STUDENTEVALUATIONOFFIELDWORKEXPERIENCE.docVIP

STUDENT EVALUATION OF FIELDWORK EXPERIENCE Thomas Jefferson University Instructions to the student: Complete this STUDENT EVALUATION OF THE FIELDWORK EXPERIENCE (SEFWE) form prior to your final meeting with your fieldwork educator(s). The evaluation of the student (FWPE) should be reviewed first, followed by the student’s evaluation of the fieldwork experience (SEFWE), allowing the student to be honest and constructive. Provide both hard copy and electronic copy to your FW educator (they should be identical). It is imperative that you review the form with your supervisor and that both parties sign on page 1. Send the original to the Department of Occupational Therapy at TJU, and keep a copy for yourself. This information may be reviewed by future students in the TJU Department of Occupational Therapy. Instructions to the Fieldwork Educator: The evaluation of the student (FWPE) should be reviewed first, followed by the student’s evaluation of the fieldwork experience (SEFWE), allowing the student to be honest and constructive. Please review and email the completed electronic copy of the SEFWE that the student gave you to either caryn.johnson@jefferson.edu or susan.santalucia@jefferson.edu after reviewing it. It must come from the supervisor’s email address, not the student’s. Fieldwork Site: First FWII Second FWII Address: Placement Dates: From: To: Days absent: Please write your email address here if you don’t mind future students contacting you to ask you about your experience at this site: We have mutually shared and clarified this Student Evaluation of Fieldwork Experience report. Student’s Name (please print) FW Educator Name/Credentials (please print) OT Fieldwork Practice Settings (check all that apply): Hospital-based settings In-Patient Acute 1.1 In-Patient Rehab 1.2 SNF/Sub-Acute 1.3 General Rehab Outpt 1.4 Outpt Hands 1.5 Pediatric Hospital In-Patient 1.6 Pediatric Hospital Outpt 1.7 In-Patien