"Student Evaluation Form"

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STUDENT EVALUATION FORM
Primary Supervisor’s Name
Student Name
Site Name
Practicum hrs/wk
th
th
th
Mid-Year (due Jan 15
)
End-of-Year (due June 15
)
Revision (due July 15
)
Evaluation Period
Please rate the student’s performance in the following areas by checking the appropriate column for each item.
Code: E = Exceptional EE = Exceeds Expectation ME = Meets Expectation I = Improvement Needed U = Unsatisfactory
N/O=No Opportunity to Observe
E
EE
ME
I
U
N/O
I.
English & Literacy
A. Reading & Writing Skills:
Grammar and Usage
Demonstrates Writing Strategy
Problem Solving and Conceptualization
Ability to Draw Conclusions
B. Listening & Speaking
Ability to Formulate Impressions
Ability to Communicate Feedback
Contextual Understanding
Ability to Deliver Presentation
Quality of Written Content
Effective Communication Skills
II.
Mathematical Skills:
Concepts & Procedures
Problem Solving
Communicating Reasoning
Modeling & Data Analysis
Model Concepts for Real World Application
III.
Research Skills:
Problem Conceptualization
Investigation of Topic
Data analysis skills
Quality of writing
IV.
Personal/ Ethical:
Motivation to learn; effort extended toward skill mastery
Ability to work independently
Completion of work in a timely manner
Carefulness of work
Dependability
Professional manner with peers and supervisors
Knowledge of and adherence to ethical standards
Sensitivity to cultural diversity of others
V.
Responsiveness to Supervision:
Comes prepared for learning
Openness to supervisory feedback
Incorporates supervisory feedback
STUDENT EVALUATION FORM
Primary Supervisor’s Name
Student Name
Site Name
Practicum hrs/wk
th
th
th
Mid-Year (due Jan 15
)
End-of-Year (due June 15
)
Revision (due July 15
)
Evaluation Period
Please rate the student’s performance in the following areas by checking the appropriate column for each item.
Code: E = Exceptional EE = Exceeds Expectation ME = Meets Expectation I = Improvement Needed U = Unsatisfactory
N/O=No Opportunity to Observe
E
EE
ME
I
U
N/O
I.
English & Literacy
A. Reading & Writing Skills:
Grammar and Usage
Demonstrates Writing Strategy
Problem Solving and Conceptualization
Ability to Draw Conclusions
B. Listening & Speaking
Ability to Formulate Impressions
Ability to Communicate Feedback
Contextual Understanding
Ability to Deliver Presentation
Quality of Written Content
Effective Communication Skills
II.
Mathematical Skills:
Concepts & Procedures
Problem Solving
Communicating Reasoning
Modeling & Data Analysis
Model Concepts for Real World Application
III.
Research Skills:
Problem Conceptualization
Investigation of Topic
Data analysis skills
Quality of writing
IV.
Personal/ Ethical:
Motivation to learn; effort extended toward skill mastery
Ability to work independently
Completion of work in a timely manner
Carefulness of work
Dependability
Professional manner with peers and supervisors
Knowledge of and adherence to ethical standards
Sensitivity to cultural diversity of others
V.
Responsiveness to Supervision:
Comes prepared for learning
Openness to supervisory feedback
Incorporates supervisory feedback
Strengths: Please share with us your general impressions of the student’s particular academic, professional, and/or personal
strengths. What improvements has the student made during his/her time with you?
Weaknesses: What areas do you feel represent relative weaknesses for this student? What would you like this student to continue to
work on?
What would you recommend as an overall rating for this student to date?
Exceptional: displays exceptional competence, functions autonomously, professional level
Excellent: consistently exceeds expectations for acceptable work, functions with high autonomy
Above average: frequently exceeds expectations for acceptable work, functions with high autonomy
Average: meets expectations, average competence, functions well with supervision
Below average: generally meets expectations, functions adequately with close supervision
Poor: occasionally meets expectations, requires much supervision, needs improvement
Very poor: seriously below expectations, requires extensive remediation
Important note: end-of-year evaluations are considered provisional in the sense that supervisors will have an opportunity to
revise evaluations in the period immediately following the conclusion of the practicum placement.
*Important: Forms are not
considered complete unless they
Supervisor’s Signature
Date
contain all three signatures.
Student’s Signature upon review and discussion of this form
Date
Mentor’s Signature upon review and discussion of this form
Date
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