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MSW Concentration Learning Plan & Field Evaluation Student: Student ID #: Semester/Year: Permanent Non- UND Email Address: Field Instructor: Field Instructor’s Phone/Email: Agency: Faculty Field Liaison: This Learning Plan is based on the ten competencies students are expected to demonstrate upon finishing their internship. Each competency has identified practice behaviors specific to the competency. The field instructor will help the student identify practice opportunities, including timelines, related to the competency which will be identified and assessed during the semester. The practice behaviors are closely related to each other and may be addressed with the same internship activities. You should refer to the Learning Plan each week in supervision and update it as field activities change. Any substantive changes must be approved by the faculty field liaison. This evaluation presents an opportunity for the student and field instructor to evaluate the student’s growth and development of the ten competency areas developed by the Council on Social Work Education. By the end of the internship, the student will have demonstrated competency in each of the following arenas of performance as an advanced generalist social worker. For students who do not demonstrate the designated benchmark in any practice behavior, please indicate, in the instructor’s comments, specific plans to support student need for development in these areas. If there is a need for a remedial plan to assist the student in achieving a competency, the faculty field liaison will meet with the student and field instructor to develop the plan. Students may exceed a benchmark if they meet the criteria defined in practice behaviors. The Final Field Evaluation will ask you to evaluate skill development in each of these areas. For each evaluation item, please rate the student accordingly to the following scale: 0 Not Skilled: Student does not demonstrate this skill at all. 1 Beginning Skill: Student has to consciously work at this skill. 2 Moderate Skill: This skill is becoming more integrated in the student’s practice.

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MSW Concentration Learning Plan & Field Evaluation

Student: Student ID #:

Semester/Year: Permanent Non-UND Email Address:

Field Instructor: Field Instructor’s Phone/Email:

Agency: Faculty Field Liaison:

This Learning Plan is based on the ten competencies students are expected to demonstrate upon finishing their internship. Each competency has identified practice behaviors specific to the competency. The field instructor will help the student identify practice opportunities, including timelines, related to the competency which will be identified and assessed during the semester. The practice behaviors are closely related to each other and may be addressed with the same internship activities. You should refer to the Learning Plan each week in supervision and update it as field activities change. Any substantive changes must be approved by the faculty field liaison. This evaluation presents an opportunity for the student and field instructor to evaluate the student’s growth and development of the ten competency areas developed by the Council on Social Work Education. By the end of the internship, the student will have demonstrated competency in each of the following arenas of performance as an advanced generalist social worker. For students who do not demonstrate the designated benchmark in any practice behavior, please indicate, in the instructor’s comments, specific plans to support student need for development in these areas. If there is a need for a remedial plan to assist the student in achieving a competency, the faculty field liaison will meet with the student and field instructor to develop the plan. Students may exceed a benchmark if they meet the criteria defined in practice behaviors. The Final Field Evaluation will ask you to evaluate skill development in each of these areas.

For each evaluation item, please rate the student accordingly to the following scale:

0 Not Skilled: Student does not demonstrate this skill at all.1 Beginning Skill: Student has to consciously work at this skill.2 Moderate Skill: This skill is becoming more integrated in the student’s practice.3 Skilled: Student demonstrates this skill with confidence.4 Advanced Skill: The student demonstrates this skill with confidence and has made it an integral part of their practice.

N/A No Opportunity: Student has not yet had the opportunity to demonstrate this skill.

2.0 - Desired benchmark for first half of internship.3.0 - Desired benchmark for second half of internship.

Comments may be made under any competency statement, if desired. Please be sure to indicate those areas in which you think the student is particularly strong and those areas that need improvement. This evaluation is intended to give the student feedback about her or his performance. Final scores will contribute to the determination of final grade (Pass/Fail).

Please sign and return the Learning Plan to faculty field liaison when completed.

Competency 1.0 – Identify as a professional social worker and conduct oneself accordingly.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Advocate for creative and inclusive strategies that will help all clients reach their full potential.

Continually model a professional identity as a reflective and reflexive advanced generalist practitioner, practicing conscious use of self and self-correction in practice situations.

Adhere to and model professional roles and boundaries.

Form professional relationships and model professional demeanor in behavior, appearance, and communication.

Engage in career and lifelong learning.

Evaluate and synthesize learning experiences and practice skills through the appropriate use of supervision and consultation.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

1S/he advocates for creative and inclusive strategies that will help all clients reach their full potential.

2S/he continually models a professional identity as a reflective and reflexive advanced generalist practitioner, practicing conscious use of self and self-correction in practice situations.

3 S/he adheres to and models professional roles and boundaries.

4S/he forms professional relationships and models professional demeanor in behavior, appearance, and communication.

