Fieldwork Supervisor Evaluation of HUSR Student

SUPERVISOR EVALUATION OF HUSR STUDENT

Student Name

Please indicate the date you completed this survey.
Enter date according to this format, MM/DD/YYYY.
(EX: 04/24/2021 would indicate April 24, 2021)

Semester and Year (EX: Spring 2022):

Please indicate the appropriate Internship Course Number:

396
495
496

Please provide the name of the program, or programs, in which the intern was involved:

Briefly describe the kinds of learning experiences made available to the student. Include any special orientation or training the student attended.

Did the student complete the activities written on their Learning Plan?

Yes
No

Did the student demonstrate the expected skills listed on their Learning Plan?

Yes
No

Please describe the primary methods used to monitor and assess the student’s performance (i.e., direct observation, written reports, etc.)

Please choose the most appropriate response below as you evaluate the student’s performance in regard to their PROFESSIONALISM.

Extremely unprofessional
Somewhat unprofessional
Neither professional nor unprofessional
Somewhat professional
Extremely professional

Please choose the most appropriate response below as you evaluate the student’s performance in regard to their PERSONAL CHARACTERISTICS.

Extremely difficult to work with
Somewhat difficult to work with
Neither difficult nor easy to work with
Somewhat easy to work with
Extremely easy to work with

Please rate student's ability to develop and maintain professional relationships with clients/consumers/co-workers from various cultural/ethnic backgrounds.

Not Acceptable
Somewhat Acceptable
Acceptable
Outstanding

Did supervisory conferences take place on a regular basis?

Yes
No

How much time per week was spent in supervisory activities with the student intern? Please select the option below that most closely represents the typical time spent.

Was the student provided with group supervision, individual supervision, or both?

Group supervision
Individual supervision
Both Group and Individual supervision

What were/are the student’s primary strengths?

In what areas do you think the student needs improvement?

Taking this entire evaluation into consideration, how would you rate the student's performance overall?

Significantly Below Average
Slightly Below Average
Average
Slightly Above Average
Significantly Above Average

Please sign below. Use your finger on a touch screen or your mouse to provide your signature below. Once signed, click on the blue arrow to your right to submit your evaluation.

Sign Here

clear

Supervisor Email (for copy of responses):