<p> 1</p><p>University of Georgia School of Social Work SOWK 7055 Concentration Final Field Evaluation FACE SHEET</p><p>Student Name:______Check One: ____Fall ____Year</p><p>Field Instructor:______Spring ____Year</p><p>Field Site:______Clinical____CEPD</p><p>Placement hours completed at time of evaluation:______</p><p>Please check all methods of evaluation used to evaluate your student’s progress:</p><p>____Direct observation ____Review of all written work ____Weekly supervision ____Feedback from task supervisors or other staff ____Feedback from other community/agency personnel ____Taped interviews/meetings ____Role-play situations in supervision ____Other:______</p><p>Grade: Please assign a letter grade that reflects the student’s performance in field placement. You may choose to give + or – with the letter grade (e.g., A-, B+, B-, C+, C-)</p><p>The student’s recommended grade for field placement this semester is:______</p><p>Field Instructor Signature:______Date:______</p><p>Faculty Liaison’s Signature (when providing social work supervision):______</p><p>I have read this evaluation and have discussed it with my Field Instructor.</p><p>I have attached an addendum to this evaluation: ____No ____Yes</p><p>Student’s Signature:______Date:______2</p><p>Field Instructor Evaluation of Advanced Community Empowerment & Program Development (CEPD) Competencies End of 1st semester/7055</p><p>Name of Student ______Date ______</p><p>Name of Field Instructor______Agency ______</p><p>Instructions for Field Instructor Evaluation The Council on Social Work Education (CSWE) identifies 10 Practice Competencies (#2.1.1 through 2.1.10) for all MSW graduates of accredited schools of social work. In the table below each competency you will find a list of practice behaviors that demonstrate mastery of the broader competency. Please rate the student’s ability to perform each of the practice behaviors using the following scale. Indicate your response by circling only one number to the right of each practice behavior. A rating of 3 is equivalent to adequate competency for a beginning MSW practitioner. 1=Very Low Level of Competence 2=Low Level of Competence 3=Adequate Level of Competence 4=High Level of Competence 5=Very High Level of Competence NO= No opportunity to demonstrate practice behavior in the field setting</p><p>2.1.1 Identify as a professional social worker and conducts oneself accordingly</p><p>A Identify opportunities for social work involvement to empower social 1 2 3 4 5 NO systems, enhance human functioning, and promote social justice B Maintain professional boundaries, roles, and demeanor in CEPD 1 2 3 4 5 NO practice settings</p><p>Comments: 3</p><p>2.1.2 Apply social work ethical principles to guide professional practice</p><p>A Apply ethical decision-making principles and frameworks to issues 1 2 3 4 5 NO specific to social work practice in community and organizational development</p><p>Comments:</p><p>2.1.3 Apply critical thinking to inform and communicate professional judgments</p><p>A Evaluate, select, and implement appropriate assessment, intervention, 1 2 3 4 5 NO and evaluation tools for use with target social systems B Communicate effectively with diverse stakeholders and with multi- 1 2 3 4 5 NO disciplinary colleagues</p><p>Comments:</p><p>2.1.4 Engage diversity and difference in practice</p><p>A Identify factors and contexts that impact the development and 1 2 3 4 5 NO functioning of social systems (i.e. organizations, programs, and communities) B Conduct assessments of social systems using diverse theoretical 1 2 3 4 5 NO frameworks C Identify structures and systems that oppress, marginalize, or alienate 1 2 3 4 5 NO people and develop interventions to minimize, neutralize, or ameliorate these structures and factors</p><p>Comments: 4</p><p>2.1.5 Advance human rights and social and economic justice</p><p>A Advocate for human rights and social and economic justice across all 1 2 3 4 5 NO types of social systems B Engage in practices that advance social and economic justice 1 2 3 4 5 NO</p><p>Comments:</p><p>2.1.6 Engage in research-informed practice and practice-informed research</p><p>A Relate theoretical frameworks and evidence-based research to social 1 2 3 4 5 NO systems and circumstances B Assess, intervene, and evaluate strategies for empowering people in 1 2 3 4 5 NO all types of social systems C Apply foundation research skills to the evaluation of intervention 1 2 3 4 5 NO strategies D Work collaboratively with agency personnel or faculty member to 1 2 3 4 5 NO assess and improve intervention effectiveness or conduct program evaluation</p><p>Comments:</p><p>2.1.7 Apply knowledge of human behavior and the social environment</p><p>A Utilize appropriate theoretical perspectives and knowledge from 1 2 3 4 5 NO other disciplines to understand diverse human contexts (i.e. biological, psychological, social, spiritual, and cultural) and ways to assess them</p><p>Comments: 5</p><p>2.1.8 Engage in policy practice to advance social and economic well-being and to deliver social work services</p><p>A Apply policy practice skills in working with people in all types of 1 2 3 4 5 NO social systems</p><p>Comments:</p><p>2.1.9 Respond to contexts that shape practice</p><p>A Act as change agents to promote optimal functioning in all types of 1 2 3 4 5 NO social systems (i.e. organizations, programs, and communities) B Advocate for promoting social justice and positive social change 1 2 3 4 5 NO</p><p>Comments:</p><p>2.1.10 Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities</p><p>Engagement A Engage diverse groups (e.g., gender, race/ethnicity, sexual 1 2 3 4 5 NO orientation, age, etc.) in a variety of settings Assessment B Make effective use of assessment tools and protocols to analyze and 1 2 3 4 5 NO intervene in organizations, programs, and communities C Conduct needs assessments (including collecting new information 1 2 3 4 5 NO and identifying and using existing data) D Relate theories, models, and research appropriate to social systems 1 2 3 4 5 NO and circumstances 6</p><p>Intervention E Develop and implement collaborative, multidisciplinary prevention 1 2 3 4 5 NO and intervention strategies F Make effective use of prevention strategies across types of social 1 2 3 4 5 NO systems G Make effective use of intervention strategies across types of social 1 2 3 4 5 NO systems Evaluation H Apply research skills to the evaluation of diverse types of social 1 2 3 4 5 NO systems I Identify and utilize appropriate evaluation tools 1 2 3 4 5 NO J Communicate and disseminate evaluation results appropriate tot the 1 2 3 4 5 NO intended audience K Work collaboratively with agency personnel or faculty member to 1 2 3 4 5 NO assess and improve intervention effectiveness or conduct program evaluation</p><p>Comments:</p>