5 S/he engages in career and lifelong learning.

6S/he evaluates and synthesizes learning experiences and practice skills through the appropriate use of supervision and consultation.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 2.0 – Apply social work ethical principles to guide professional practice.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Systematically implement practice skills to manage personal values and allow professional values to guide practice.

Apply the values base and ethical principles of social work within complex practice settings and across practice levels.

Analyze value statements and make informed value-based professional judgments that address and resolve conflicts and ambiguities.

Demonstrate leadership in applying ethical reasoning for problem resolution.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

7S/he systematically implements practice skills to manage personal values and allows professional values to guide practice.

8S/he applies the values base and ethical principles of social work within complex practice settings and across practice levels.

9S/he analyzes value statements and makes informed value-based professional judgments that address and resolve conflicts and ambiguities.

10 S/he demonstrates leadership in applying ethical reasoning for problem resolution.Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 3.0 – Apply critical thinking to inform and communicate professional judgments.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Distinguish, appraise, and integrate a broad range of interdisciplinary and multi-disciplinary knowledge, including research-based knowledge, and practice wisdom.

Analyze models of assessment, prevention, intervention, and evaluation, and apply knowledge and experience to differentially select practice strategies.

Demonstrate proficiency in using logic, critical thinking, and creativity in oral and written communication.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

11S/he distinguishes, appraises, and integrates a broad range of interdisciplinary and multi-disciplinary knowledge, including research-based knowledge, and practice wisdom.

12S/he analyzes models of assessment, prevention, intervention, and evaluation, and applies knowledge and experience to differentially select practice strategies.

13S/he demonstrates proficiency in using logic, critical thinking, and creativity in oral and written communication.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 4.0 – Engage diversity and difference in practice.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Apply strengths and empowerment perspective as practice approaches with diverse groups at multiple levels.

Transform one’s behavior in response to recognition of one’s biases related to difference or diversity.

Modify and adapt mainstream knowledge and interventions to meet the needs of diverse populations.

Respect and apply to one’s practice the wealth of knowledge extant within the community and available from people who have lived with the problem or condition.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

14S/he applies strengths and empowerment perspective as practice approaches with diverse groups at multiple levels.

15S/he transforms one’s behavior in response to recognition of one’s biases related to difference or diversity.

16S/he modifies and adapts mainstream knowledge and interventions to meet the needs of diverse populations.

17S/he respects and applies to one’s practice the wealth of knowledge extant within the community and available from people who have lived with the problem or condition.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 5.0 – Advance human rights and social and economic justice.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Help clients and colleagues understand the mechanisms of oppression and discrimination so they can better plan and implement strategies to address them.

Advance specific principles from national and international professional documents to eliminate social, economic, and environmental injustice.

Use leadership skills to advance social and economic justice.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

18S/he helps clients and colleagues understand the mechanisms of oppression and discrimination so they can better plan and implement strategies to address them.

19S/he advances specific principles from national and international professional documents to eliminate social, economic, and environmental injustice.

20 S/he uses leadership skills to advance social and economic justice.Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 6.0 – Engage in research-informed practice and practice-informed research.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Design and implement research processes within practice settings.

Evaluate the relative merits of research evidence and apply research knowledge to inform and improve practice.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor21 S/he designs and implements research processes within practice settings.

22S/he evaluates the relative merits of research evidence and applies research knowledge to inform and improve practice.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 7.0 – Apply knowledge of human behavior and the social environment.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Differentially apply conceptual frameworks to guide the processes of assessment, prevention, intervention, and evaluation.

Synthesize a broad understanding of multi-disciplinary knowledge related to person and environment, and critique the strengths, weaknesses, and assumptions of theoretical frameworks.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

23S/he differentially applies conceptual frameworks to guide the processes of assessment, prevention, intervention, and evaluation.

24S/he synthesizes a broad understanding of multi-disciplinary knowledge related to person and environment, and critiques the strengths, weaknesses, and assumptions of theoretical frameworks.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 8.0 – Engage in policy practice to advance social and economic well-being and to deliver effective social work services.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Analyze, formulate, and advocate for policies that respond to emerging local, regional, and societal trends to advance well-being, especially for the most vulnerable.

Facilitate and strengthen the development of civic society for effective policy action.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

25S/he analyzes, formulates, and advocates for policies that respond to emerging local, regional, and societal trends to advance well-being, especially for the most vulnerable.

26 S/he facilitates and strengthens the development of civic society for effective policy action.Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

Competency 9.0 – Respond to contexts that shape practice.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Analyze changing contexts and demonstrate the ability to initiate innovative and resourceful action with regard to emerging local, regional, and societal trends, needs, and opportunities.

