MSW 593 and MSW 594 Concentration Year Field Instruction Program Evaluation Project Review Form by MSW Faculty Student Agency Date Submitted Agency Field Instructor Faculty Field Liaison Date Reviewed The following questions serve as guidelines for project review; include written comments. Completeness 1. Does the proposal fully describe the evaluation project? 2. What questions do you still have about the project? Utility 3. Will the program evaluation culminate in useful information for the field agency? 4. Is the project sufficiently substantial to provide for a quality learning experience for the student? Congruence with Advanced Concentration Curriculum 5. Does this project meet academic rigor for an evaluation project in the Concentration curriculum? Consistency with Evaluation and Research section of the NASW Code of Ethics (5.02) 6. Does the project include adequate protection for human subjects including: Informed consent Appropriate process for Informed Consent Voluntary Participation Disclosure of Risks for Participation Minimal risk Access to support services Avoidance of dual relationships Feasibility 7. Can this project reasonably be completed within the timeline that the student submitted? (Also consider fiscal issues, sampling, sufficiency of supervision and research training to complete project) Institutional Review Board 8. Is there a need for IRB review of this project? (Necessary in cases that are investigator-initiated, where presentations will be made outside of the agency, and where primary data collection is not within the agency.)