency as the Education Coordinator. Not all organizations / agencies have one employee designated as the Education Coordinator to coordinate all student placements. In some organizations / agencies, each Field Instructor is responsible for all aspects of coordinating placements. If applicable, please provide information about the person in charge of student placements at your organization / agency (Education Coordinator). The information you provide will be used to keep the Education Coordinator informed and upto-date on the activities of the School of Social Work, including workshops for Field Instructors. If you have questions about the collection, use and disclosure of this information by the School of Social Work, please contact the Field Education Manager at swfield@ryerson.ca or 416-9795000, ext. 7241. Name: Title: Program: Address: Email: Telephone number: Other number: E. Field Placement Details Describe the social work student’s role as it relates to the field placement being offered. Include: information about the department(s) / program(s) / project(s), population being served, the potential learning experiences, and other details that will help students know what to expect. The more information you provide, the better we may be able to find potentially good match(es). The following are examples of tasks and activities that our students have experienced in field placements. Select all those that apply to the field placement being offered. Field Placement Information Form | 3 Accompaniment of service user Intake Administrative tasks Internet / web use Advocacy Meeting facilitation Arts-based / informed practices Newsletters / publications Assessment Observing others’ practice Case management Oral presentations Case presentations / case conferences Organizational planning / development Client monitoring Participation in staff / team meetings Client support Policy analysis Coalition work Policy development Committee work Program development Community development Program evaluation Community outreach Proposal writing Crisis intervention Public education Direct practice with communities Referrals Direct practice with families Research Direct practice with groups Skills development with client Direct practice with individuals Social action Discharge planning Social planning Documentation of practice / intervention Special projects Follow-ups with client Telephone counseling Fundraising Use of mandated assessment tools Information giving Volunteer training / coordination Address where the field placement will primarily be located. If the placement requires frequent travel, please let us know how often, where (e.g., home visits, travel through community, court visits, etc.), and if it can be done on public transit. Field Placement Opportunity Form | 4 Is the primary location accessible? Select all those that apply. Physically accessible – for example, if needed, the space has an elevator, wide hallways, ramps inside / outside of building, automatic doors, accessible washrooms, etc. Accessible to trans, Two-Spirit and non-binary people – for example, the space has all gender washrooms and/or trans inclusive washroom policy Visually accessible – for example, braille on signs, desktop magnifiers, etc. Other: If needed by a student, could your organization / agency provide assistive technology(ies) to students? Examples include screen readers or software. Yes No Students are expected to be in placement during ordinary working hours (approximately 9 am to 5 pm or 7 placement hours per day, excluding breaks) unless otherwise arranged with both the school and the placement setting. What will be the typical working hours for the field placement being offered? A small number of our students seek field placements that offer flexible hours. Will this field placement involve one or more of the following? If yes, please specify: Evening hours: Weekend hours: Shift work: Flexible hours: The following are examples of attributes that our students possess. Select all those that are best suited to the field placement being offered: New to field Works well independently Previous placement / work experience Enjoys office environment Works well with little supervision Enjoys community-based work Field Placement Information Form | 5 Enjoys fast-paced work environment Enjoys highly structured environment Will students require a police record check for the field placement begin offered? Yes, police reference check – vulnerable sector screening Yes, police record check without a vulnerable sector search (e.g., clearance letter) No, police record check not required Do not know at this time NOTE: The School of Social Work at Ryerson University does not require that students obtain a police record check for admission to the program or for field placements. For this reason, the school does not oversee police record checks for student placements. Once matched with a placement setting, each student is instructed to inquire about the organization / agency’s protocols concerning police record checks and, if applicable, how to obtain one. Unless informed otherwise by organizations / agencies, students are responsible for covering the cost for obtaining police record checks. Will students require inoculations and medical tests for the field placement being offered? Select all those that apply: Chest x-ray Routine physical Flu shot TB skin test Hepatitis vaccination Proof of immunization Other: NOTE: The School of Social Work’s Field Education Office can provide those students requiring inoculations and / or medical tests information about options upon request. Students are however responsible for providing placement settings any required documentation. Unless informed otherwise by organizations / agencies, students are responsible for covering the cost for obtaining medical tests. Are there other preferences / requirements for the field placement being offered? Select all those that apply: Addictions course Driver’s licence (G) Availability of own car on placement days Proof of automobile liability insurance Language(s) required other than English: Field Placement Information Form | 6 Lived experience with the population / communities being served. For example, a history of addictions if working in addictions / harm reduction field. Other: If any of the above are assets / preferences rather than requirements, list them here. F. Students Students in a social work program at Ryerson (BSW or MSW) are expected to put in ordinary working hours (approximately 9 am to 5 pm or 7 placement hours per day, excluding meal breaks), unless otherwise arranged with both the school and the placement setting. Students in the 3rd year of the BSW program are expected to be in field placement 14 hours per week, usually on Tuesday and Thursday from September to mid-April for a total of 336 hours. Students in the 4th year of the BSW program are expected to be in their field placement 21 hours per week, usually on Wednesday, Thursday and Friday from September to mid-April for a total of 504 hours. Students in the MSW program are expected to be in their field placement 21 hours per week, usually on Wednesday, Thursday and Friday from January to June for a total of 450 hours. From the options listed in the following table, specify the number of students that this placement opportunity is best suited for. Term 3rd year BSW student(s) 4th year BSW student(s) MSW student(s) September to April # # Not applicable May to July / August* # # Not applicable January to June Not applicable Not applicable # * May to July/August term is available to a small number of BSW students. Field Placement Information Form | 7 G. Additional Information Is there any additional information about the field placement being offered you think the School of Social Work should know? H. Next Steps If we do find one or more student(s) who would potentially be good matches, someone from our office will email the contact person and let you know the name(s) of the student(s) who will be contacting them with a copy of their cover letter and resume and to arrange an interview. If you have a particular timeline that you follow regarding interviews with students, please feel free to let us know in section G of this form. Thank you for considering offering a learning opportunity to one or more BSW and / or MSW students from Ryerson University. Your support and willingness to provide instruction in the field is an integral part of our program. Field Placement Information Form | 8