BUENA VISTA UNIVERSITY

GRADUATE PROGRAM
PROFESSIONAL SCHOOL COUNSELING FIELD PRACTICUM
PROFESSIONAL SCHOOL COUNSELOR
SCHOOL COUNSELING PRACTICUM PERFORMANCE EVALUATION FORM
EVALUATION PERIOD:
April 2016

January 2016

NAME OF COUNSELOR: Kimberly Abram-Bryant

SCHOOL: Taft Middle School, Cedar Rapids
EVALUATOR: Alice Kitterman

TITLE: School Counselor________

COUNSELOR EVALUATION FORM

AND JOB DESCRIPTION
The school counselor evaluation form will used by the graduate student as a self-audit
guide to the field practicum experience. It will also be used by supervisors to evaluate
the student-counselors performance in the field practicum.
DIRECTIONS FOR FORM COMPLETION:
I.

5
4
3
2
1
N/O
II.

THE RATING SCALE: Please write the appropriate number in the space provided
beside each item. Mark the space N/O if you had no opportunity to observe and/or to
evaluate. The rating scale is:
- -Performance is clearly outstanding
- -Performance consistently exceeds standards
- -Performance consistently meets standards
- -Performance is below expectations; consultation is required;
and improvement is needed in specific areas
- -Performance is unsatisfactory or lacking, and little or no
improvement has resulted from consultation
- -No opportunity to observe and/or evaluate
COMPLETING THE EVALUATION FORM: Numerical ratings are to be assigned to each
indicator. The indicator ratings are averaged to arrive at the role average of the
counselor's performance. An N/O rating is not calculated in the role average.

It is not necessary for the evaluator to comment on each indicator; however, comments are
encouraged for some areas where exceptional strength is indicated (i.e., a 4 or 5 rating
is earned) or for areas which require improvement (i.e., a 1 or 2 rating is earned).
16

PROFESSIONAL SCHOOL COUNSELOR

PERFORMANCE EVALUATION REPORT
ROLE 1: PROGRAM MANAGEMENT
A. PLANS, IMPLEMENTS, AND EVALUATES A
COMPREHENSIVE PROGRAM OF PROFESSIONAL
SCHOOL COUNSEING, INCLUDING COUNSELING SERVICES.
1. Uses a planning process to define needs, priorities
and program objectives.

N/O

2. Implements a comprehensive and balanced program.

N/O

3. Evaluates the effectiveness of individual activities and the

overall program in meeting desired student outcomes. N/O

4. Educates the school staff, parents and the community

about the guidance program through a public information
program.
N/O

ADD SCORES

ROLE AVERAGE 4.5

ROLE 2: GUIDANCE
A. TEACHES THE SCHOOL DEVELOPMENTAL SCHOOL COUNSELING
CORE CURRICULUM.
1. Outlines, in writing, a school counseling core curriculum
consistent with the district's guidance program plan
and tailored to the specific building level needs.
N/O

2. Teaches core curriculum units effectively units effectively. N/O

ADD SCORES

N/O

B. ASSISTS TEACHERS IN THE TEACHING OF SCHOOL COUNSELING

RELATED CURRICULUM.
1. Consults with administrators and teachers regarding
the teacher's areas of responsibility in teaching the
developmental school counseling core curriculum.

17

N/O

2. Supports teachers in teaching of a school counseling core curriculum

which are developmentally based.
N/O
1
2

ADD SCORES

N/O

C. GUIDES INDIVIDUALS AND GROUPS OF STUDENTS

THROUGH THE DEVELOPMENT OF EDUCATIONAL
PLANS AND CAREER AWARENESS.
1. Involves students in personalized educational and
career awareness.

N/O

2. Presents relevant information accurately and without

bias.

N/O

ADD SCORES

ROLE AVERAGE

ROLE 3: COUNSELING
A. COUNSELS INDIVIDUAL STUDENTS WITH PRESENTING
NEEDS/CONCERNS.
1. Provides counseling systematically.

N/O

2. Responds to students individually.

N/O

ADD SCORES

10

B. COUNSELS SMALL GROUPS OF STUDENTS WITH

PRESENTING NEEDS/CONCERNS.
1. Provides counseling in groups as appropriate.

N/O

2. Provides group counseling systematically.

N/O

ADD SCORES

10

C. USES ACCEPTED THEORIES AND TECHNIQUES

APPROPRIATE TO SCHOOL COUNSELING.
1. Uses accepted theories.

N/O

2. Uses effective techniques.

N/O

ADD SCORES
ROLE AVERAGE

18

10
5

ROLE 4: CONSULTATION
A. CONSULTS WITH PARENTS, TEACHERS, ADMINISTRATORS
AND OTHER RELEVANT INDIVIDUALS TO ENHANCE THEIR
WORK WITH STUDENTS.
1. Provides professional expertise collaboratively.

