Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
California State University, Long BeachSchool of Social Work
SW 495 A/BUNDERGRADUATE LEARNING AGREEMENT
ANDSENIOR
COMPREHENSIVE SKILLS EVALUATION
Academic Year 2019-2020
Student Name (print): ____________________________________________
Seminar Instructor/Liaison Name (print):_______________________________
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Student Identification Information
Student First Name
Student Middle Name
Student Last Name
Student ID
Student Field Liaison/Professor Information
Liaison Name
Agency Identification InformationAgency and Program NameAgency Address
Agency Contact Person
Agency Phone Number
Field Instructor Identification Information
Field Instructor Name
Field Instructor Phone
Field Instructor Email
Preceptor Identification Information
Preceptor Name
Preceptor Phone
Preceptor Email
1
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
The Agency and the Community
A. Agency Mission
B. Briefly describe your agency’s organizational structures:
C. Describe the agency services available to the community:
2
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
The Agency and the Community - Continued
D. Briefly describe the community served by your agency and include:1. Geographic location and location of the agency within the
community:
2. Ethnicity of the population served:
3. Socio-economic status of population:
4. Community’s need for resources:
5. Community’s perception of the agency:
6. Agencies to whom referrals are made:
7. What were the sources of your information in answering the above?
3
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
General Time Management
1. Days and hours in field placement:
2. Day, time, and length of individual field instruction:
3. Names(s) of preceptor(s) and/or contact person in field instructor’s absence:
4. Day and time of field seminar:
5. If the plan is for you to rotate or change programs in the agency, specify the time frame for the rotation:
4
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Student Expectations for Supervision in the Field/Instruction
1. Describe your expectations of the supervision process.
2. Describe your expectations of yourself in supervision.
3. Describe your expectations of your Field Instructor.
4. Describe your expectations of your Preceptor (if applicable).
5
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Field Instructor Teaching Plan
1. Detail your expectations of your student in supervision.
2. How do you structure your weekly field instruction? Briefly describe your teaching plan. Please include how you plan to maximize diversity in your case assignments for each student.
3. Describe your plan for use of a preceptor with your student (If applicable).
a. Role of Preceptor
b. Detail your plan for monitoring and evaluating this experience:
6
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Orientation ChecklistAgency Overview
Review agency vision and mission/purpose statementTour of agencyIntroductions to colleagues, support staff, and administrationReview organizational structureReview the role of the agency in relation to the community and its resourcesReview security and/or safety procedures and protocol
Agency Policies and ProtocolsReview office procedures, supplies, and provisionsReview telephone and communication/computer utilizationReview intake/admissions/eligibility policy and proceduresReview internal communicationReview parking detailsReview mileage policyReview agency, department, and/or unit meeting scheduleReview client record/charting, policies and proceduresReview forms for documentation/accountabilityReview regulations regarding confidentiality, release of information, etc.Review client fees/payment scheduleReview client emergency protocolReview child or elder abuse reporting protocolReview work schedule, including lunch and breaksReview information/referral policyReview agency policy regarding harassmentReview agency policy regarding discriminationReview agency policy regarding the Americans with Disabilities ActReview agency policy regarding OSHAReview agency policy regarding HIPAA
Field Instructor and Student ResponsibilitiesReview expectations for supervision and scheduleReview educationally based recording scheduleReview use of preceptor (if applicable)Review plan for diversity/multi-cultural experiencesReview plan for monitoring of student hours (by both field instructor and student)Review agency training or staff development opportunitiesReview student’s personal safety issues and concerns and strategies to deal with them
Signature DateField Instructor
7
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Student
Senior Field Evaluation – To Be Completed At the End of Fall Semester
INSTRUCTIONS FOR RATING INTERNS:Comments required at the end of each semester, the student’s level of skill development should be a minimum of 2-3 for all practice behaviors at the end of the Fall semester. Please contact the Field Liaison with any 1 rating.
