Practicum Grading Form

Note: This form is to be completed online by the supervisor.

Please note that it is important to get these grades in in a timely manner as there are now federal regulations that can affect students' funding.
All sections below are required unless otherwise specified.
Below there are 28 competencies upon which to grade each student.
To move from item to item you can use the tab button on your computer.
Once you finish the form, you will be asked to give each student either one or two grades.
- All supervisors except Intensive Supervisors will complete the grade box labeled Practicum Grade.
- Only Intensive Supervisors and NSU PSC Faculty Supervisors will complete the grade box labeled Intensive Supervision Grade.
We also encourage all supervisors to provide written comments including strengths and areas that need improvement in the box at the end of this form.
When you are finished with this form, 2 copies of this form must be printed and signed by the student and supervisor: give one copy to the student to keep and have the student bring the second copy to the CTC office to be included in his/her file.

Name of Student:

Date:

Supervisor's Name:

Supervisor's Email:

Supervisor:

Practicum Type:

Evaluation (Semester):

Evaluation (Year):

Doctoral Program:

Grading Rubric

A = 93-100% Meets or Exceeds Expectations

A- = 90-92% Meets or Exceeds Expectations

B+ = 88-89% Meets Expectations

B = 83-87% Meets Expectations

B- = 80-82% Minimum Level of Achievement

C+ = 78-79% Does not meet Expectations

C = 73-77 % Does not meet Expectations

C- = 70-72% Does not meet Expectations

F = Below 70% Does not meet Expectations

I. RESEARCH: Ability to understand and to evaluate research critically to inform professional functioning.

Applies evidence of critical review and evaluation of research when planning assessments and/or interventions for clients.

Includes diversity considerations in evaluating research when selecting interventions and assessment techniques.

II. PROFESSIONAL VALUES AND ATTITUDES: Behavior and comportment that reflect the values and attitudes of professional psychology

Demonstrates integrity/honesty, personal responsibility, and adherence to professional values.

Understands how to conduct oneself in a professional manner.

Is accountable and reliable.

Shows concern for the welfare of others.

Exhibits beginning understanding of self as professional; 'thinking like a psychologist'.

Demonstrates basic mindfulness and self-awareness

Shows emerging self-assessment skills and the ability to identify personal biases that can undermine clinical judgment.

10)

Engages in self-care (attention to personal health and well-being to assure effective professional functioning); demonstrates understanding of the importance of self-care in effective practice; shows knowledge of self-care methods; attention to self-care.

11)

Responded professionally in increasing complex situations with a greater degree of independence across the practicum year. For final Practicum evaluation only (Mark N/A at all other points)

III. COMMUNICATION AND INTERPERSONAL SKILLS: Ability to communicate clearly and to relate effectively with others.

12)

Develops and maintains productive and respectful relationships with a wide range of individuals, including colleagues, supervisors, supervisees, professionals from other disciplines.

13)

Develops and maintains productive and respectful relationships with individuals receiving psychological services.

14)

Communicates clearly using verbal, nonverbal, and written communications in a professional context.

15)

Demonstrates a thorough grasp of professional language and concepts.

16)

Demonstrates the ability to manage difficult communication effectively.

17)

Negotiates differences and handles conflict satisfactorily.

18)

Is open and receptive to supervisory feedback.

IV. INDIVIDUAL AND CULTURAL DIVERSITY Knowledge, awareness, sensitivities, and skills in working with diverse individuals, groups, and systems.

19)

Shows an understanding of how own personal/cultural history, attitudes, and biases may affect how he/she understands and interacts with people different from himself/herself.

20)

Understands the current theoretical and empirical knowledge base as it relates to addressing diversity in all professional activities, including supervision/consultation and service (prevention, intervention, and assessment).

21)

Demonstrates the ability to integrate both awareness and knowledge of individual and cultural differences in the conduct of professional roles (e.g., psychological assessment, intervention, consultation, and supervision).

