SOCIAL SERVICES DIPLOMA PROGRAM

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1 SOCIAL SERVICES DIPLOMA PROGRAM GUIDE FOR PRACTICUM MENTORS / SUPERVISORS Faculty of Health and Human Services Revised January 2016

2 Contents Glossary of Terms... 3 Introduction... 4 Health and Human Services Mission Statement... 4 Program Overview... 5 Objectives of Program... 5 Purpose of Practica... 6 Practicum Overview... 6 Course Descriptions... 6 Practicum Roles and Responsibilities... 6 Student... 7 Practicum Mentor / Supervisor... 7 Vancouver Island University Practicum Coordinator... 8 Vancouver Island University Practicum Instructor... 9 Evaluation... 9 Confidentiality Affiliation Agreements Workers Compensation Board Coverage / Student Use of Vehicles during Practicum Students Driving Others During Placement Critical Incident Reporting Criminal Record Check Handling Performance Concerns with Students Recommended Guidelines Tips on Field Placement Appendix I Social Worker Declaration Appendix II Social Work Code of Ethics Declaration: Signature Form Appendix III Learning Plan Developing Your Learning Plan Developing your Learning Goals and Activities Appendix IV Sample Affiliation Agreement Appendix V Sample Student Evaluation Form Appendix VI Website References Appendix VII Policies & Information on Safety Driving Clients Page 2

3 SOCIAL SERVICES DIPLOMA PROGRAM Guide for Practicum Mentors / Supervisors Glossary of Terms Student also known as Practicum Student An individual currently enrolled in the Vancouver Island University (VIU) Social Services Diploma Program. Practicum Mentor/Supervisor is responsible for supporting the student s learning in the practicum setting. Practicum Instructor/Faculty/Professor also known as the Program Instructor. The Practicum Instructor is employed by Vancouver Island University and teaches the practicum course. Practicum Coordinator The Vancouver Island University staff member who makes arrangements with existing and new practicum agencies for the placement of students. Practicum Site The setting where the student undertakes practicum. Also referred to as Practicum Agency. Codes of Conduct several codes of conduct govern Social Services students. VIU has student conduct policies, including anti harassment, academic integrity, and behaviour codes inside and outside the classroom. The Social Work profession also has professional Codes of Conduct governing their members. Some Practicum sites have specific codes as well, such as dress code or safety protocols. Social Services students are expected to know and adhere to all of these codes and protocols. Code of Ethics: Set of ethical values and principles established by the Canadian Association for Social Workers that Social Service Diploma students are expected to be familiar with and adhere to in their social services practicum and work. Learning Plan Signed written agreement the student will develop in consultation with their VIU practicum instructor and agency mentor describing their goals for practicum and the tasks and activities they will undertake to achieve their goals. The Learning Plan will be form the basis for practicum evaluation. Affiliation Agreements: signed written contractual agreement between Vancouver Island University and practicum host organization outlining the terms, responsibilities, liability and insurance contingencies for all parties. Page 3

4 Introduction Mentor / Supervisor Guide Social Services Diploma Program The Social Services Diploma Program at Vancouver Island University (VIU) prepares graduates to work in the field of Social Services. The Practicum is an essential and integral part of the overall training and education of the Social Services Diploma program. The two year diploma program, which may be taken on a full or part time basis, is designed to prepare students for a range of social service settings, including child, youth and family agencies, women s programs, life skills programs, vocational counseling, services for seniors, mental health and addictions agencies, multicultural organizations and volunteer centers. The diploma also awards up to 60 credits towards VIU s Bachelor of Social Work degree. The practicum component of the program is designed to provide students with the knowledge, skills and competencies necessary for Social Service work. The success of the field practicum is dependent upon the cooperation and investment of the students, the community agencies and the Practicum Instructor. We value the contribution of the Practicum mentors and supervisors as they provide an integral part of the students learning. This is where practice and theory come together! Health and Human Services Mission Statement Our Mission: In Health and Human Services at Vancouver Island University we foster student success. We develop and maintain relevant, responsive and stimulating learning opportunities that are community based, globally and locally, and offered in a visionary, inter professional environment that is conducive to learning and promotes health and wellness for all. Our Beliefs: We believe that learning is a lifelong endeavor, and we work together with individuals and communities to co create a positive, relational environment that promotes a sense of belonging, personal and collaborative participation, a sense of community, and enhanced well being. We believe our work should be based on clear communication and open dialogue, evidence based practice and research, and on joy and passion. August, 2008 Page 4

