PSYC 491 Professional Field Experience Supervisor Evaluation

Thank you again for your help in supervising this student’s practicum. Your evaluation
of the student’s performance is very important in determining the student’s grade for the
course. You are also encouraged to review your evaluation with the student so they can
benefit from your feedback. Please complete and return the evaluation to me by the
final Wednesday of the current semester.

Dates are listed on the field experience website: psychology.wvu.edu/students/current-undergraduate-students/fieldexperience

If you have questions or concerns, please contact Stephanie McWilliams at srmcwilliams@mail.wvu.edu.

Student Name Student Name * First Last
Supervisor Name Supervisor Name * First Last
Agency *
When completing this evaluation, please keep in mind that the student is an undergraduate psychology major. Rate the student in comparison with other such students, not in comparison with experienced graduate students or agency staff.
Please provide a brief list of the activities the student engaged in this semester. *
Approximately how much time per week did you spend with the student? *
Describe the nature of your contact with the student. *
Besides direct contact with the student, on what other sources of information are you basing your evaluation (e.g., feedback from others, written work, etc.)? *
Basic Work Requirements
Arrives on time consistently. *

Arrives on time consistently. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Uses time effectively. *

Uses time effectively. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Informs supervisor and makes arrangements for absences. *

Informs supervisor and makes arrangements for absences. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Reliably completes requested or assigned tasks on time. *

Reliably completes requested or assigned tasks on time. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Completes required total number of hours or days on site. *

Completes required total number of hours or days on site. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Is responsive to norms about clothing, language, etc., on site. *

Is responsive to norms about clothing, language, etc., on site. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Ethical Awareness and Conduct
Possesses knowledge of general ethical guidelines. *

Possesses knowledge of general ethical guidelines. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Possesses knowledge of ethical guidelines applicable to the practicum site. *

Possesses knowledge of ethical guidelines applicable to the practicum site. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Demonstrates awareness and sensitivity to ethical issues. *

Demonstrates awareness and sensitivity to ethical issues. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Behaves consistently with ethical guidelines. *

Behaves consistently with ethical guidelines. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Student Preparation before Beginning Practicum
Had adequate background knowledge about client population at beginning of practicum. *

Had adequate background knowledge about client population at beginning of practicum. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Had adequate background knowledge about treatment approaches (or consulting strategies, problem-solving approaches, etc.) at beginning of practicum. *

Had adequate background knowledge about treatment approaches (or consulting strategies, problem-solving approaches, etc.) at beginning of practicum. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Possessed relevant skills at beginning of practicum. *

Possessed relevant skills at beginning of practicum. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Student Learning During Practicum
Is receptive to learning when new information is offered. *

Is receptive to learning when new information is offered. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Actively seeks new information from staff or supervisor. *

Actively seeks new information from staff or supervisor. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Shows the ability to learn and understand new information. *

Shows the ability to learn and understand new information. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Has acquired an understanding of concepts, theories, and information. *

Has acquired an understanding of concepts, theories, and information. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Shows the ability to apply new information in practicum activities. *

Shows the ability to apply new information in practicum activities. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Has obtained an appropriate level of knowledge and skills during the practicum. *

Has obtained an appropriate level of knowledge and skills during the practicum. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Response to Supervision
Actively seeks supervision when necessary. *

Actively seeks supervision when necessary. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Is receptive to feedback and suggestions from supervisor. *

Is receptive to feedback and suggestions from supervisor. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Understands information communicated in supervision. *

Understands information communicated in supervision. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Successfully implements suggestions from supervisor. *

Successfully implements suggestions from supervisor. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Is aware of areas that need improvement. *

Is aware of areas that need improvement. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Shows willingness to explore personal strengths and weaknesses. *

Shows willingness to explore personal strengths and weaknesses. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Interactions with Clients
Appears comfortable interacting with clients. *

Appears comfortable interacting with clients. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Initiates interactions with clients. *

Initiates interactions with clients. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Communicates effectively with clients. *

Communicates effectively with clients. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Builds rapport and respect with clients. *

Builds rapport and respect with clients. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Is sensitive and responsive to clients’ needs. *

Is sensitive and responsive to clients’ needs. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Is sensitive to cultural, age, and gender differences. *

Is sensitive to cultural, age, and gender differences. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Interactions with Coworkers
Appears comfortable interacting with other staff members. *

Appears comfortable interacting with other staff members. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Initiates interactions with staff. *

Initiates interactions with staff. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Communicates effectively with staff. *

Communicates effectively with staff. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Effectively conveys information and expresses own opinions. *

Effectively conveys information and expresses own opinions. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Effectively receives information and opinions from others. *

Effectively receives information and opinions from others. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Work Products
Reliably and accurately keeps records. *

Reliably and accurately keeps records. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Written or verbal reports are accurate and factually correct. *

Written or verbal reports are accurate and factually correct. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Written or verbal reports are presented in professional manner. *

Written or verbal reports are presented in professional manner. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
Reports are clinically or administratively useful. *

Reports are clinically or administratively useful. N/A 1: Far below expectations. Needs much improvement. A concern. 2: Below expectations. Needs some improvement to meet standards. 3: Acceptable. Meets standards at average level for practicum students. 4: Above expectations. Performs above average level for practicum students. 5: Far above expectations. A definite strength. Performs well beyond average for practicum students.
General
Overall, what would you identify as this practicum student’s strong points? *
What would you identify as areas in which this practicum student needs improvement? *
Are there any ways in which the Department of Psychology could better prepare students for practicum placements at your site? *
To your knowledge, did the student complete the number of hours of work indicated as
required in his or her Practicum Agreement Form? *

To your knowledge, did the student complete the number of hours of work indicated as
required in his or her Practicum Agreement Form? Yes No
Based on your experience with this student, would you hire this student? *

Based on your experience with this student, would you hire this student? Yes, I already have or am planning to offer a position to this student. Yes, I would hire this student if any positions were available. No
Please assign a numerical grade and a letter grade to this student’s performance using a 100-point scale where 90-100=A, 80-89=B, 70-79=C, 60-69=D, and less than 60=F.
Points (0-100) *
Letter Grade (A, B, C, D, F) *
Are you willing to supervise additional undergraduate practicum students in the future? *

Are you willing to supervise additional undergraduate practicum students in the future? Yes No
Draw your signature into the box below. *

Clear
Please attach a record of the times the student worked with this form. *

Attach Files

PSYC 491 Professional Field Experience Supervisor Evaluation

PSYC 491 Professional Field Experience Supervisor Evaluation

Basic Work Requirements

Ethical Awareness and Conduct

Student Preparation before Beginning Practicum

Student Learning During Practicum

Response to Supervision

Interactions with Clients

Interactions with Coworkers

Work Products

General