ࡱ> surs bjbj\\ 4L6ij6ij Kt t mmmmm8\_(;_=_=_=_=_=_=_8bd|=_m=_mmR_^mm;_;_X]PfLA^ Z8'_h_0_CZje`rjep]]jem^=_=_<_jet 3: PLAN FOR SUPERVISION (COMMSCI 9502) Student Name: Level of Study (Year & Term): Clinical Educator: Date: ABOUT THE STUDENT: Previous Experience Clinical Previous Related Experience (can include, but is not limited to, previous work/volunteer in health care settings, any work in customer service, working with diverse populations, working with children): Student Clinicians Learning and Communication How best I learn: Student clinicians strengths: Student clinicians areas for development: ABOUT THE CLINIC: Supervisors Expectations Compulsory: Optional: Supervisory Process Time for Supervision: Preparation Required for Supervision: Style of Supervision: ABOUT THE PLACEMENT Placement Objectives General Placement Objectives Goals for current clinical placement (include at least one SMART goal): Evaluation Student Clinicians will be evaluated using Canadian Assessment of Clinical Competence (ACC) across 7 Roles. At the end of this course students are expected to demonstrate skill levels between novice to advanced intermediate (depending on the Role). See the ACC Milestones, ACC Assessment Tool, ACC Ratings Scale, and Course Performance Expectations in the course or clinical educator website. Course Performance Expectations for COMMSCI 9502: 1. Role of ExpertENTERMIDTERMEND1.1 Knowledge Expert NoviceAdvanced NoviceIntermediate1.2 Clinical Expert - AssessmentNoviceAdvanced NoviceIntermediate1.3 Clinical Expect - InterventionNoviceAdvanced NoviceIntermediate2. Role of CommunicatorNoviceAdvanced NoviceIntermediate3. Role of CollaboratorNoviceAdvanced NoviceIntermediate4. Role of AdvocateEarly NoviceNoviceAdvanced Novice5. Role of ScholarAdvanced NoviceIntermediateAdvanced Intermediate6. Role of ManagerNoviceAdvanced NoviceIntermediate7. Role of Professional IntermediateIntermediateAdvanced Intermediate Frequency of Evaluation (eg. Weekly, mid-practicum, end of practicum). A written self-evaluation is recommended for mid-term and required for end of practicum Mid-term and end of practicum feedback will be provided by your clinical educator Verbal feedback and consel with be ongoing (e.g. at the end of patient interactions, and end of clinic day). General progress expectations may be reviewed each week. Method of appeal in the event of a dissonant evaluation: In the event of a dissonant evaluation the student is asked to first appeal to the clinical educator directly. If a resolution is not met the student may request a formal appeal. The process is outlined in the Student Handbook STATEMENT OF COMMITMENT We (names of clinical supervisor and student) agree to the above with the option that this plan can be modified according to circumstance, with the agreement of both parties. 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