Student Self-Evaluation Form printable pdf download

Student Self-Evaluation Form

STUDENT SELF-EVALUTION FORM

Student: __________________________

Date: ______________________________

Client’s initials:_____________________

Clinical activity: ______________________

This form may be used by the student for self-evaluation of clinical skills/performance on a session-by-

session or weekly basis. This form should be reviewed with the clinical educator.

What went well and why? What was successful about the session(s)?

What did not go well and why? What made the session(s) less successful?

What will I keep the same and why? What will I do differently next time and why?

Areas to consider when self-evaluating your own skills and performance:

- Professionalism

- Counselling/interviewing

- Interaction with client/family

- Behaviour management

- Assessment planning/preparation

- Test administration

- Interpretation of test results

- Communicating results to client

- Treatment planning/preparation

- Treatment implementation

- Data collection

- Session analysis

Appendix B-17

School of Human Communication Disorders

Clinical Practicum Handbook 2015-2016 for Speech-Language Pathology

Student Self-Evaluation Form