Intern Summary of Portfolio Evaluation Feedback Intern: 0 = Unsatisfactory 1 = Basic 2 = Proficient 3 = Distinguished Faculty Reviewer: Domain Requirements Reviewer’s Comments Rating 0, 1, 2, 3 (Refer to syllabus for specific details) Domain I: Data-Based Decision-Making and Domain summary sheet & documentation of work Accountability samples Domain II: Consultation and Collaboration Domain summary sheet & documentation of work samples Domain III: Interventions and Instructional Domain summary sheet & documentation of work Support to Develop Academic Skills samples Domain IV: Interventions and Mental Health Domain summary sheet& documentation of work Services to Develop Social and Life Skills samples Domain V: School-Wide Practices to Domain summary sheet & documentation of work Promote Learning samples Domain VI: Preventative and Responsive Domain summary sheet & documentation of work Services samples Domain VII: Family-School Collaboration Domain summary sheet & documentation of work Services samples Domain VIII: Diversity in Development and Domain summary sheet & documentation of work Learning samples Domain IX: Research and Program Domain summary sheet & documentation of work Evaluation samples DOMAIN X: Legal, Ethical, and Domain summary sheet & documentation of work Professional Practice samples On-Site Supervisor’s Evaluation of School Psychology Interns Brigham Young University School Psychology Program
Intern Summary of Portfolio Evaluation Feedback Intern: Faculty Reviewer: 0 = Unsatisfactory 1 = Basic 2 = Proficient 3 = Distinguished Domain Requirements (Refer to syllabus for specific details) Reviewer’s Comments Rating 0, 1, 2, 3 Domain I: Data-Based Decision-Making 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 Instructional 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 On-Site Supervisor’s Evaluation of School Psychology Interns Brigham Young University School Psychology Program
cpse-eds-handbook-2014-15-Final-v2.docx