ࡱ> RTQ /bjbj>> .FTT'pppppL3t{3}3}3}3}3}3}3$p5"83p3pp3 pp{3{31;3P_/!r*1g33031\8Bz80;38p;3,0"-33"38 6: BTSchool Psychology Ph.D. Program Student Self-Assessment for Annual Review Name: School year: Year in program (circle one): First Second Third The following self-assessment survey is the first step of the annual review process. It is designed to assist you and the program in assessing your performance and making related improvement plans as needed. Your responses will be reviewed by the School Psychology Committee, after which you will meet with your advisor. Reflecting on your experiences over the last year, respond to the items in this survey with an improvement-oriented focus (e.g., How did you perform? How can you sustain effective performance? How can you make progress in areas in need of improvement?). Please submit this form with your portfolio to your advisor no later than Monday, March 9th. I. ACADEMIC COURSEWORK AND PERFORMANCE a. List the classes you have completed in the last 12 months and your grades. Course # Grade Course # Grade Regarding your performance in classes Answer the following questions, with the scale: Never Sometimes Always (1) (3) (5) I am on time for class. 1 2 3 4 5 I attend all classes. 1 2 3 4 5 If I have to miss a class, I notify my professor prior to being absent. 1 2 3 4 5 I ask questions as needed. 1 2 3 4 5 I complete assignments on time. 1 2 3 4 5 I am engaged in classroom discussion. 1 2 3 4 5 I possess and display initiative to learn and work hard. 1 2 3 4 5 I am well prepared for exams. 1 2 3 4 5 I keep up with readings and assignments. 1 2 3 4 5 I do outside reading (beyond the requirements). 1 2 3 4 5 Based on these items or other considerations, (a) state one or more specific goals for yourself to sustain and/or improve your performance in classes during the coming school year, and (b) for each goal, indicate how you will know youve accomplished it. Other (Please add any other comments related to your performance in classes that you wish to share): II. ASSISTANTSHIP a. Have you had an assistantship in the past year? YES NO (if no, skip this section) Regarding your assistantship performance and experiences Answer the following questions, with the scale: Never Sometimes Always (1) (3) (5) I am punctual. 1 2 3 4 5 I notify my supervisor if my schedule changes. 1 2 3 4 5 I interact positively with my supervisor. 1 2 3 4 5 I interact positively with other R.A.s. 1 2 3 4 5 I complete work as requested in a timely manner. 1 2 3 4 5 I seek out new experiences. 1 2 3 4 5 I ask my supervisor for more responsibilities when appropriate. 1 2 3 4 5 I initiate and explore research/scholarship opportunities. 1 2 3 4 5 I manage my time efficiently. 1 2 3 4 5 What skills have you acquired or strengthened as a result of your assistantship experience? What skills would you like to obtain (or obtain more of) during your assistantship? Based on the above items or other considerations, (a) state one or more specific goals for yourself to sustain and/or improve your assistantship performance during the coming school year, and (b) for each goal, indicate how you will know youve accomplished it. Other (Please add any other comments related to your assistantship performance or experiences that you wish to share): III. FIELD EXPERIENCES During the past year, in what setting(s) or capacities have you interacted with professionals outside of UCA? Regarding your professional field experiences and interactions outside of UCA Answer the following questions, with the scale: Never Sometimes Always (1) (3) (5) I am punctual? 1 2 3 4 5 I notify my field supervisor/contact 1 2 3 4 5 prior to absence? I interact positively? 1 2 3 4 5 I complete work as requested? 1 2 3 4 5 I actively participate/contribute? 1 2 3 4 5 Based on the above items or other considerations, (a) state one or more specific goals for yourself to sustain and/or improve your field-based performance during the coming school year, and (b) for each goal, indicate how you will know youve accomplished it. In what professional organizations are you currently a member? List professional conferences you have attended throughout the past year. Conference Date Other (Please add any other comments related to your field-based performance or experiences that you wish to share): IV. RESEARCH/SCHOLARSHIP/PROFESSIONAL PRESENTATIONS What are you specific areas of research/scholarship/presentation interest? List your research/scholarship activities during the previous year. What were the results of such activities? Check all that apply. Improved my research skills Improved my scholarship/publication/writing skills ______ Improved my professional presentation skills ______ Professional presentation Worked on a manuscript for publication Submitted a manuscript for publication Other Based on the above items or other considerations, (a) state one or two specific goals for yourself to sustain and/or improve your performance or future work in these areas (b) for each goal, indicate how you will know youve accomplished it. Other (Please add any other comments related to your research/scholarship/public presentation performance or experiences that you wish to share): For this next section, you may want to consult your student handbook regarding the coursework that contributes to each of the program objectives. Rate each topic below based on the amount of coverage you feel was incorporated into the curriculum through coursework, field experiences, teaching/research experiences, etc. Secondly, rate your perceived level of competency in each of the areas. Program objectives Rating __________ Insufficient Sufficient Exemplary 1. Understanding and application of knowledge of core components of the field of school psychology, namely historical foundations, ethical and legal guidelines, and other professional issues. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 2. Acknowledging, respecting, and appropriately accommodating for individual differences and their influences on learning and development. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 3. Understanding and application of the knowledge of social, biological, and cognitive features of and influences on child development. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 4. Working collaboratively (at the systems, building, classroom, or individual levels) in schools, school-related, and other settings that serve the educational, health, and psychological health needs of children, adolescents, and families. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 5. Data-based decision-making and accountability practices in all professional activities and interactions. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 6. Direct and indirect service provision in assessment, counseling, and interventions to prevent or remediate problems in childrens cognitive, academic, and social competencies. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 7. Critical review/evaluation and working knowledge of the psychological and educational research literature. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 8. Program evaluation, research design, data analysis, and data interpretation. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 9. Dissemination of results of research to the profession and broader community. Amount of coverage in curriculum. 1 2 3 4 5 Perceived level of competence. 1 2 3 4 5 Thank you for your feedback that will contribute to your annual review and needed program changes. Please return this form to your advisor by March 9th. 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