Number of hours completed:
If the student has not completed the required number of hours, please describe in detail the plan for these hours to be completed:___________________________________________________________________________________ ___________________________________________________________________________________ Student Strengths: Areas Needing Improvement:
Field Instructor Signature Date
8
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Student Signature Date
Student’s signature acknowledges that the student has participated in and has reviewed the evaluation.
Senior Field Evaluation – To Be Completed At the End of Spring Semester
INSTRUCTIONS FOR RATING INTERNS:Comments required at the end of each semester, the student’s level of skill development should be a minimum of 3-4 for all practice behaviors at the end of the Spring semester. Please contact the Field Liaison with any ratings below 3.
Number of hours completed:
If the student has not completed the required number of hours, please describe in detail the plan for these hours to be completed:___________________________________________________________________________________ ___________________________________________________________________________________
Areas of strength and suggestions for further development:
Field Instructor Signature Date
9
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Student Signature Date
Student’s signature acknowledges that the student has participated in and has reviewed the evaluation.
10
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
INSTRUCTIONS FOR RATING INTERNS
Level 1 = does not meet expectation Level 2 = beginning level of skill Level 3 = competentLevel 4 = advancedLevel 5 = mastered
Comments required at the end of each semester, the student’s level of skill development should be a minimum of 2-3 for all practice behaviors at the end of the Fall semester. Please contact the Field Liaison with any ratings of 1.Comments required at the end of each semester, the student’s level of skill development should be a minimum of 3-4 for all practice behaviors at the end of the Spring semester. Please contact the Field Liaison with any ratings below 3.
LEARNING AGREEMENT INSTRUCTIONS
The shaded area under each competency is the Learning Agreement Plan. The Student and Field Instructor will identify planned learning activities specific to the agency. The activities will provide opportunities to achieve each competency. A minimum of three activities must be listed for each competency. You may add more rows if needed.
11
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #1: Ethical and Professional Behavior - Intern identifies as a professional social worker and conduct oneself accordingly. Apply social work ethical principles to guide professional practice.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #11.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level
of Skill Competent Advanced Mastered
1 2 3 4 5
Fall Spring
a. Articulates the various roles, functions, and purposes of social workers b. Demonstrates professional behavior in (demeanor, appearance and
communication)c. Establishes and maintains professional boundaries (with clients, staff, field
instructor & other professionals)d. Engages in appropriate use of supervision and consultatione. Demonstrates ability to be self-evaluative and accountable for his/her own
learning and professional development.f. Makes ethical decisions by applying ethical standards of the NASW Code of
Ethics.g. Recognizes and understands how professional values can guide social work
practice.h. Applies ethical problem solving strategies in situations of uncertainty. i. Applies relevant legal standards to practice (such as mandated reporting,
parental consent, legal consent, etc.).j. Demonstrates insight into personal dynamics, feelings, and values.k. Writes professionally with clarity, organization, and conciseness.l. Articulates orally with clarity, organization, and conciseness.m. Uses technology to enhance the communication of ideas.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: ____
12
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
_________________________
______
Competency #2 Diversity and Difference - Intern engages diversity and difference in practice.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #21.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Recognizes how a culture’s structures and values may oppress, discriminate, and marginalize, as well as enhance privilege or power. b. Recognizes own biases and values, recognizing one’s role as a learner, in work with diverse and different groups.c. Views oneself as a learner and seeks guidance from experienced professionals and others.d. Understands and applies the multiple aspects of diversity including but not limited to age, class, color, disability, ethnicity, gender, gender identity and expression, immigration status, race religion, political ideology, and sexual orientation in shaping life experiences.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: ___________________________________________________________________________________________
13
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
____________________________________________________________________________________________ ___________________________________________________________________________________________
14
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #3: Social Justice and Human Rights - Intern advances human rights, social, economic, and environmental justice.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #31.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Understands theories, forms and mechanisms of oppression and discrimination to promote human and civil rights. b. Is knowledgeable of local, regional and global programs and services available for advocacy of human rights.c. Engages in practices that advance human rights and social and economic justice.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: ______________________________________________________________________________ ___________________________________________________________________________________________
15
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #4: Research and Practice – Intern engages in research-informed practice and practice informed research.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #41.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Is familiar with a variety of research methods.
