COLLEGE OF ARTS AND SCIENCES

UNIVERSITY OF THE PHILIPPINES MANILA

The National Health Sciences Center
Padre Faura, Manila

Department of Behavioral Sciences

BS 190 PRACTICUM SUPERVISOR EVALUATION FORM

Student: ________________________________
Site: ________________________________
Supervisor: ________________________________
Date: ________________________________

PERFORMANCE INDICATORS RATING

I. JOB KNOWLEDGE AND COMPETENCY
Demonstrates appropriate practical/technical skills needed to perform assigned tasks 5 4 3 2 1 NA
Shows understanding of expectations of the jobs or tasks at-hand 5 4 3 2 1 NA
II. PRODUCTIVITY AND RELIABILITY
Regularly and promptly attends meetings/duty 5 4 3 2 1 NA
Uses appropriate time and task management 5 4 3 2 1 NA
Completes assigned work on time 5 4 3 2 1 NA
Accomplishes assigned work accurately and completely 5 4 3 2 1 NA
Shows ability to handle multiple responsibilities in effective manner 5 4 3 2 1 NA
III. PLANNING AND ORGANIZATION SKILLS
Helps set goals and timetable for the team 5 4 3 2 1 NA
Approaches task in systematic manner 5 4 3 2 1 NA
Clearly identifies resources required to complete tasks 5 4 3 2 1 NA
IV. INITIATIVE, COMMITMENT AND LEADERSHIP
Shows initiative and motivation in task performance 5 4 3 2 1 NA
Shows willingness to accept additional tasks 5 4 3 2 1 NA
Does not hesitate to seek guidance when goals or tasks are unclear 5 4 3 2 1 NA
Willingly assists team members in accomplishing tasks when needed 5 4 3 2 1 NA
Seeks active leadership in the group 5 4 3 2 1 NA
V. INDEPENDENCE AND DECISION-MAKING SKILLS
Finishes tasks without overly depending on other team members 5 4 3 2 1 NA
Makes sound judgment on decision-making tasks 5 4 3 2 1 NA
VI. PROBLEM-SOLVING AND CREATIVITY
Participates actively in identifying and defining problems and working toward solutions 5 4 3 2 1 NA
Uses creative problem solving techniques such as generating ideas from different
5 4 3 2 1 NA
viewpoints
VII. INTERPERSONAL SKILLS
Helps avoid or minimize group/team conflicts 5 4 3 2 1 NA
Responds well to feedback and criticism 5 4 3 2 1 NA
Promotes positive and collaborative work relationships 5 4 3 2 1 NA
VIII. FLEXIBILITY AND ADAPTABILITY
Shows flexibility and adapts well to changing priorities and demands 5 4 3 2 1 NA
Maintains calmness amidst work stress and pressures 5 4 3 2 1 NA
Shows positive disposition/attitude on constructive disagreements 5 4 3 2 1 NA
IX. COMMUNICATION SKILLS
Communicates clearly and with civility 5 4 3 2 1 NA
Gives constructive feedback 5 4 3 2 1 NA
X. INTEGRITY
Shows respect and courtesy to colleagues, team members and clients 5 4 3 2 1 NA
Displays integrity and ethical behaviors 5 4 3 2 1 NA
Overall is a valuable member of the team 5 4 3 2 1 NA

What are the student’s strong points? What are the areas the student can improve on?

Other comments:

Please provide your Signed:

General Numerical Grade: _________

Guide: ________________________________________________________
97–100 - Excellent (1.0) Signature
93–96 - (1.25)
89–92 - Outstanding (1.5)
85–88 - (1.75)
81–84 - Very Good (2.0) ________________________________________________________
77–80 - Above average (2.25) Printed Name
73–76 - Average (2.5)
69–72 - Below average (2.75)
65–68 - Passing (3.0)
61–64 - Conditional Failure (4.0) ________________________________________________________
> 60 - Failed (5.0) Date