Provide leadership in promoting sustainable within- and cross-system changes in service delivery and practice to improve the quality of social services and build healthier communities.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

27S/he analyzes changing contexts and demonstrates the ability to initiate innovative and resourceful action with regard to emerging local, regional, and societal trends, needs, and opportunities.

28S/he provides leadership in promoting sustainable within- and cross-system changes in service delivery and practice to improve the quality of social services and build healthier communities.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

10.0 – Engage with individuals, families, groups, organizations, and communities.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Continuously adapt one’s ability to effectively and substantively engage with client systems across practice levels.

Using empathy and other interpersonal skills, attend to the interpersonal dynamics and contextual factors that both strengthen and potentially threaten helping relationships.

Evaluate complexity of client circumstances and develop a mutually agreed-on focus of work and desired outcomes.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

29S/he continuously adapts one’s ability to effectively and substantively engage with client systems across practice levels.

30S/he uses empathy and other interpersonal skills, attends to the interpersonal dynamics and contextual factors that both strengthen and potentially threaten helping relationships.

31S/he evaluates complexity of client circumstances and develops a mutually agreed-on focus of work and desired outcomes.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

10.1 – Assess with individuals, families, groups, organizations, and communities.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Show increasing ability to independently conduct assessments as a continuing and dynamic process.

Systematically and purposefully utilize assessment data to assess client strengths and challenges.

Establish a culturally responsive relationship with client that encourages them to be equal participants in the establishment of goals and expected outcomes.

Develop and utilize appropriate and effective strengths-based and empowerment-oriented intervention strategies based on continuous assessment.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

32S/he shows increasing ability to independently conduct assessments as a continuing and dynamic process.

33S/he systematically and purposefully utilizes assessment data to assess client strengths and challenges.

34S/he establishes a culturally responsive relationship with client that encourages them to be equal participants in the establishment of goals and expected outcomes.

35S/he develops and utilizes appropriate and effective strengths-based and empowerment-oriented intervention strategies based on continuous assessment.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

10.2 – Intervene with individuals, families, groups, organizations, and communities.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Initiate actions to actualize the professional values and ethics of social work practice while attending to the specific organizational goals of the employing agency.

Develop and utilize appropriate and effective prevention strategies that build and harness client capacities.

Differentially utilize a variety of evidence-based tools and strategies to help clients resolve complex problems.

Demonstrate the ability to navigate complex systems to coordinate care and advocate for clients at multiple system levels.

Facilitate effective client-centered terminations and transitions.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

36S/he initiates actions to actualize the professional values and ethics of social work practice while attending to the specific organizational goals of the employing agency.

37S/he develops and implements prevention interventions that enhance client capacities and promote well-being.

38S/he differentially utilizes a variety of evidence-based tools and strategies to help clients resolve complex problems.

39S/he demonstrates the ability to navigate complex systems to coordinate care and advocate for clients at multiple system levels.

40 S/he facilitates effective client-centered terminations and transitions.Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

10.3 – Evaluate with individuals, families, groups, organizations, and communities.

LEARNING PLANPractice Behaviors Internship Activities with Timeline How will the practice behaviors be evaluated?

Critically analyze, monitor, and evaluate advanced generalist practice interventions across systems at multiple levels with diverse populations.

EVALUATION Mid-Term Evaluation Final Evaluation0=Not Skilled 1=Beginning 2=Moderate 3=Skilled 4=Advanced N/A=No Opportunity Student Field Instructor Student Field Instructor

41S/he critically analyzes, monitors, and evaluates advanced generalist practice interventions across systems at multiple levels with diverse populations.

Instructor’s Mid-Term Comments:

Instructor’s Final Comments:

LEARNING PLAN

Signatures

Student: ________________________________________________________________________________________________ Date: ______________________________

Field Instructor: _______________________________________________________________________________________ Date: ______________________________

Faculty Field Liaison: __________________________________________________________________________________ Date: ______________________________

MID-TERM EVALUATION

Mid-Term CommentsStudent’s strengths:

Student’s areas for improvement:

Signatures

Student: ________________________________________________________________________________________________ Date: ______________________________

Field Instructor: _______________________________________________________________________________________ Date: ______________________________

FINAL EVALUATION

Final CommentsStudent’s strengths:

Student’s areas for improvement:

Signatures

My field instructor has discussed this final evaluation with me and I have received a copy. My agreement or disagreement is as follows:

I agree with the final evaluation. I do not agree with the final evaluation.*

*If the student disagrees with this evaluation, she/he should attach an explanation of their disagreement.

Student: ________________________________________________________________________________________________ Date: ______________________________

Field Instructor: _______________________________________________________________________________________ Date: ______________________________

All signatories should retain a copy of this Learning Plan & Field Evaluation.