RSU
Social and Behavioral Sciences
Site Supervisor Evaluation:
Intern Form
 

Instructions:
This form is designed to give interns the opportunity to provide feedback about the supervision they received during their internship. This information will be useful in future discussions with site supervisors and will help RSU faculty evaluate the learning opportunities of this particular site.

Internship Site
Supervisor Name
Intern Name
Evaluation Date

Comments About Site

Answer Code for Evaluation Items and Questions
Each item that follows asks you to indicate the frequency with which activities of supervision occurred, your satisfaction with the activities, or both the frequency and your satisfaction. Please rate frequency based and satisfaction on a rating scale from 1 to 5 with 1 indicating that your were completely dissatisfied and 5 signifying that you were completely satisfied. Frequency and satisfaction ratings need not be the same. For example, if you met for less than the agreed upon amount of time for supervision, you might rate the frequency at number 3. Your satisfaction might be anywhere from 1 to 5 depending on what you felt about this issue.

NA. - Not Applicable or not enough information to form a judgment
1. Far Below Expectations -
2. Below Expectations -
3. Acceptable -
4. Above Expectations -
5. Far Above Expectations -

I. Scheduling and Availability

Frequency - Supervisor had contact with intern as planned
Satisfaction - Supervisor had contact with intern as planned
Frequency - Supervisor was available for additional contact
Satisfaction - Supervisor was available for additional contact

II. Introduction to Site Setting

Frequency - Supervisor gave you a tour of the site at beginning of internship
Satisfaction - Supervisor gave you a tour of the site at beginning of internship
Frequency - Supervisor introduced you to staff at beginning of your internship
Satisfaction - Supervisor introduced you to staff at beginning of your internship
Frequency - Supervisor discussed procedures and policies at the beginning of your internship
Satisfaction - Supervisor discussed procedures and policies at the beginning of your internship
Frequency - Supervisor discussed ethical and legal issues at the beginning of your internship
Satisfaction - Supervisor discussed ethical and legal issues at the beginning of your internship

III. Activities at Your Internship

Frequency - Supervisor allowed you to observe informal interactions with clients but did not allow direct participation
Satisfaction - Supervisor allowed you to observe informal interactions with clients but did not allow direct participation
Frequency - Supervisor allowed you to observe formal and direct activities with clients
Satisfaction - Supervisor allowed you to observe formal and direct activities with clients
Frequency - Supervisor allowed you to informally interact with staff members
Satisfaction - Supervisor allowed you to informally interact with staff members
Frequency - Supervisor allowed you to attend meetings and participate in informative conversations
Satisfaction - Supervisor allowed you to attend meetings and participate in informative conversations
Frequency - Supervisor allowed you access to records, reports, case notes, assessments, correspondence, etc.
Satisfaction - Supervisor allowed you access to records, reports, case notes, assessments, correspondence, etc.
What additional site activities would have been useful to your internship

IV. Activities of Supervision

Frequency - Supervisor reviewed your interactions with people outside the internship site
Satisfaction - Supervisor reviewed your interactions with people outside the internship site
Frequency - You were allowed to observe supervisor performing daily activities
Satisfaction - You were allowed to observe supervisor performing daily activities
Frequency - You were allowed to perform daily activities under direct supervision of your supervisor
Satisfaction - You were allowed to perform daily activities under direct supervision of your supervisor
Frequency - Your were allowed to discuss institutional issues with your supervisor
Satisfaction - Your were allowed to discuss institutional issues with your supervisor
Frequency - You were given instruction in specific topics or skills
Satisfaction - You were given instruction in specific topics or skills
Frequency - Your supervisor directly reviewed various documents that you wrote
Satisfaction - Your supervisor directly reviewed various documents that you wrote
Frequency - Your supervisor discussed with you your personal impressions and reactions to your activities related to your internship
Satisfaction - Your supervisor discussed with you your personal impressions and reactions to your activities related to your internship
Frequency - You were able to discuss your intern-supervisor relationship as needed
Satisfaction - You were able to discuss your intern-supervisor relationship as needed
What additional activities with your supervisor would have been useful to your internship

V. Feedback From Your Supervisor

Frequency - Your supervisor recognized areas where your skills and/or knowledge were relatively strong
Satisfaction - Your supervisor recognized areas where your skills and/or knowledge were relatively strong
Frequency - Your supervisor recognized areas where your skills and/or knowledge needed improvement
Satisfaction - Your supervisor recognized areas where your skills and/or knowledge needed improvement
Frequency - Your supervisor recognized and complimented you for accomplishments done well at your internship site
Satisfaction - Your supervisor recognized and complimented you for accomplishments done well at your internship site
Frequency - Your supervisor let you know when your performance had not been good in certain areas
Satisfaction - Your supervisor let you know when your performance had not been good in certain areas
Frequency - Your supervisor provided emotional support
Satisfaction - Your supervisor provided emotional support
Frequency - Your supervisor handled differences between you in a professional manner
Satisfaction - Your supervisor handled differences between you in a professional manner
Briefly describe ways in which you feel feedback from your supervisor was helpful or lacking during your internship
Briefly describe anything about supervision that was not helpful
Briefly describe ways in which supervision could have been more helpful/beneficial to your

Thank you for your time in completing this evaluation of your site supervisor.