Social Work Department

BSW/Foundation Learning Agreement and Final Evaluation

Student Name Student ID

Student Address Zip

Student Email Home Phone Cell

Field Site

Site Address Zip Phone

Field Supervisor Phone Ext.

Field Supervisor E-mail Cell

(Task Instructor information if appropriate)

Task Instructor Phone Ext.

Task Instructor E-mail Cell

ASU Faculty Liaison

The student will complete the Learning Agreement with the assistance of the Field Supervisor. Learning activities will provide the opportunity for students to demonstrate the competencies. The student should write a rough draft and present the draft for discussion to the FS. The contents of the final document must be agreed to by all involved parties with everyone receiving a copy.

The Learning Agreement serves as a guide to assess academic and professional performance throughout the semester. It is a tool for an informal mid-semester assessment during the site visit with the Faculty Liaison to assess the student’s progress. If needed, amendments can be added on the original with date of change. .

At the end of the semester, this form will be used to assess overall student performance. The FS will evaluate each objective with the rating scale and complete the evaluation of professional work skills. The fall assessment should serve as a planning tool for the spring semester, but a new agreement will be developed.

The student is responsible for managing the original document that must be present at the midterm evaluation to allow all parties to sign the midterm summary. The original will then be given to the FS prior to the final site visit to allow the FS to evaluate the student’s performance with the rating scale. The original will be turned into the SW Dept. by the faculty liaison, and placed in the student’s file.

It is not required that all competencies be assessed the fall learning agreement, but all competencies must be assessed and documented in the spring learning agreement.

In this section of the Learning Agreement, students should identify the tasks and/or activities that will enable them to demonstrate the objectives of the specific competencies.

Rating Scale

1 – Consistently fails to meet expectations	2 – Occasionally meets expectations	3 – Meets Expectations

4 – Occasionally exceeds expectations	5 – Consistently exceeds expectations	6 – N/A

1. Demonstrate Ethical and Professional Behavior

Make ethical decisions by applying the standards of the NASW Code of Ethics Learning activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use reflection and self-regulation to manage personal values and maintain professionalism in practice situations Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Demonstrate professional demeanor in behavior; appearance and oral, written and electronic communication Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use technology ethically and appropriately Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use guidance of supervision and consultation Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

2. Engage Diversity and Difference in Practice

Apply and communicate understanding of diversity in shaping life experiences at micro, mezzo, and macro levels Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Present self as a lifelong learner and engage clients and constituencies as experts of their own experiences Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply self-awareness & self-regulation to manage the influence of personal biases and values Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

3. Advance Human Rights and Social, Economic, and Environmental Justice.

Apply understanding of social, economic, and environmental justice to advocate for human rights Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Engage in practices that advance social, economic, and environmental justice Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

4. Engage in Practice-informed Research and Research-informed Practice.

Use practice experience and theory to inform scientific inquiry and research Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply critical thinking to engage in analysis of quantitative and qualitative research Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use research evidence to inform and improve practice, policy, and service delivery Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

5. Engage in Policy Practice

Identify social policy at the local, state, and federal level that impacts service delivery, and access to social services Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Assess how social welfare and economic policies impact the delivery of and access to social services Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply critical thinking to analyze, formulate, and advocate for policies that advance social justice Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

Engage with Individuals, Families, Groups, Organizations, and Communities

Apply knowledge of HBSE, person-in-environment, and other theoretical frameworks to engage clients and constituencies Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use empathy, reflection, and interpersonal skills to effectively engage diverse clients and constituencies Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

7. Assess Individuals, Families, Groups, Organizations, and Communities

Collect and organize data, and apply critical thinking to interpret information from clients and constituencies Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply knowledge of HBSE, person-in-environment, and other theoretical frameworks in the analysis of assessment data. Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Develop mutually agreed-on intervention goals and objectives based on the assessment of strengths, needs, and challenges. Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Select appropriate intervention strategies based on assessment, research knowledge, values, and preferences of clients. Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

Intervene with Individuals, Families, Groups, Organizations, and Communities

Critically choose and implement interventions to achieve practice goals and enhance capacities of clients. Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply knowledge of HBSE, person-in-environment, and other theoretical frameworks in interventions with clients Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Use inter-professional collaboration as appropriate to achieve beneficial practice outcomes Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Facilitate effective transitions and endings that advance mutually agreed-on goals Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

9. Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities

Select and use appropriate methods for evaluation of outcomes Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply knowledge of HBSE, person-in-environment, and other theoretical frameworks in the evaluation of outcomes Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Critically analyze, monitor, and evaluate intervention and program processes and outcomes Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating
Apply evaluation findings to improve practice effectiveness at the micro, mezzo, and macro levels Learning Activity	Final Outcomes/Evaluation -to be completed at conclusion of semester
Rating

Learning Agreement Signatures:

My signature below indicates that I agree that the above-mentioned tasks/activities are achievable this semester. I have participated in the formation of this document and will fulfill my role to complete the activities planned.

_____________________________________________________	_____________________________

Signature of Field Supervisor	Date

__________________________________________________________	_____________________________

Signature of Task Instructor (If Applicable)	Date

__________________________________________________________	____________________________

Signature of Student	Date

___________________________________________________________ ______________________________

Signature of Faculty Liaison	Date

Midterm Site Visit Date: ___________________________

Summary & Comments

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Strengths Noted

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Recommendations and/or addendums made to Learning Agreement

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

________________________________	______________________________

Faculty Liaison	Date	Field Supervisor	Date

________________________________	_____________________________

Student**	Date	Task Supervisor	Date

**My signature reflects that I was present for this site visit and aware of the current assessment and recommendations**

Evaluation of Student Basic Work Skills and Attributes

To the Field Supervisor – After completing the rating scale above relative to each Learning Activity, please use the following scale to rate your student’s basic work skills and attributes

Rating Scale

1 – Consistently fails to meet expectations	2 – Occasionally meets expectations	3 – Meets Expectations

4 – Occasionally exceeds expectations	5 – Consistently exceeds expectations	6 – N/A

Demonstrates positive time management skills.

Works independently and is reliable.

Open to suggestions in supervision.

Implements supervision suggestions and instructions.

Copes appropriately with job demands and stresses.

Expresses opinions and ideas in useful manner.

Recognizes need for continued professional growth.

Relates appropriately to staff in agency.

Relates appropriately to clients in agency.

Responds to communications with respect and empathy.

Demonstrates professional writing skills.

Maintains accurate, complete, up-to-date records.

Field Supervisor recommendation of final letter grade _____

Final Evaluation Signatures:

My signature below indicates that I have either completed the evaluation or have reviewed the evaluation.

FIELD SUPERVISOR RESPONSE TO EVALUATION

Field Supervisor’s Comments (Optional)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

______________________________________	_______________________________

Signature of Field Supervisor	Date

____________________________________________	______________________

Signature of Task Instructor (If applicable)	Date

STUDENT RESPONSE TO EVALUATION

_____ I agree	_____ I agree with reservation	_____ I disagree

Students Comments (Optional)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

______________________________________	_______________________________

Signature of Student	Date

____________________________________________	________________________________

Signature of Faculty Liaison	Date