3/23/2016

Midterm Evaluation

MIDTERM EVALUATION
This form is to be completed by the Field Instructor and discussed with student. It will automatically
be sent to the Faculty Field Liaison once it is completed online.
Student:

Teresa Hurtgen

Agency:
Covenant House Michigan
Agency Field Instructor(s): Kathryn Douglass LMSW
Faculty Field Liaison:

Galen Duncan PhD

Please Check One:

X BSW
BSW WOW
MSW Foundation Year
MSW Advance Year
Q3 Please check and complete all that apply.
X Student has received agency orientation and work space has been assigned.
X Student has completed 120 hours to date.
X Student is actively engaged in weekly supervision.
X Learning Plan has been completed and submitted to the Field Instructor and Faculty Field Liaison.
X Process Recordings or PRACSIS have been reviewed by Field Instructor and submitted to the
Faculty Field Liaison (students should check with assigned Faculty Field Liaison to nd out the
number of Process Recordings or PRACSIS required).
Please describe any areas of strength or concern in regard to the students performance and/or
the availability of required learning assignments.
Ms. Hurtgen is really developing her skills. She has strong professional approach and practices with
condence. She knows her supervisor, her work responsibilities, her clients and her colleagues. Its
great to have her here at Covenant House and to coach her through her academic challenges
Instructions for completing the mid-term evaluation: Please evaluate students performance halfway
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Midterm Evaluation

through the semester by indicating Progress, No Progress, or No Opportunity. Please reference the
students Learning Plan specic practice outcomes to determine the rating.
Performance rating scale based on the (11) competencies:
PROGRESS Student met performance expectation and/or is exhibiting progression to meet
expectations
NO PROGRESS Student did not meet performance expectations
NO OPPORTUNITY There was not an opportunity to meet expectations
COMPETENCY AREAS 1 11
Identify as a professional social worker and conduct oneself accordingly.

PROGRESS

Apply social work ethical principles to guide professional practice.

PROGRESS

Apply critical thinking to inform and communicate professional judgments.

PROGRESS

Engage diversity and difference in practice.

PROGRESS

Advance human rights and social and economic justice.

PROGRESS

Engage in research-informed practice and practice-informed research.

PROGRESS

Apply knowledge of human behavior and the social environment.

PROGRESS

Engage in policy practice to advance social and economic well-being and to deliver
effective social work services.

PROGRESS

Respond to contexts that shape practice.

PROGRESS

Engage, assess, intervene, and evaluate with individuals, families, groups,

organizations, and communities.

PROGRESS

Analyze the impact of the urban context on a range of client systems, including
practice implications.

PROGRESS

If there is a Competency Area in which the student has not met minimum performance
expectations to date, a plan of action must be noted below. If there will not be an opportunity to
address a competency area, please state that.
Ms. Hurtgen is progressing in all areas of competency.
In the section below, please provide an Overall Rating of Progress or No Progress for the students
performance, as indicated by the rating that is most frequent of the eleven (11) competencies. All
parties are required to sign the midterm evaluation to indicate that they have discussed the evaluation,
even if the student does not agree with the evaluation.
FIELD INSTRUCTOR SECTION
Recommend:

PROGRESS

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Midterm Evaluation

Comments:
Ms. Hurtgen is thriving as a generalist social worker.
**Please note: By typing my name below, I certify that I have reviewed the document, completed my
portion and agree with the content.
(Douglass, Kathryn): Kathryn Douglass LMSW Feb 26, 2016 2:09 PM
Field Instructor (agency-based supervisor)

STUDENT SECTION
I... Agree with the evaluation.
Comments:
I feel condent that I am developing and strengthening my skills as a BSW student, I appreciate the
guidance provided to me here at Covenant House Michigan and really strive to take advantage of the
opportunity effectively.
**Please note: By typing my name below, I certify that I have reviewed the document, completed my
portion and agree with the content.
By signing you will submit Midterm FIASC information to the assigned faculty advisor from the
Wayne State University School of Social Work. Once the form is completed you will not be able to
modify your responses.
(Hurtgen, Teresa): Teresa R. Hurtgen Feb 29, 2016 9:57 AM
Student
(Galen Duncan): galen duncan Mar 1, 2016 10:26 AM
Faculty Field Liaison

CLOSE

Printable Version
IPT Document Management System January 1, 2014
Form: 40094

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