Psychology Department
Bethel University Psychology Department
Site Supervisor Evaluation
| Student's Name: _______________________ | Semester (circle one): Fall Spring 20__ |
| Site Supervisor: ________________________ | Site: _________________________ |
Explanation of Scale: 5 = Outstanding 4
= Above Average; 3 = Average; 2 = BeAverage; 1 = Deficient
NA = Not Applicable
- Accomplishment of internship goals (How well, in your estimation, did the student accomplish
the goals for the internship that were laid out at the beginning of
the semester. Feel free to use examples to clarify your comments.)
5 4 3 2 1 NA Comments:
- Ability to use Supervision (Includes attendance, involvement in supervisory process, ability to
hear supervisor, ability to use supervision for growth and learning)
5 4 3 2 1 NA Comments:
- Professional Conduct
(Includes relates well to staff, timeliness, etc.)
5 4 3 2 1 NA Comments:
Total Practicum Hours To Date: ____________
|
________________________ Supervisor's Signature |
__________ Date |
________________________ Student's Signature |
__________ Date |