N/O

2. Interprets information and ideas effectively.

N/O

3. Advocates for students.

N/O

ADD SCORES

15

ROLE AVERAGE

ROLE 5: COORDINATION
A. COORDINATES WITH SCHOOL AND COMMUNITY PERSONNEL
TO BRING TOGETHER RESOURCES FOR STUDENTS.
1. Maintains a communication system that effectively collects
and disseminates information about students to other
professionals as appropriate.
N/O

2. Develops and maintains positive working relationships

with other school professionals.

N/O

3. Develops and maintains positive working relationships

with representatives of community resources.

N/O

ADD SCORES

4.7

B. USES AN EFFECTIVE REFERRAL PROCESS FOR

ASSISTING STUDENTS AND OTHERS TO USE SPECIAL
PROGRAMS AND SERVICES.
1. Accurately assesses students' and their families' needs
for referral.
N/O

2. Participates actively in the process for referral of students

to school/district special programs and/or services.
N/O

3. Uses an effective referral process for assisting students

and others to use AEA and community agencies and
services.
N/O

ADD SCORES
ROLE AVERAGE

19

15
5

ROLE 6: ASSESSMENT
A. PARTICIPATES IN THE PLANNING AND EVALUATION OF
THE SCHOOL GROUP STANDARDIZED TESTING PROGRAM.
1. Is knowledgeable in the principles of testing and
measurement which underlie standardized testing
program development.

N/O

2. Collaborates in the planning and evaluation of the group

standardized testing program.
N/O

ADD SCORES

N/O

B. INTERPRETS TEST AND OTHER APPRAISAL RESULTS

APPROPRIATELY.
1. Correctly applies principles of test and measurement to
tests and other appraisal results interpretation.
N/O

2. Interprets test and other appraisal results to school

personnel.

N/O

3. Interprets test and other appraisal results to students

and their parents.

N/O

4. Uses other sources of student data as assessment

tools for the purpose of educational planning.

N/O

5. Maintains the confidentiality of student assessment.

N/O

6. Ensures that the uses of student records are for the

benefit of students and personnel working with those
students.

N/O

ADD SCORES

14

ROLE AVERAGE 4.7

ROLE 7: PROFESSIONALISM
A. ADHERES TO ETHICAL AND LEGAL STANDARDS
1. Observes ethical standards of the Iowa and the
American School Counselor Association.
N/O
1
2
3

2. Observes relevant legal standards.

N/O
2

5
20

ADD
SCORES

10

B. ADHERES TO PROFESSIONAL DISTRICT STANDARDS

1. Pursues continuous professional growth and
development.
N/O
2

5
2. Keeps abreast of current and innovative procedures
and practices in the fields of school counseling
and in education.
N/O

5
3. Selects counselor interventions appropriate to
students issues and circumstances.
N/O

5
4. Creates an atmosphere in which confidence,
understanding and respect result in a helping
relationship.
N/O

5. Maintains positive working relationships with other

counselors.

N/O

6. Maintains professional records.

N/O
1

21

7.

Respects the integrity of the student.

N/O

ADD SCORES
30

22

ROLE AVERAGE
WORKSHEET FOR FIGURING FINAL EVALUATION RATING
ROLE

AVERAGE SCORE

PROGRAM MANAGEMENT

4.5

GUIDANCE

N/O

COUNSELING

CONSULTATION

COORDINATION

ASSESSMENT

4.7

PROFESSIONALISM

ADD SEVEN ROLE SCORES

29.2

DIVIDE BY SEVEN TO OBTAIN

OVERALL RATING

4.9

SUMMARY EVALUATION
For this evaluation period, the overall appraisal of this counselor's performance is given below. It reflects
an average of the ratings by role with an indicator.
X

4.5-5.0

Performance is clearly outstanding.

3.5-4.49

Performance consistently exceeds standards.

2.5-3.49

Performance consistently meets standards.

1.5-2.49

Performance is below expectations; consultation is required; and

improvement is needed in specific areas.

1.0-1.49

Performance is unsatisfactory or lacking, and little or no

improvement has resulted from consultation.

Alice Kitterman
ON-SITE EVALUATOR'S SIGNATURE

School Counselor

4/14/16

TITLE

DATE

I have discussed this evaluation with the evaluator and have received a copy. If I do not agree with this
evaluation, I understand that I may submit a letter in duplicate stating my position. A copy is to be
retained by the evaluator and the original is to be given to the Director of Personnel/Human Resources to
be placed in my personnel file.

