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2015
January
T
Test Report
Test Report
0%
Exit Survey
Hello:
You are invited to participate in our survey [BTMH Evaluation Program]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Learning and Growth
1. Inadequate and ineffective
2. Basic skills, but not ready for practice
3. Adequate skills for entry level practice
4. Competent and ethical practice
5. Excellent/outstanding practice
The intern takes responsibility for learning
The intern is receptive and responsive to feedback
The intern demonstrates capacity for critical self-reflection
Workplace Communication and Behaviour
1. Inadequate and ineffective
2. Basic skills, but not ready for practice
3. Adequate skills for entry level practice
4. Competent and ethical practice
5. Excellent/outstanding practice
The intern demonstrates understanding of agency mission and approach
The intern respects agency policy and procedures
The intern communicates effectively with the staff team
The intern works collaboratively with others
The intern demonstrates strong organizational skills and effective time management
The intern documents case work effectively and in accordance with agency policy
Mental Health Practice
1. Inadequate and ineffective
2. Basic skills, but not ready for practice
3. Adequate skills for entry level practice
4. Competent and ethical practice
5. Excellent/outstanding practice
Engagement: the intern establishes rapport with clients
Empathy: the intern responds appropriately to client needs, feelings, and values
Assessment: the intern demonstrates understanding of context/systems affecting client behaviour
Intervention: the intern is able to choose an appropriate intervention (individual or group)
Anti-Oppressive Practice:
the intern demonstrates sensitivity to unequal power relations and respect for diversity
Understanding the Ontario Practice Context
1. Inadequate and ineffective
2. Basic skills, but not ready for practice
3. Adequate skills for entry level practice
4. Competent and ethical practice
5. Excellent/outstanding practice
The intern makes appropriate referrals
The intern demonstrates understanding of laws and service systems affecting clients
The intern advocates effectively on behalf of clients
The intern contributes ideas and initiatives that enhance service accessibility and relevance
Professional Practice and Ethics
1. Inadequate and ineffective
2. Basic skills, but not ready for practice
3. Adequate skills for entry-level practice
4. Competent and ethical practice
5. Excellent/outstanding practice
The intern presents in a consistently professional manner, with poise and confidence
The intern demonstrates respect for privacy and confidentiality
The intern demonstrates an understanding of professional ethics
The intern communicates effectively with a range of stakeholders
The intern practices self-care
Qualitative Feedback:
Areas for further learning and practice:
I consider this intern ready for employment in a setting similar to this one:
YES
NO
Comments/Suggestions:
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