Doctorate in Clinical Psychology Exeter
Front Sheet for Electronic Submission of Clinical Assessment
Trainee Name:
Assessment Date:
Placement Period: Please delete as appropriate –
YEAR 1 PART 1 - 81 days (including theory/practice days and annual leave)
YEAR 1 PART 2 - 66 days (including theory/practice days and annual leave)
YEAR 2 PART 1 - 70 days (including theory/practice days and annual leave)
YEAR 2 PART 2 - 69 days (including theory/practice days and annual leave)
YEAR 3
Annual Leave:
Sickness Leave:
Study Leave Taken:
Placement Provider:
(e.g Sompar/DHUFT)
Supervisor Overall Evaluation
To be completed at each of the assessment points
Portfolio of Clinical Experience
Pass
Conditional Pass
Referred
Fail
Referred
Fail
Trainee’s Competence
Pass
Conditional Pass
If conditional pass please specify which learning needs require particular attention in the next placement
period and must be identified in the next stage of placement planning:
If referred please specify which significant concerns in one or more competence area(s) must be urgently
addressed through an action plan for subsequent placement period(s):
Assessment: Clinical Goals, Portfolio and Observation; For work undertaken on placement:
“I certify that the work reported in this assessment took place as described and I have signed and
contributed to the feedback within the document.”
A copy has been sent to the clinical tutor by the trainee.
Supervisor name:
Supervisor Signature:
Trainee name:
Trainee signature:
To be sent through to Morgane Colleau, Programme Administrator, by e-mail at DClinPsy@exeter.ac.uk
having been signed and scanned (or signed electronically), with the paperwork
Paperwork Summary Checklist
You are advised to allow a month for filling in these documents, given that annual leave and sick leave
can disrupt the process of signing and completion.
Procedures for a late submission are overtaken by University regulations and the Board of Examiners may
need to be informed. If work is submitted late this will normally lead to a Conditional Pass as this is a
professional issue.
If you have any queries, please contact your clinical tutor.
1
2
Electronic Front Page for Clinical Submission
( incorporating Placement Summary, providing
basic information on placement including number
of days and the Supervisor Overall Evaluation
Form)
Portfolio of Clinical Experience
3
Log Book - a running record of clinical work,
completed by trainees on a weekly basis
throughout placement.
Cumulative Record - a cumulative record
completed prior to initial placement and then at
each assessment period after that.
Clinical Competence Goals & Evaluation
General Placement Outline
Competence Areas - based around core
competences. Each section needs to be
completed. Clearly, many goals will be ongoing
or, indeed, maintained at this point, but this will
need to be stated explicitly
Supervisor Reflection
Trainee Reflection
Observation Tool