MEd SACP PRACTICUM FINAL EVALUATION FORM

Name of Student: Amanda Medland

Practicum:

656 (Academic)

Date: August 11, 2014

675 (Cog/Neuro)

676 (Soc/Emo/Beh)

Student Practicum Expectations

In this practicum, it is expected that students will begin by observing the supervising
professional and other professionals before taking an active role in professional activities.
At this level, most students will require some support while engaging in tasks (planning,
implementation). It is expected that student skill level will increase with each practicum. We
ask you to use competent, entry-level school psychology practice as the standard for
evaluation or comparison. This evaluation form should be completed at least twice during
the practicum: 1) by August 1st and 2) at the completion of the practicum (August 14th).
Please use the following rating scale in evaluating the student on the characteristics listed
below:

Needs
Improvement:

Not an appropriate goal for this practicum level

Student's skills reflect insufficient mastery in this area;

Student needs additional course-based instruction in this
skill
Plans should be made to assure student gains extra practice
in this skill prior to leaving the program

Student is comfortably independent in this skill

A. PERSONAL CHARACTERISTICS
Presents a professional appearance

N/A

N/O

Satisfactory

Competent:

ImprovementNeeds

Student's skills in this area are adequate for practice in

schools; Student should continue to practice this skill under
professional supervision

Unsatisfactory

Satisfactory:

Competent

Not Applicable
(N/A):
Not
Observed/No
opportunity
(N/O)
Unsatisfactory:

Relates well to children/youth

Interpersonal skills: respectful attitude and manner;

sensitivity
Teamwork skills: works well with supervisors,
colleagues, and other professionals
Communicates and listens effectively

Demonstrates dependability

X
X

Meets difficult situations with self-control

Shows evidence of continued self-evaluation

Accepts constructive feedback

Utilizes constructive feedback

Adaptability /Flexibility / Responsiveness

B. ASSESSMENT & CONSULTATION SKILLS

Assessment-planning skills (i.e., suitable to
circumstances and client needs)
Interviewing skills (e.g., with child/youth, parents,
teachers, program staff) to collect relevant
assessment information
File review skills (identifies pertinent file
information to support assessment)

N/A
X

N/O

Competent

Satisfactory

Tolerance for others values and viewpoints

ImprovementNeeds

Unsatisfactory

Judgment and common sense

X
X

Observational skills (e.g,. during interview,

formal testing, formal observation)

Displays accuracy in administering and

scoring tests and other measurements

Analyzes and interprets assessment results in a

meaningful and thorough fashion
Assess youths behaviour based on DSM-IV (or V)
criteria
Recommendations (follow
logically from the assessment results and
are educationally relevant)
Oral feedback skills (Able to verbally
communicate assessment results and
measurement concepts in a clear and
understandable manner)
Problem identification skills when working with
consultation clients
Establishes effective collaborative relationships
with parents (and school personnel, if applicable)

X
X
X
X

X
X

Individualization skills (Ability to adjust and tailor

response to needs of client)
Consultation skills (e.g., educating, problemsolving, modelling, coaching)

X
X

No. assessments completed:

Supervisor comments regarding student involvement in assessment-related activities: Amanda
works diligently to learn new tests and to ensure that she follows standardization. Her
interpretation and writing skills are good and will improve as she moves forward in the
program.

Satisfactory

N/A

Yes

Competent

ImprovementNeeds

C. TREATMENT AND INTERVENTION

Unsatisfactory

Supervisor comments regarding student involvement in consultation-related activities:

Able to accept and give appropriate feedback. Works well with parents and supervisor

N/A
N/O
Intervention planning: Capable of developing social, X
emotional goals
Intervention planning: Capable of developing
X
academic goals
Intervention planning: Capable of developing
behavioural goals
Program planning: Considers client needs and
X
organizational capacity when recommending,
developing, or planning interventions
Intervention skills with groups: Facilitates
X
implementation of appropriate evidence-based
intervention / treatment plans
Intervention skills with individuals: Utilizes
X
prevention and intervention techniques with
individual clients (e.g., psycho-education, problemsolving, supportive counselling)
Responsiveness: Monitors client response; adapts to X
circumstances and client needs
Supervisor comments regarding student involvement in intervention-related activities:

D. ETHICAL AND PROFESSIONAL RESPONSIBILITIES*

Efficient: establishes priorities and manages time well

Responsible / Dependable: Present, punctual, accepts tasks, follows

through
Policies & Procedures: Followed through on practicum site policies and
procedures (i.e., on site hours; confidentiality)
Documentation: maintained file documentation

Met with supervisor for hours required by practicum

X
X

No

Attendance: present and prepared for team meetings and weekly

lectures1
Participation: involved in team meetings, team cases, and weekly
lectures
Communication: Keeps supervisors and administrators informed of
unusual events and activities, as well as routine matters
Studentship: Takes direction, accepts and responds well to feedback

Proactive in seeking consultation and supervision to support skill

development
Competence: Demonstrates awareness of limits of competence; seeks
supervision as necessary
Professional Practice: Demonstrates understanding of, and practices in
accordance with, CAP Standards of Practice and Canadian Code of Ethics
for Psychologists
*ratings of no on any of these items will result in a failure of a learning task.

N/A

N/O

Competent

Satisfactory

ImprovementNeeds

Unsatisfactory

E. SUMMARY EVALUATION
Overall Rating of the Practicum Student

For midterm evaluation only: Clearly identify any areas, if any, that may be of particular
concern with respect to the students performance and which may impede their ability to
successfully complete the practicum:
For final evaluation only: This student has reached the practicum goals and is ready to
continue In their program. X Yes
No
Comments: Amanda is an enthusiastic and competent student who puts great effort into
developing her assessment skills and expanding her knowledge. Wonderful to work with.

F. PROFESSIONAL GOALS
Given the above ratings of the practicum student's current professional skills, identify the
three most important goals for the upcoming evaluation period. For formative evaluation,
goals may relate to specific skill development, experiences or activities to be emphasized, or
areas in need of further development in the balance of the practicum. For the summative
evaluation, goals may relate to areas for continued training/supervision or areas for
continuing professional development. At this point in their program, all students are
expected to have areas of improvement. Additional written summary may be included and
added to the back of this document as needed.
1. Increasing assessment skills
2. developing understanding of DSM V and case conceptualizations
3. developing stronger report writing skills
1 Failure to attend 3 scheduled activities in real-time (assessments, group meetings, lectures, supervision, etc.) will
results in an automatic failure of the course.

I have read the ratings and comments above:

NAME (please print)

SIGNATURE2

DATE

______________________________
Student

_________________________

____________

______________________________
Practicum Supervisor

_________________________

____________

______________________________
Course Instructor

_________________________

____________

2 The student's signature indicates only that the evaluation has been discussed with the practicum student.