WIXLIB

Texas A&M University-CommerceSchool of Social WorkLearning Contract & Evaluation SWK 553Student Name:Semester/Year:Agency:Faculty Liaison:Field Instructor:On-Site Supervisor (if applicable)The Learning Plan is a tool to guide the field practicum experience. The Learning Planincorporates learning objectives, agency goals and learning opportunities for the student alongwith the student’s individual learning goals and objectives within the field agency. In theinstance whereas an agency may not have services available to help the student meet all therequired learning objectives, field instructors may identify and utilize opportunities outside of theagency.Instruction for Completing the Learning ContractThe student, in collaboration with the field instructor and/or on-site task supervisor (whenapplicable) completes the initial learning plan. The learning plan is a fluid tool available forreview during weekly supervision sessions allowing opportunities to gauge progress andmeasure of achievement for the evaluation process. Understanding that activities, tasks andbehaviors are subject to change during the semester, should the Learning Contract change atany time, please indicate changes directly on the Learning Contract.The Learning Contract form also provides both mid-term and final assessments of students'attainment of learning objectives, agency goals and learning opportunities outlined in the initialplan.1 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Rating Scale for Evaluation of Field Placement PerformanceInstructions for Rating Students Interns on the 10 competencies in the First Part of theEvaluation:The 10 competencies specified in this evaluation form are those established Council onSocial Work Education (CSWE) the national accrediting association for social work education.Each competency consists of applicable practice behaviors. Please rate the student using therating scale below on each of the practice behaviors listed.5 4 3 2 1 n/aExcellent (advanced competence/proficient in activity)Good (competent in activity)Average(met expectations - emerging competent)Fair (met minimal expectations - but insufficient)Poor (Did not meet expectations)Not applicable, as the intern has not had the opportunity to demonstrate competence inthis areaNote that the scale represents assessment up to that point in the semester and indicates thestudent's growth in each competency via completion of learning activitiesThe above scale does NOT represent points for total "score" constituting a "grade" for thecourse* While you may provide comments under any competency statement, explanation is requiredfor any rating under three (3). It is helpful in assessing a student's progress if you can indicatethose areas where the student is particularly strong and areas needing improvement.This evaluation provides the student feedback about her or his performance. The faculty liaisonhas responsibility of assigning the grade for field instruction. Assignment of a final grade in thecourse is based on:(1) The Faculty liaison’s overall evaluation of the student’s performance in the fieldplacement in conjunction with the field instructor’s evaluation(2) Attendance and participation in field seminar as outlined in the course syllabi(3) Submission of required materials such as: intern logs, seminar participation; papersthat integrate field with classroom instruction.If you prefer to use another evaluation system in addition to this form to evaluate astudent’s performance, please discuss this with the faculty supervisor.2 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.1 Identify as a Professional Social Worker and Conduct Oneself AccordinglyProfessional BehaviorMid-TermFinal2.1.1.1 Has a commitment to career-long learning and growth2.1.1.2 Advocates for client access to services of social work2.1.1.3 Practice personal reflection and self-correction to assurecontinual professional development2.1.1.4 Attends to professional roles and boundaries2.1.1.5 Demonstrates professional demeanor in appearance,behavior and communication2.1.1.6 Uses Supervision and Consultation effectivelyActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.1.11.21.31.41.51.6Mid-Term CommentsFinal Comments3 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.2 Apply Social Work Ethical Principles to Guide Professional PracticeProfessional Behavior2.1.2.1 Makes ethical decisions by applying standards ofthe National Association of Social Workers Codeof Ethics and as applicable, of the InternationalFederation of Social Workers/InternationalAssociation of Schools of Social Work Ethics inSocial Work, Statement of Principles2.1.2.2 Recognizes and manages personal values toguide practice2.1.2.3 Tolerates well ambiguity in resolving ethicalconflicts2.1.2.4 Is able to apply strategies of ethical reasoning toarrive at principled decisionsMid-TermFinalActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.2.12.22.32.4Mid-Term CommentsFinal Comments4 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.3 Apply Critical Thinking to Inform and Communicate ProfessionalJudgmentsProfessional BehaviorMid-TermFinal2.1.3.1 Is skilled at appraising and integrating multiplesources of knowledge and practice wisdom2.1.3.2 Is skilled at analyzing models of assessment,prevention, intervention, and evaluation2.1.3.4 Demonstrates effective communication in workingwith individuals, families, groups andorganizationsActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.3.13.23.3Mid-Term CommentsFinal Comments5 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.4 Engage Diversity and Difference in PracticeProfessional Behavior2.1.4.1 Recognizes the extent to which a culture'sstructures and values may oppress, marginalize,alienate, or create or enhance privilege andpower2.1.4.2 Has sufficient self-awareness to eliminate theinfluence of personal biases and values inworking with diverse groups2.1.4.3 Recognizes and communicates her or hisunderstanding of the importance of difference inshaping life experiences2.1.4.4 Views herself or himself as a learner andengages those he or she works with asinformantsMid-TermFinalActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.4.14.24.34.4Mid-Term CommentsFinal Comments6 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.5 Advance Human Rights and Social and Economic JusticeProfessional Behavior2.1.5.12.1.5.22.1.5.3Understands the forms and mechanisms ofoppression and discriminationIs skilled at advocating for human rights andsocial and economic justiceIs skilled at engaging in practices that advancesocial and economic justiceMid-TermFinalActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.5.15.25.3Mid-Term CommentsFinal Comments7 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.6 Engage in research-informed practice and practice-informed researchProfessional Behavior2.1.6.12.1.6.2Is skilled at using practice experience to informscientific inquiryUses research evidence to inform practiceMid-TermFinalActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.6.16.2Mid-Term CommentsFinal Comments8 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.7 Apply Knowledge of Human Behavior in the Social EnvironmentProfessional Behavior2.1.7.12.1.7.2Utilize conceptual frameworks to guide theprocesses of assessment, intervention andevaluationCritique and apply knowledge to understandperson and environmentMid-TermFinalActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.7.17.2Mid-Term CommentsFinal Comments9 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.8 Engage in policy practice to advance well-being and deliver services2.1.8.12.1.8.2Professional BehaviorMid-TermFinalIs skilled at analyzing, formulating and advocatingfor policies that advance social well-beingIs skilled at collaborating with colleagues andclients for effective policy practice.Activities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.8.18.2Mid-Term CommentsFinal Comments10 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6

Competency 2.1.9 Responds to Context that Shape Practice2.1.9.12.1.9.2Professional BehaviorMid-TermFinalIs skilled at continuously discovering, appraising, andattending to changing locales, populations, scientificand technological developments and emergingsocietal trends in order to provide relevant servicesIs skilled at providing leadership in promotingsustainable changes in service delivery and practiceto improve the quality of social servicesActivities, tasks and behaviors should be listed that will provide evidence of growth incompetencies. In writing the learning activities, one should answer the question, "How is thestudent going to demonstrate the above practice behaviors and ultimately the competency atthis agency"? List below learning activities that will reflect the corresponding professionalbehaviors.9.19.2Mid-Term CommentsFinal Comments11 MSW Foundation L e a r n i n g C o n t r a c t 2 0 1 6