Student Evaluation of Internship and Internship Supervisor

LONGWOOD UNIVERSITY
THERAPEUTIC RECREATION PROGRAM

PART I: STUDENT EVALUATION OF INTERNSHIP

Each student is expected to complete this evaluation prior to the end of the semester.

Name

Date and year of Intership:

Internship Agency:

Name of agency supervisor:

Junior

Senior

1.SUMMARY OF INTERNSHIP RESPONSIBILITIES (Include regular duties; assignments and projects; scheduled meetings; special events, etc.)

2. ANALYSIS OF PERFORMANCE (Include strengths; area needing further development; problems encountered during internship and actions taken to resolve these; questions raised during this internship; new information you learned about yourself; attainment of goals and objectives, etc.)

RATING SCALE

Using the code given below, please rate the following variables as these pertain to your internship experience.

5=EXCELLENT
4=GOOD; LITTLE IMPROVEMENT NEEDED
3=OKAY; SOME IMPROVEMENT NEEDED
2=FAIR; REQUIRES SUBSTANTIAL IMPROVEMENT
1=POOR; SHOULD BE CHANGED

SECTION A: ORIENTATION PROGRAM

Section A: ORIENTATION PROGRAM	1	2	3	4	5
1. Orientation to agency's purpose and philosophy
2. Orientation to agency's goals and services
3. Introduction to key staff members
4. Orientation and training period adequate
5. Relevant and necessary time and materials provided for orientation and training
6.Policies and procedures thoroughly explained

	1	Text answers
	Rating scale	Text answers
7. Other: Please explain
Comments

SECTION B: SUPERVISION

SECTION B: SUPERVISION	1	2	3	4	5
8. Agency supervisor provided an adequate number of new work experiences along with optimum instruction and supervision
9. Supervisor was readily available to answer questions and review my work
10. Supervision meetings were held often enough to meet my training needs
11. Supervisor gave frequent and adequate feedback about my performance