5 Program Overview The Social Services Diploma program is based on a systems model that reflects working in partnership with clients, colleagues and community. The student learns skills in self awareness, working with systems, conflict resolution, professionalism, values, ethics, roles and responsibilities, and other related competencies to enhance social service work practice. Examination of various theories of community organizing, networking and advocacy are introduced and analyzed. The program assists students to develop different problem solving approaches to individual and community issues in the Social Services field. Students will learn to apply and integrate theoretical knowledge to concrete situations. Students are encouraged to reflect on values and attitudes in relation to Social Services practice. Students who successfully complete the diploma program will develop knowledge, skills and selfawareness in areas such as social work practice, social policy, conflict resolution, community development, interpersonal skills, leadership and supervision, and other special topic areas. Course Titles Introduction to Social Welfare in Canada Introduction to Social Work Practice Developmental Psychology Family Studies Alternative Conflict Resolution in Criminal Justice Systems Interpersonal Communication Skills Mental Health and Addictions Methods in Social Work Practice Practicum Selected Special Topics Objectives of Program To offer accredited and recognized course work at the post secondary level that is relevant to Social Services. To provide students with generic multidisciplinary skills and perspectives for work in the Social Services field. To strengthen understanding of working in the community context. To prepare students for employment in the Social Service field. To expose students to realistic work experiences in which they can test theories, gain knowledge, develop skills and abilities, and access personal suitability for the field of Social Services. Page 5

6 To enable students to continue on with related diplomas and / or degrees Purpose of Practica Practicum experiences are intended to provide a structured and supervised opportunity that reflects a generalist approach to Social Service work. The overall purpose of the Social Service practicum is to assist students to develop and transfer theoretical skills through direct practice within the Social Services field. Through a combination of classroom instruction, on going supervision and direct practice, the student will gain the ability to understand, translate and integrate theory and practice. Practicum Overview In the third semester, students will be introduced to and will explore issues related to the field placement experience. In the spring of the second year, students will be required to complete a six week, 210 hour block practicum within a Social Services agency. The student will seek input from the Practicum Mentor / Supervisor in developing a Learning Plan that outlines goals, objectives, tasks and responsibilities that will consolidate and integrate core skills and practice concepts presented throughout the practicum. Course Descriptions SOCW 281/282 Practicum I & II Once students have completed at least 80% of their academic course work, they will be placed for a sixweek, 210 hour block practicum. Students are placed with a Social Service agency / organization where the focus is on integration and application of theory, skills and practice in a supervised setting. An interview may be required by the agency. Students are expected to demonstrate their ability to understand systemic structures and functions of a service agency in relation to clients, community and other agency workers. Practicum Roles and Responsibilities The field work experience/practicum is a partnership between the student, the University Instructor, the Practicum Coordinator and the Practicum Mentor / Supervisor. All parties in the relationship assume certain roles and responsibilities which are outlined below. Page 6

7 Student The student carries responsibility for his / her professional and personal development. Specific expectations are to: Commit to making good use of supervision, taking initiative and guidance from personnel at the agency and developing and using practice skills. Comply with the agency s protocol regarding confidentiality, work policies and procedures, hours of work, dress, etc. Seek out information regarding any specific protocols or contractual agreements that may pertain to the practicum site. Demonstrate professional attitude, ethics and conduct when interacting with clients and agency personnel. Attend the practicum placement for the required number of days and hours specified by the program. Report illness and / or absence to the Practicum Mentor / Supervisor, and the Practicum Instructor. Maintain contact with the Practicum Instructor, keeping him / her informed of any changes, concerns or issues that arise in the practicum. Arrange for and participate in feedback sessions and formal evaluation processes involving the Practicum Mentor / Supervisor and the Practicum Instructor. Attend and participate in practicum seminars. Provide the Practicum Instructor and Mentor / Supervisor with a final copy of your Learning Plan (Goals and Objectives) within the first two weeks of placement. Practicum Mentor / Supervisor The Practicum Mentor / Supervisor plays a key role in guiding the learning process of the student. It is a consulting role that bridges the gap between theory and practice and provides mentorship to the student. Each student will be assigned to a Practicum Mentor / Supervisor whose responsibilities are to: Be aware of and participate in the development of the learning goals and objectives of the student. Provide time for orientation to acquaint the student with the agency s policies, procedures, programs and overall philosophy. Ensure that any site specific protocol or contractual agreement terms regarding student placement are followed. Introduce the student to other staff members. Page 7

8 Provide meaningful learning opportunities for the student to fulfill his/her learning goals, objectives, and carry out practicum assignments. Provide consistent, appropriate and supportive individual consultation (usually a specified meeting time each week) and supervision for the student that encourages the student s own learning. Monitor the student s learning and progress, and provide the student with ongoing verbal and written feedback. Meet with the student and the Practicum Instructor at mutually agreed times to discuss and review the student s progress and to provide input for interim and final evaluations. Maintain contact with the Practicum Instructor to discuss any concerns, questions, suggestions or issues regarding the student or the program. Inform the student of any potentially unusual or disruptive client behaviour and how to deal with this (e.g. anxiety, anger). Vancouver Island University Practicum Coordinator The Practicum Coordinator is responsible for setting up and facilitating the practicum placement process. In consultation with VIU faculty s/he will make arrangements with new and existing practicum agencies for student field placements. It is the responsibility of the Practicum Coordinator to: Consult with the student to discuss their learning needs and placement interests. Consult with VIU faculty, as needed, to determine the student s placement and learning needs. Identify who in the agency will take on the supervisor role for the student and outline appropriate tasks and responsibilities to ensure that a suitable learning experience can be provided. Outline the placement process and provide students with information regarding placement agency s expectations. Ensure that both the student and the Practicum Mentor / Supervisor are informed of any specific protocols or contractual agreements that are site specific. Provide the agency with information about the program, field placement procedures, practicum expectations and evaluation process. Ensure that both the Practicum Mentor and the student have confirmed a workable practicum schedule. Be available to the Practicum Mentor / Supervisor for clarification or consultation on the practicum placement process. Recruit and develop possible practicum placements. Page 8

