Practicum Portfolio: Summary of Evaluation Feedback Student: Faculty Reviewer: Date: To be completed by the faculty supervisors Requirements Reviewer’s Comments Overall Rating 0, 1, 2, 3 to syllabus for specific details) Domain Domain I: Data-Based Domain summary sheet & documentation of and Accountability work samples Domain II: Consultation and Domain summary sheet Collaboration & documentation of work samples Domain III: Interventions and Domain summary sheet & documentation of Instruction Support to Develop work samples Academic Skills Domain IV: Interventions and Domain summary sheet & documentation of Mental Health Services to work samples Develop Social and Life Skills Domain V: School-Wide Domain summary sheet & documentation of Practices to Promote Learning work samples Domain VI: Preventative and Domain summary sheet & documentation of Responsive Services work samples Domain VII: Family-School Domain summary sheet & documentation of Collaboration Services work samples Domain VIII: Diversity in Domain summary sheet & documentation of Development and Learning work samples Domain IX: Research and Domain summary sheet & documentation of Program Evaluation work samples Domain X: Legal, Ethical, and Domain summary sheet & documentation of Professional Practice work samples Example: PRACTICUM GOAL SETTING CHART Goal Plan for: ___________________________________ Date: __________
Practicum Portfolio: Summary of Evaluation Feedback Student: Faculty Reviewer: Date: To be completed by the faculty supervisors Domain Requirements to syllabus for specific details) Reviewer’s Comments Overall Rating 0, 1, 2, 3 Domain I: Data-Based and Accountability Domain summary sheet & documentation of work samples Domain II: Consultation and Collaboration Domain summary sheet & documentation of work samples Domain III: Interventions and Instruction Support to Develop Academic Skills Domain summary sheet & documentation of work samples Domain IV: Interventions and Mental Health Services to Develop Social and Life Skills Domain summary sheet & documentation of work samples Domain V: School-Wide Practices to Promote Learning Domain summary sheet & documentation of work samples Domain VI: Preventative and Responsive Services Domain summary sheet & documentation of work samples Domain VII: Family-School Collaboration Services Domain summary sheet & documentation of work samples Domain VIII: Diversity in Development and Learning Domain summary sheet & documentation of work samples Domain IX: Research and Program Evaluation Domain summary sheet & documentation of work samples Domain X: Legal, Ethical, and Professional Practice Domain summary sheet & documentation of work samples Example: PRACTICUM GOAL SETTING CHART Goal Plan for: ___________________________________ Date: __________
cpse-eds-handbook-2014-15-Final-v2.docx