22)

Articulates an approach to working effectively with diverse individuals and and applies this approach effectively

V. ETHICAL LEGAL STANDARDS AND POLICY - Application of ethical concepts and awareness of legal issues regarding professional activities with individuals, groups, and organizations.

23)

Demonstrates basic knowledge of the principles of the APA Ethical Principles and Code of Conduct [ethical practice and basic skills in ethical decision making]; beginning knowledge of legal and regulatory issues in the practice of psychology that apply to practice while placed at practicum setting.

24)

Exhibits awareness and application of an ethical decision-making model applied to practice.

25)

Ethical attitudes and values evident in conduct.

VI. ASSESSMENT - Assessment and diagnosis of problems, capabilities, and issues associated with individuals, groups, and/or organizations.

26)

Demonstrates knowledge of measurement across domains of functioning and practice settings.

27)

Demonstrates basic knowledge regarding the range of normal and abnormal behavior in the context of stages of human development and diversity.

28)

Shows basic knowledge of formulating diagnosis and case conceptualization.

29)

Completes reports and or progress notes in a timely manner.

VII. INTERVENTION - Interventions designed to alleviate suffering and to promote health and well-being of individuals, groups, and/or organizations.

30)

Develop evidence-based intervention plans specific to the service delivery goals.

31)

Implement interventions informed by the current scientific/scholarly literature, assessment findings, diversity characteristics, and contextual variables.

32)

Demonstrate the ability to apply the relevant research literature to clinical decision making.

33)

Demonstrates basic helping skills (e.g., effective listening, communication of understanding and empathy, use of open-ended questions and other facilitating techniques, including clarification, confrontation, feedback, and silences).

34)

Modify and adapt evidence-based approaches effectively when a clear evidence-base is lacking.

35)

Evaluate intervention effectiveness, and adapt intervention goals and methods consistent with ongoing evaluation.

VIII.SUPERVISION

36)

Demonstrates basic knowledge of expectations for supervision.

37)

Shows interpersonal skills of communication and openness to feedback.

38)

Exhibits basic knowledge of and sensitivity to issues related to individual and cultural differences as they apply to the supervision process and relationships.

39)

Shows awareness of need for straightforward, truthful, and respectful communication in supervisory relationship.

IX. CONSULTATION AND INTERPROFESSIONAL/INTERDISCIPLINARY SKILLS

Ability to provide expert guidance in response to a client's goals and to interact effectively with professionals from multiple disciplines.

40)

Demonstrates knowledge and respect for the roles and perspectives of other professions and professionals.

IMPORTANT: Before giving grades make sure that you consider that each grade should be given relative to each student's practicum level (i.e., first year students are typically new, second year students have had one year of practicum at CPS, and elective students have had 2 years of practica).

Practicum grade:
(For all Supervisors except Intensive Supervisors.)

Intensive supervision grade:
Only for Intensive Supervisors and NSU PSC Faculty Supervisors

Total Practicum Hours Credited: Fill in only at last semester of practicum (Mark N/A at all other points)

Overall Comments, Including Strengths and Areas Needing Improvement:

Additional Comments:

I affirm that I observed this student providing services either live or via a recording during this grading period.

I affirm that I directly supervised on a weekly basis the above named practicum student's performance of the clinical activities summarized herein, and that I was a licensed psychologist for the entirety of that supervision period. If you are an intensive supervisor, please select N/A.

Please read before submitting this form:

Once you hit the submit button, if it does not take you to the top of the form where it will say, Thank you for completing the evaluation form, then you have left one or more questions blank. Scroll up and you will see what questions still need an answer.
Once you submit this form, a copy of it will be sent to your email. You can then print out the form from your printer. Two copies must be printed out and signed by the student and supervisor: 1 is for the student to keep and 1 is for you to send to the Clinical Training Office (Dr. Garcia-Lavin) College of Psychology, Nova Southeastern University, 3301 College Ave. Ft. Lauderdale, Florida 33314.

Please print completed form before submitting, as it may not be returned to you. We're having email issues. Sorry.

Please verify that you have completed all required fields and are not a robot before submitting this form.