Becoming a Site
Evaluation of Student



Evaluation of Student

1.Student and Supervisor
Student Name:   

  if other:

  if other:
Field Placement Supervisor:   
Supervisor's Contact:   

    Did the student complete his/her required hours?


Evaluation Term:   
Internship Dates(DD/MM/YYYY):   

    Consider the student’s Learning Objectives as described in the Internship Agreement/Field Placement Planning Form or as redefined over the course of the field placement.

How well did the student meet main objectives of the field placement?



    Please rate the student's professional performance for each category below. Feel free to leave comments.

a. Organizational Skills
(sets priorities and reasonable deadlines, meets timelines for deliverables, completes tasks on time, fulfills commitment to others)



b. Communication Skills
(verbal and written, listening skills, asks for and gives feedback, contributions at meetings)



c. Interpersonal Skills
(relationship with coworkers, relationshp with supervisor, team player)



d. Attitude and Initiative
(self-reliant, resourceful, flexible, dependable, curious)



e. Critical and Strategic Thinking Skills
(assess information to make informed decisions; sees the big picture and understands how actions fit into a plan; problem solves)



f. Technical Skills
(application of skills expected of this position)



5.School/University Support
    a. Had you served as a Field Placement Supervisor for the SPH in the past?


b. Would you be willing to serve as a Field Placement Supervisor next semester?


d. What is your overall rating of the field placement experience?





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