Westfield State University
Department of Social Work
MSW FOUNDATION (First Year or Second Year Part-time) FIELD PLACEMENT
EVALUATION OF STUDENT FORM
Student’s Name___________ Supervisor’s Name____________
Date Evaluation Completed______
Semester: Fall_____
Spring____
Purposes and Uses of this Form: The purpose of this form is to evaluate the student’s progress as
specifically and objectively as possible. A thoughtful and thorough evaluation will help the student build
on strengths, as well as address areas of concern, while developing and practicing essential Social Work
knowledge, values, and skills. This form will also help the Social Work Program to recognize exceptional
students, as well as those students who may need to develop a plan for remediation prior to the beginning
of the next semester (if 1st. semester) or before passing the Field Practicum (if 2nd. semester).
Aggregate data from this form, with all identifying information removed, will also be used to assess the
Westfield State University Department of Social Work’s overall success in preparing and graduating
students who are competent to enter the field of Social Work.
Competency Ratings
This evaluation form is based on the Department of Social Work’s Competency Goals, which are also the
Competencies established by the Council on Social Work Education’s Educational Policy and
Accreditation Standards (CSWE, 2008, 2010). Each competency goal includes a set of measurable
Practice Behaviors that reflect the social work practitioner’s expected level of knowledge, values, and
skills at the foundation (BSW or First Year MSW) or advanced (2nd. Year MSW) levels. The expectation
for students at the foundation level is that they will begin to demonstrate the knowledge, values, and
skills listed below for each Program Competency in the first semester and be able to consistently
demonstrate the practice behavior at a basic level at the end of the second semester. Please evaluate your
student’s progress toward achieving the listed practice behaviors using the following scale:
1
3
The student has not demonstrated any evidence of this Practice Behavior (i.e., social work
knowledge, value, or skill) and appears unlikely to be able to demonstrate such evidence in the
near future (no evidence/not likely)
The student appears likely to demonstrate this Practice Behavior in the near future (no
evidence/likely)
The student is sometimes able to demonstrate this Practice Behavior (some evidence/inconsistent)
4
The student is consistently able to demonstrate this Practice Behavior (evidence/consistent)
5
The student excels in this Practice Behavior (evidence/excels)
2
N/A The student has not had the opportunity to demonstrate competence in this area
Summary Ratings Table
Practice
Behavior
1
no evidence/
unlikely
2
no evidence/
likely
3
some
evidence/
inconsistent
4.
evidence/
consistent
5.
evidence/
excels
N/A
Please check the appropriate box in the ratings tables below to indicate your evaluation of the
student’s level of competence in each area at the time of the evaluation. If you wish, you may also
explain your ratings or make comments in the space following each rating scale.
EVALUATION CRITERIA AND RATINGS TABLES
Program Competency 1: The student Identifies as a professional social worker and conducts himself or
herself accordingly, as demonstrated by the ability to:
1. advocate for client access to the services of
social work
2. practice personal reflection and self-correction
to assure continual professional development
3. attend to professional roles and boundaries
4. demonstrate professional demeanor in
behavior, appearance, and communication
5. engage in career-long learning
6. use supervision and consultation
1
2
3
4
5
N/A
1
2
3
4
5
N/A
1
1
2
2
3
3
4
4
5
5
N/A
N/A
1
1
2
2
3
3
4
4
5
5
N/A
N/A
Comments:
Program Competency 2: The student conducts his or her professional practice according to the values and
ethical principles of professional social work, as demonstrated by the ability to:
1. recognize and manage personal values in a way that
allows professional values to guide practice
2. make ethical decisions by applying standards of the
National Association of Social Workers Code of Ethics
and, as applicable, of the International Federation of
Social Workers/International Association of Schools of
Social Work Ethics in Social Work, Statement of
Principles
3. tolerate ambiguity in resolving ethical conflicts
4. apply strategies of ethical reasoning to arrive at
principled decisions
Comments:
2
1
2
3
4
5
N/A
1
2
3
4
5
N/A
1
1
2
2
3
3
4
4
5
5
N/A
N/A
Program Competency 3: The student applies critical thinking and communication skills to evaluate and
inform professional judgments in practice, as demonstrated by the ability to:
1. distinguish, appraise, and integrate multiple sources of
knowledge, including research-based knowledge and
practice wisdom
2. analyze models of assessment, prevention,
intervention, and evaluation
3. demonstrate effective oral and written
communication in working with individuals,
families, groups, organizations, communities, and
colleagues
1
2
3
1
2
3
1
2
3
5
N/A
4
5
N/A
4
5
N/A
Comments:
Program Competency 4: The student engages in informed, sensitive, and competent practice with diverse
and oppressed groups, as demonstrated by the ability to:
1. recognize the extent to which a culture’s structures and
values may oppress, marginalize, alienate, or create or
enhance privilege and power
2. gain self-awareness in order to eliminate the influence
of personal biases and values in working with diverse
groups
3. recognize and communicate his or her understanding of
the importance of difference in shaping life experiences
4. view herself or himself as a learner and clients as
experts on their own experiences
1
2
3
4
5
N/A
1
2
3
4
5
N/A
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Comments:
Program Competency 5: The student promotes human rights and social and economic justice, as
demonstrated by the ability to:
1. understand the forms and mechanisms of oppression
and discrimination
2. understand the importance of advocating for human
rights and social and economic justice
3. engage in practices that promote human rights and
social and economic justice.
