MIDTERM EVALUATION

This form is to be completed by the Field Instructor and discussed with student. It will automatically be
sent to the Faculty Field Liaison once it is completed online.
Student:

Crystal Manney

Agency:
Critical Signal Technologies
Agency Field Instructor(s): Sherri Gerber-Somers, LMSW
Faculty Field Liaison:
Glenn Whitelaw, LMSW
Please Check One:
X BSW
BSW WOW
MSW Foundation Year
MSW Advance Year
Q3 Please check and complete all that apply.
X Student has received agency orientation and work space has been assigned.
X Student has completed 102.25 hours to date.
X Student is actively engaged in weekly supervision.
X Learning Plan has been completed and submitted to the Field Instructor and Faculty Field Liaison.
X Process Recordings or PRACSIS have been reviewed by Field Instructor and submitted to the Faculty
Field Liaison (students should check with assigned Faculty Field Liaison to find out the number of
Process Recordings or PRACSIS required).
Please describe any areas of strength or concern in regard to the students performance and/or the
availability of required learning assignments.
Crystal takes initiative in a variety of ways to increase her knowledge within the organization and also the
Social Work . She organized a meeting with the CEO and one of the Vice Presidents to learn about other
parts of the organization and how the Social Work department plays a role.
Instructions for completing the mid-term evaluation: Please evaluate students performance halfway

through the semester by indicating Progress, No Progress, or No Opportunity. Please reference the
students Learning Plan specific practice outcomes to determine the rating.
Performance rating scale based on the (11) competencies:
PROGRESS Student met performance expectation and/or is exhibiting progression to meet
expectations
NO PROGRESS Student did not meet performance expectations
NO OPPORTUNITY There was not an opportunity to meet expectations
COMPETENCY AREAS 1 11
Identify as a professional social worker and conduct oneself accordingly.

PROGRESS

Apply social work ethical principles to guide professional practice.

PROGRESS

Apply critical thinking to inform and communicate professional judgments.

PROGRESS

Engage diversity and difference in practice.

PROGRESS

Advance human rights and social and economic justice.

PROGRESS

Engage in research-informed practice and practice-informed research.

PROGRESS

Apply knowledge of human behavior and the social environment.

PROGRESS

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

PROGRESS

Respond to contexts that shape practice.

PROGRESS

Engage, assess, intervene, and evaluate with individuals, families, groups, organizations,
and communities.

PROGRESS

Analyze the impact of the urban context on a range of client systems, including practice
implications.

PROGRESS

If there is a Competency Area in which the student has not met minimum performance
expectations to date, a plan of action must be noted below. If there will not be an opportunity to
address a competency area, please state that.
N/A
In the section below, please provide an Overall Rating of Progress or No Progress for the students
performance, as indicated by the rating that is most frequent of the eleven (11) competencies. All parties
are required to sign the midterm evaluation to indicate that they have discussed the evaluation, even if the
student does not agree with the evaluation.
FIELD INSTRUCTOR SECTION
Recommend:

PROGRESS

Comments:
Crystal continues to make progress on her learning plan- in every area.
**Please note: By typing my name below, I certify that I have reviewed the document, completed my
portion and agree with the content.
(Gerber-Somers, Sherri): Sherri Gerber-Somers, LMSW Feb 17, 2016 6:23 PM
Field Instructor (agency-based supervisor)

STUDENT SECTION
I... Agree with the evaluation.
Comments:
Always looking for more possible learning opportunities within this agency.
**Please note: By typing my name below, I certify that I have reviewed the document, completed my
portion and agree with the content.
By signing you will submit Midterm FIASC information to the assigned faculty advisor from the Wayne
State University School of Social Work. Once the form is completed you will not be able to modify your
responses.
(Manney, Crystal): Crystal Manney Feb 19, 2016 9:17 AM
Student
(Glenn Whitelaw): Glenn D.C. Whitelaw LMSW Feb 19, 2016 2:16 PM
Faculty Field Liaison
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IPT Document Management System January 1, 2014

Form: 40137