b. Critically evaluates and applies research evidence to inform practice.
c. Uses practice experience to inform scientific inquiry
d. Understands and responds to ongoing emerging societal trends, and scientific and technological developments.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: ______________________________________________________________________________ ___________________________________________________________________________________________
16
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #5: Policy Practice - Intern engages in policy informed practice to advance social and economic well-being and to deliver effective social work services.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #51.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Identifies the role of policy in service delivery and its impact on social welfare delivery system.
b. Identifies the role of practice in policy development.
c. Engages and advocates in policy practice for effective policy actions that advances social well-being.d. Recognizes the importance of collaboration with colleagues and clients for effective policy action.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: _____________________________________________________________________________________ ___________________________________________________________________________________________
17
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #6: Engagement – Intern engages with individuals, families, groups, organizations, and communities.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #61.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Develops a collaborative working relationship with client systems of all sizes.
b. Demonstrates use of empathy and active listening skills
c. Is aware of how they are perceived by clients, and able to modify behavior as indicated by client responsed. Demonstrates ability to develop trusting working relationships with clients.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: ____________________________________________________________________________________ ___________________________________________________________________________________________
18
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
19
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #7: Assessment - Intern assesses individuals, families, groups, organizations, and communities.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #71.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Assesses client’s systems, conducts assessment, including strengths, risk factors, and cultural considerationsb. Able to organize key content areas including basic summary and interpretation of client data.
c. Develops mutually agreed upon goals/outcomes
d. Selects appropriate intervention strategies based on assessment.e. Integrates, analyzes, and synthesizes information from a variety of perspectives and multiple sources of knowledge in the development of professional judgment and assessment. f. Utilizes conceptual frameworks to guide process of assessment.g. Critiques and applies knowledge of theoretical frameworks to understand person and environment, and their reciprocal interactions (which is how they impact each other).
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: _____________________________________________________________________________________ ___________________________________________________________________________________________
20
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #8: Intervention - Intern intervenes with individuals, families, groups, organizations, and communities.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #81.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Demonstrates ability to define client needs in behavioral and measurable terms that are realistic and attainable.b. Selects intervention strategy appropriate to client goals, including prevention as indicated
c. Implements intervention strategy to attain client goals and initiatives
d. Advocates for clients and works collaboratively with available resources
e. Facilitates transitions and endings
f. Utilizes conceptual frameworks to guide process of intervention.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: _____________________________________________________________________________________ ___________________________________________________________________________________________
21
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
22
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
Competency #9: Evaluation – Intern evaluates practice with individuals, families, groups, organizations, and communities.
LEARNING OPPORTUNITIES AND STUDENT ACTIVITIES TO ACHIEVE COMPETENCY #91.
2.
3.
Evaluation of Practice BehaviorsDoes Not Meet
ExpectationBeginning Level of
SkillCompete
nt Advanced Mastered
1 2 3 4 5
Fall Spring
a. Critically analyzes monitors and evaluates interventions.
b. Utilizes evaluation data to revise interventions.
c. Able to appropriately end client relationship, evaluate need for further resources when needed.
d. Utilizes conceptual frameworks to guide process of evaluation.
e. Analyzes and evaluates agency’s response to changes and needs of the community.f. Demonstrates an ability to identify and appraise existing services and resources.g. Provides suggestions for change in service delivery and practice, based on contextual analysis.
Comments required for all ratings at the end of each semester. Please contact the Liaison about any ratings of 1 in fall semester and any ratings below 3 in spring semester: _____________________________________________________________________________________ __________________________________________________________________________________________________
23
California State University, Long BeachSchool of Social Work
Field Education
Undergraduate Learning Agreement & Mid-Year Evaluation
_____________________________________________________________________________________________________________________________________________________________________________________________
24