Comments:
3
1
2
3
4
5
N/A
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Program Competency 6: The student engages in research-informed practice and practice-informed
research, as demonstrated by the ability to:
1. use practice experience to inform scientific inquiry
2. use research evidence to inform practice
1
1
2
2
3
3
4
4
5
5
N/A
N/A
Comments:
Program Competency 7: The student applies knowledge of human behavior and the social environment to
professional practice, as demonstrated by the ability to:
1. utilize conceptual frameworks to guide the processes of
assessment, intervention, and evaluation
2. critique and apply knowledge to understand person and
environment
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Comments
Program Competency 8: The student engages in policy practice to promote social and economic wellbeing and to deliver effective services, as demonstrated by the ability to:
1. analyze, formulate, and advocate for policies that
advance social well-being
2. collaborate with colleagues and clients in developing
and implementing effective policy action
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Comments:
Program Competency 9: The student recognizes and responds to the dynamic contexts that shape practice,
as demonstrated by the ability to:
1. continuously discover, appraise, and attend to changing
locales, populations, scientific and technological
developments, and emerging societal trends to provide
relevant services
2. provide leadership in promoting sustainable changes in
service delivery and practice to improve the quality of
social services.
Comments:
4
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Program Competency 10: The student has acquired the knowledge and skills required for engaging,
assessing, intervening and evaluating with individuals, families, groups, organizations, and communities,
as demonstrated by the ability to:
1. engage in professional practice involving the dynamic
and interactive processes of engagement, assessment,
intervention, and evaluation at multiple levels.
2. demonstrate practice knowledge including identifying,
analyzing, and implementing evidence-based
interventions designed to achieve client goals; using
research and technological advances; evaluating
program outcomes and practice effectiveness.
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Comments:
Program Competency 10a: The student has basic knowledge and skills required to engage client systems,
as demonstrated by the ability to:
1. substantively and effectively prepare for action with
individuals, families, groups, organizations, and
communities
2. use empathy and other interpersonal skills
1
2
3
4
5
N/A
1
2
3
4
5
N/A
3. collaborate with clients to develop mutually agreed-on
focus of work and outcomes
1
2
3
4
5
N/A
Comments:
Program Competency 10b: The student has the basic knowledge and skills required for assessment of
client systems, as demonstrated by the ability to:
1. collect, organize, and interpret client data
2. assess client strengths and limitations
3. collaborate upon mutually agreed-on intervention goals
and objectives; and
4. select appropriate intervention strategies.
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
N/A
N/A
N/A
1
2
3
4
5
N/A
Comments:
Program Competency 10c: The student has the knowledge and skills required for the assessment of client
systems of all sizes, as demonstrated by the ability to:
1. initiate actions to achieve organizational goals
1
2
3
4
5
N/A
2. help clients resolve problems
1
2
3
4
5
N/A
3. negotiate, mediate, and advocate for clients
1
2
3
4
5
N/A
Comments:
5
Program Competency 10d: The student has the basic knowledge and skills required for evaluating client
systems of all sizes, as demonstrated by the ability to:
1. critically analyze, monitor, and evaluate interventions
at the beginning stages of the process
2. use ongoing monitoring and evaluation processes to
improve practice at all stages and levels of intervention
1
2
3
4
5
N/A
1
2
3
4
5
N/A
Comments:
SUMMARY AND RECOMMENDATIONS
1. Please identify this student’s three most significant strengths.
2. Please identify this student’s three most significant areas for improvement.
3. Do you have any additional comments about or recommendations for this student?
Recommended Grade:
Please indicate the overall evaluation of the student’s field performance by circling the recommended
grade.
A (outstanding)
B (above average)
C (average)
_______________________________
Supervisor / Date
6
D (below average)
F (fail)