MIDTERM EVALUATION

This form is to be completed by the Field Instructor and discussed with student. It will
automatically be sent to the Faculty Advisor once it is completed online.
Student:
Sara Kornoski
Agency:
community Housing Network
Agency Field Instructor(s): Jessie Korte
Faculty Advisor:
Stephanie Laughlin
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 157.5 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 Advisor.
Process Recordings or PRACSIS have been reviewed by Field Instructor and submitted to the
X Faculty Advisor (students should check with assigned Faculty Advisor to find 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.
Sara current employment working with a DD individual has given her skills to be empathetic
with CHN's PP. Sara uses supervision appropriately and really brings her knowledge from the
classroom into her internship.
Please see notes below with what to work on.

Instructions for completing the mid-term evaluation: Please evaluate students performance
halfway through the semester by indicating Progress, No Progress, or No Opportunity. Please
reference the students Learning Plan specific 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.
Apply social work ethical principles to guide professional practice.
Apply critical thinking to inform and communicate professional judgments.
Engage diversity and difference in practice.
Advance human rights and social and economic justice.
Engage in research-informed practice and practice-informed research.
Apply knowledge of human behavior and the social environment.
Engage in policy practice to advance social and economic well-being and to deliver
effective social work services.
Respond to contexts that shape practice.
Engage, assess, intervene, and evaluate with individuals, families, groups,
organizations, and communities.
Analyze the impact of the urban context on a range of client systems, including
practice implications.

PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
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.
N/a
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

Comments:
Sara is doing well in our agency. The few things that I recommend that she works on is asking
questions for clarity and help when unsure about a task.
To continue to work on proper case note writing skills.
**Please note: By typing my name below, I certify that I have reviewed the document,
completed my portion and agree with the content.
(Korte, Jessie): Jessie Korte Jul 9, 2014 10:53 AM
Field Instructor (agency-based supervisor)

STUDENT SECTION
I... Agree with the evaluation.
Comments:
ok
**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.
(Kornoski, Sara): Sara Kornoski Jul 16, 2014 7:35 PM
Student

(Stephanie Laughlin): Stephanie Laughlin LMSW Jul 19, 2014 9:50 AM

Faculty Advisor

Printable Version
IPT Document Management System January 1, 2014
Form: 1217

MIDTERM EVALUATION
This form is to be completed by the Field Instructor and discussed with student. It will
automatically be sent to the Faculty Advisor once it is completed online.
Student:
Sara Kornoski
Agency:
Community Housing Network
Agency Field Instructor(s): Jessie Korte
Faculty Advisor:
Stephanie Laughlin
Please Check One:
X BSW
BSW WOW
MSW Foundation Year
MSW Advance Year
Q3 Please check and complete all that apply.
Student has received agency orientation and work space has been assigned.
X Student has completed 275.5 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 Advisor.
Process Recordings or PRACSIS have been reviewed by Field Instructor and submitted to the
X Faculty Advisor (students should check with assigned Faculty Advisor to find 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.
Sarah needs more practice in the SW field to obtain more confidence and skills with interacting
with participants. She appears to have a little fear on how to converse with "challenging"
interactions with participants.
Sara asks good questions and uses supervision appropriately.

Instructions for completing the mid-term evaluation: Please evaluate students performance
halfway through the semester by indicating Progress, No Progress, or No Opportunity. Please
reference the students Learning Plan specific 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.
Apply social work ethical principles to guide professional practice.
Apply critical thinking to inform and communicate professional judgments.
Engage diversity and difference in practice.
Advance human rights and social and economic justice.
Engage in research-informed practice and practice-informed research.
Apply knowledge of human behavior and the social environment.
Engage in policy practice to advance social and economic well-being and to deliver
effective social work services.
Respond to contexts that shape practice.
Engage, assess, intervene, and evaluate with individuals, families, groups,
organizations, and communities.
Analyze the impact of the urban context on a range of client systems, including
practice implications.

PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
PROGRESS
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.
There was concern in the beginning how well Sara was gaining knowledge and training. Sara
appears to have gotten over that hump.
Sara appears to feel more comfortable with her role in the Emergency Solutions Grant.
Needs to continue to work on her verbal communication to stay on topic and professional.
Sara appears to have a passion for social advocacy.
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
Comments:
Sarah is doing well and comfortable with her role

**Please note: By typing my name below, I certify that I have reviewed the document,
completed my portion and agree with the content.
(Jessie Korte): Jessie Korte Nov 6, 2014 11:22 AM
Field Instructor (agency-based supervisor)

STUDENT SECTION
I... Agree with the evaluation.
Comments:
I enjoy working in the Emergency Solutions Grant at Community Housing Network.
**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.
(Kornoski, Sara): Sara Kornoski Oct 23, 2014 1:24 PM
Student

(Stephanie Laughlin): Stephanie Laughlin LMSW Nov 7, 2014 10:17 PM

Faculty Advisor

Printable Version
IPT Document Management System January 1, 2014
Form: 3156