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Med Sacp Practicum Final Evaluation Form Name of Student: Amanda Medland
Med Sacp Practicum Final Evaluation Form Name of Student: Amanda Medland
Med Sacp Practicum Final Evaluation Form Name of Student: Amanda Medland
656 (Academic)
675 (Cog/Neuro)
676 (Soc/Emo/Beh)
Needs
Improvement:
A. PERSONAL CHARACTERISTICS
Presents a professional appearance
N/A
N/O
Satisfactory
Competent:
ImprovementNeeds
Unsatisfactory
Satisfactory:
Competent
Not Applicable
(N/A):
Not
Observed/No
opportunity
(N/O)
Unsatisfactory:
Demonstrates dependability
X
X
N/A
X
N/O
Competent
Satisfactory
ImprovementNeeds
Unsatisfactory
X
X
X
X
X
X
X
X
X
X
Satisfactory
N/A
Yes
Competent
ImprovementNeeds
Unsatisfactory
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:
X
X
No
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.
SIGNATURE2
DATE
______________________________
Student
_________________________
____________
______________________________
Practicum Supervisor
_________________________
____________
______________________________
Course Instructor
_________________________
____________
2 The student's signature indicates only that the evaluation has been discussed with the practicum student.