COUNSELOR'S SIGNATURE

DATE

23

PROFESSIONAL SCHOOL COUNSELOR

JOB DESCRIPTION

ROLE 1: PROGRAM MANAGEMENT

A. PLANS, IMPLEMENTS, AND EVALUATES A COMPREHENSIVE PROGRAM OF
PROFESSIONAL SCHOOL, INCLUDING COUNSELING SERVICES.
1. Uses a planning process to define needs, priorities and program objectives.
2. Implements a comprehensive and balanced program.
3. Evaluates the effectiveness of individual activities and the overall program in meeting
desired student outcomes.
4. Educates the school staff, parents and the community about the guidance program
through a public information program.
ROLE 2: GUIDANCE
A. TEACHES THE SCHOOL DEVELOPMENTAL SCHOOL COUNSELING CORE
CURRICULUM.
1. Outlines, in writing, a developmentally based school counseling core curriculum
consistent with the district's guidance program plan and tailored to specific building level
needs.
2. Teaches school counseling core curriculum units effectively.
B. ASSISTS TEACHERS IN THE TEACHING OF SCHOOL COUNLSEING RELATED
CURRICULUM.
1. Consults with administrators and teachers regarding the teacher's areas of responsibility
in teaching the developmental school counseling core curriculum.
2. Supports teachers in teaching a developmental based school counseling core
curriculum.
C. GUIDES INDIVIDUALS AND GROUPS OF STUDENTS THROUGH THE DEVELOPMENT
OF EDUCATIONAL PLANS AND CAREER AWARENESS.
1. Involves students in personalized educational and career awareness.
2. Presents relevant information accurately and without bias.

24

ROLE 3: COUNSELING
A. COUNSELS INDIVIDUAL STUDENTS WITH PRESENTING NEEDS/CONCERNS.
1. Provides counseling systematically.
2. Responds to students individually.
B. COUNSELS SMALL GROUPS OF STUDENTS WITH PRESENTING NEEDS/CONCERNS.
1. Provides counseling in groups as appropriate.
2. Provides group counseling systematically.
C. USES ACCEPTED THEORIES AND TECHNIQUES APPROPRIATE TO SCHOOL
COUNSELING.
1. Uses accepted theories.
2. Uses effective techniques.
ROLE 4: CONSULTATION
A. CONSULTS WITH PARENTS, TEACHERS, ADMINISTRATORS AND OTHER RELEVANT
INDIVIDUALS TO ENHANCE THEIR WORK WITH STUDENTS.
1. Provides professional expertise collaboratively.
2. Interprets information and ideas effectively.
3. Advocates for students.
ROLE 5: COORDINATION
A. COORDINATES WITH SCHOOL AND COMMUNITY PERSONNEL TO BRING TOGETHER
RESOURCES FOR STUDENTS.
1. Maintains a communication system that effectively collects and disseminates information
about students to other professionals as appropriate.
2. Develops and maintains positive working relationships with other school professionals.
3. Develops and maintains positive working relationships with representatives of
community resources.

25

B. USES AN EFFECTIVE REFERRAL PROCESS FOR ASSISTING STUDENTS AND

OTHERS TO USE SPECIAL PROGRAMS AND SERVICES.
1. Accurately assesses students' and their families' needs for referral.
2. Participates actively in the process for referral of students to school/district special
programs and/or services.
3. Uses an effective referral process for assisting students and others to use AEA and
community agencies and services.
ROLE 6: ASSESSMENT
A. PARTICIPATES IN THE PLANNING AND EVALUATION OF THE SCHOOL GROUP
STANDARDIZED TESTING PROGRAM.
1. Is knowledgeable in the principles of testing and measurement which underlie
standardized testing program development.
2. Collaborates in the planning and evaluation of the group standardized testing program.
B. INTERPRETS TEST AND OTHER APPRAISAL RESULTS APPROPRIATELY.
1. Correctly applies principles of test and measurement to test and other appraisal results
interpretation.
2. Interprets test and other appraisal results to school personnel.
3. Interprets test and other appraisal results to students and their parents.
4. Uses other sources of student data as assessment tools for the purpose of educational
planning.
5. Maintains the confidentiality of student assessment.
6. Ensures that the uses of student records are for the benefit of students and personnel
working with those students.
ROLE 7: PROFESSIONALISM
A. ADHERES TO ETHICAL AND LEGAL STANDARDS.
1. Observes ethical standards of the Texas and the American School Counselor Association.
2. Observes relevant legal standards.

B. ADHERES TO PROFESSIONAL DISTRICT STANDARDS.

26

1. Pursues continuous professional growth and development.

2. Keeps abreast of current and innovative procedures and practices in the fields of guidance
and counseling and in education.
3. Selects counselor interventions appropriate to students issues and circumstances.
4. Creates an atmosphere in which confidence, understanding and respect result in a helping
relationship.
5. Maintains positive working relationships with other counselors.
6. Maintains professional records.
7. Respects the integrity of the student.

27

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