Internship Performance Evaluation Department of Human Services, Washburn University

Transcription

1 Internship Performance Evaluation Department of Human Services, Washburn University Student: On-Site supervisor: Semester: 20 Agency: Supervisors and Students: At the beginning of the semester: Please meet with the student to review this evaluation form and select a subset of these objectives to focus on. You do not need to circle any numbers or complete the short answer questions at the end at this time; this is done at the end of the semester. At the end of the semester: You will rate the student on the selected objectives using an online, interactive form. We will send you the link to this evaluation near the end of the semester. Students will not pass the class unless this evaluation is completed and returned by the deadline. 1. Knowledge of persons by agency: Describe important characteristics of persons was 1 Identify strengths of persons s/he is working with Identify needs of persons s/he is working with Identify goals of persons s/he is working with Describe related legal issues Describe related ethical issues 2. Knowledge of agency organization: Describe major agency policies and procedures Describe basic management structure of agency Describe how decisions are made

2 was Identify major funding sources of agency Describe major budget categories of agency Identify agency corporate status (e.g., nonprofit?) Identify ways that agency programs are evaluated 3. Knowledge of agency services Describe range of services offered by agency Offer info to potential consumers about services Make referrals to outside agencies as 4. Knowledge of community Describe useful resources in the community Describe demographic characteristics of community Identify important community strengths/assets Identify important community needs/challenges Describe legislation/political issues relevant to agency 5. Skills related to relationships w/ persons by agency: Establish rapport with persons by agency Listen deeply to persons concerns Exhibit empathy Display cultural competence Provide accommodations for special needs Involve persons in developing their plans and 2

3 goals Support self-reliance of persons by agency was 3 Advocate for persons by agency Follow ethical guidelines and boundaries Maintain confidentiality 6. Skills related to staff relationships: Communicate effectively with staff Cooperate well with staff Participate appropriately in meetings/activities Seek supervision appropriately Receive and use feedback well Give feedback appropriately 7. Skills related to service delivery: Conduct assessments/intakes Write service delivery plans Share plans with necessary parties Evaluate progress on plans Write support plans (or discharge plans) Complete required documentation and records Facilitate groups of persons by agency Conduct programs (e.g., activities, trainings) Respond appropriately in crisis situations 8. Skills related to community: Students is able to: Locate resources in community for persons

4 Communicate effectively with community agencies was Represent the agency well in the community Educate community on important agency issues Advocate in community for rights of persons 9. Skills related to professional behavior Student: Arrives/leaves as scheduled Follows through on projects Displays positive, can-do attitude Leaves personal problems at home Takes steps to stay emotionally/physically healthy Shows initiative when a task needs to be completed Maintains behavior congruent w/agency expectations Exhibits eagerness to continue learning N/A 10. Performance on individualized learning objective #1: Met first individualized objective in contract 11. Performance on individualized learning objective #2: Met second individualized objective in contract 4

5 1. Please elaborate on special strengths this student has shown. 2. Please describe areas of growth. 3. Other comments: 4. Recommended grade: On-Site Agency Supervisor Date Student Date 5