Solutions Behavioral Healthcare Professionals

Psychology Internship Program

Intern Evaluation

Intern: _______________________________________________________________

Supervisor: ___________________________________________________________

Dates of Evaluation: ______________ to _______________

Training site:___________________________________________________________

Methods used in evaluating competency:

______ Direct Observation            ______Review of Audio/Video  ______Case Presentation

______ Documentation Review  ______ Supervision                         ______ Comments from other staff/faculty

Scoring Criteria:

1 Remedial Competence Level -- Intern shows significant deficiencies in this area, with skills below that expected of a beginning Intern. The Intern is dependent upon direct observation and detailed preparatory instruction. Intensive supervision is required to attain a basic level of competence, OR the Intern has not attained expected level of competence despite coaching and supervision.

2 Beginning Competence Level -- Intern requires intensive supervision for unfamiliar clinical activities and/or novel circumstances. Intern has a knowledge level of the skill area and can recall key points or steps. The Intern may be able to perform skills in this area at a minimal level with supervision. This is the level of competency expected for a beginning Intern working with a new clinical population, and might be an appropriate rating for beginning acquisition of a novel skill set within a new rotation.

3 Intermediate Competence Level -- Intern needs minimal structure for routine activities, but may need closer supervision for more complex situations. Generalizes knowledge, skills, and abilities across clinical activities and settings. While the Intern can perform the skills, these may require conscious awareness, i.e., thinking through the steps. This is the level expected for most skills mid-way through the internship year

4 Advanced Competence Level -- Intern is considered competent for entry-level practice in this area. Intern consistently integrates well-developed knowledge, skills and abilities into all aspects of professional practice. This skill area is fluent and can be performed without having to think through the steps. Intern functions proactively and independently in most contexts. Supervision is accessed independently when needed for complex/novel situations.

5 Full Performance Level -- Skill exceeds that expected for doctoral interns at the completion of the training year. Intern shows maturity in the ability to conceptualize and has sound thinking and judgment. The Intern has fully mastered this skill area such that it is habit, and can perform the skill automatically. Intern can manage complex situations independently. Training needs are consultative in nature.

N/A--Not Applicable/Not Observed/Cannot Say

NOTE:  This form is designed to provide interns with comprehensive, formal feedback on strengths and areas for growth.  As described in the Solutions Intern Evaluation, Retention, and Termination Policy, a score less than 3 on an individual learning element or broad competency at the 6-month evaluation will initiate the program's Due Process procedures.  Interns must receive a rating of 4 or higher on all learning elements and broad competencies at the final evaluation to demonstrate that they are prepared for entry level independent practice and licensure, and to successfully complete internship.

APA Profession Wide Competencies

Intern will achieve competence in the area of: Intervention

Establishes and maintains effective relationships with recipients of psychological services

Develops evidence-based intervention plans

Implements interventions informed by the current scientific literature, assessment findings, diversity characteristics, and contextual variables

Demonstrates the ability to apply the relevant research literature to clinical decision making

Modifies and adapts evidence-based approaches effectively when a clear evidence-base is lacking

Evaluates intervention effectiveness and adapts goals and methods consistent with ongoing evaluation

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Assessment

Demonstrates current knowledge of diagnostic classification systems, functional and dysfunctional behaviors, including consideration of client strengths and psychopathology

Demonstrates understanding of human behavior within its context (e.g., family, social, societal, and cultural)

Demonstrates the ability to apply the knowledge of functional and dysfunctional behaviors including context to the assessment and/or diagnostic process

Selects and applies assessment methods that draw from the best available empirical literature

Collects relevant data using multiple sources and methods appropriate to the identified goals and questions of the assessment as well as relevant diversity characteristics of the client

Interprets assessment results to inform case conceptualization, classification, and recommendations

Communicates findings in an accurate and effective manner sensitive to a range of audiences

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Ethical and Legal Standards

Demonstrates knowledge of and acts in accordance with the APA Ethical Principles and Code of Conduct

Demonstrates knowledge of and acts in accordance with all organizational, local, state, and federal laws, regulations, rules, and policies relevant to health service psychologists

Demonstrates knowledge of and acts in accordance with all professional standards and guidelines

Recognizes ethical dilemmas as they arise and applies ethical decision-making processes in order to resolve them

Conducts self in an ethical manner in all professional activities

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Cultural and Individual Diversity

Demonstrates an understanding of how one's own personal/cultural history, attitudes, and biases may affect how one understands and interacts with people different from oneself

Demonstrates knowledge of the current theoretical and empirical knowledge base as it relates to diversity

Integrates knowledge of individual and cultural differences in the conduct of professional roles

Demonstrates the ability to independently apply their knowledge and approach in working effectively with the range of diverse individuals and groups encountered during internship

Demonstrates the ability to work effectively with individuals whose group membership, demographic characteristics, or worldviews may differ from their own

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Research

Demonstrates the substantially independent ability to critically evaluate research

Demonstrates the substantially independent ability to disseminate research or other scholarly activities via professional publication or presentation at the local, regional or national level

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Professional Values, Attitudes, and Behaviors

Behaves in ways that reflect the values and attitudes of psychology

Engages in self‐reflection regarding personal and professional functioning

Demonstrates openness and responsiveness to feedback and supervision

Responds professionally in increasingly complex situations with a greater degree of independence as they progress across levels of training

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Interprofessional and Interdisciplinary Consultation

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

Applies knowledge about consultation in direct or simulated (e.g. role played) consultation

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Supervision

Demonstrates knowledge of supervision models and practices

Applies knowledge of supervision in direct or simulated practice with psychology trainees or other health professionals

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

Intern will achieve competence in the area of: Communication and Interpersonal Skills

Develops and maintains effective relationships with a wide range of individuals, including colleagues, communities, organizations, supervisors, supervisees, and those receiving professional services

Produces and comprehends oral, nonverbal, and written communications that are informative and well-integrated

Demonstrates effective interpersonal skills

Demonstrates the ability to manage difficult communication well

AVERAGE SCORE FOR BROAD AREA OF COMPETENCE

Comments:

OVERALL RATING (average of broad competence area scores)

Comments on Intern's overall performance, including identified strengths and areas for growth:

I acknowledge that my supervisor has reviewed this evaluation with me.

Intern’s Signature

Date

Supervisor's Signature

Date

Training Director's Signature

Date