9 Vancouver Island University Practicum Instructor The Practicum Instructor maintains contact with the Practicum Mentor / Supervisor and the student and acts as a channel between Vancouver Island University and the field placement. It is the responsibility of the Practicum Instructor to: Ensure that any site specific protocol or contractual agreement provisions regarding student placement are followed. Ensure that the learning goals and objectives developed by the student with the Practicum Mentor / Supervisor are defined and discussed. The Learning Plan should include learning objectives, tasks and responsibilities and scheduled time for consultations. Consult with the student and Practicum Mentor / Supervisor in the initial formulation of learning goals and objectives. Provide the practicum site with clear information on what is expected of all parties within the practicum relationship. Prior to placement, ensure students have the information related to general ethical practice, confidentiality and appropriate conduct. Seek to ensure that the student receives feedback, consultation, and support from the agency. Be available to the Practicum Mentor and the student for consultation. Visit the centre to review the student s progress and to discuss any modifications to learning objectives as required by the specific practicum site. Ensure that written evaluations of the student s progress are received, and that adequate feedback on the evaluation is provided to the student. Facilitate seminars to link practicum experiences to course content. The practicum instructor will ensure that the student is enrolled in the concurrent methods course where students will bring practice experiences and relate them to theories. Intervene for the purpose of problem solving, conflict resolution or handling of any other concerns or issues that may arise during the practicum. Facilitate the evaluation process and assign a final grade. Evaluation Vancouver Island University is ultimately responsible for evaluation and assignment of the final grade. The method of summative evaluation should be clearly discussed and understood by the student and the Practicum Mentor / Supervisor. Students will bring in a Learning Plan and this will form the basis of their evaluation and is discussed at the beginning of the practicum as well as at the end. In addition, there is a written Evaluation Form completed by the Mentor / Supervisor at the end of the practicum. Page 9

10 Confidentiality Mentor / Supervisor Guide Social Services Diploma Program Students are expected to adhere to the agency s policies of confidentiality. Within the practicum, it is expected that students will respect the privacy and rights of individuals and agency personnel with whom they work. Although practicum experiences may be discussed and documented for the purpose of linking knowledge to practice, the identities of the individuals and staff must not be disclosed. Affiliation Agreements Affiliation agreements are standard practice for Universities who have students at community sites. These agreements are now required for all sites mentoring VIU ECEC, CYC, SCSW, SSER and BSW students. These agreements cover responsibilities, liability and insurance contingencies for all parties. See Appendix for a Sample Affiliation Agreement. Workers Compensation Board Coverage / Student Use of Vehicles during Practicum The Ministry of Advanced Education through Vancouver Island University provides Workers Compensation Board (WCB) coverage for students while they are engaged in their approved practicum training within British Columbia. The coverage does not include the use of their vehicle or other form of transportation to the practicum site. A student driving while involved with practicum duties is covered by WCB but must also be insured by ICBC for their own private vehicle. Check the VIU Safety website at or call the Health and Safety Office at Students Driving Others During Placement The student must adhere to both the practicum placement agency and VIU policies with respect to the use of vehicles during practicum placement. Review Appendix VIII and consult with the Practicum Coordinator and agency for any additional clarification prior to transporting others while engaged in placement related activities to ensure the necessary liability coverage and documentation is in place. In some situations students may be eligible to drive an agency vehicle during the course of their field placement duties. In this instance the vehicle driven must have insurance coverage through the agency for transporting agency services users and/or staff AND VIU students must be explicitly covered by this insurance policy. In addition, if the agency service user is a minor, then parental/guardian written consent must also be obtained. See full details in Appendix VIII Page 10

11 Critical Incident Reporting In the event of a critical incident, for example an accident, act of violence, or threats, the student must report this to the Practicum Instructor and the Practicum Mentor immediately. Vancouver Island University requires a formal Incident Report to be filed within 24 hours as part of our Health and Safety policies. Practicum instructors must inform Health and Safety Services immediately of any critical incident. Students should also follow their Supervisor / Mentors instructions for reporting these incidents / accidents to the agency in accordance with agency policies. Any questions, please call VIU Health and Safety at or safety@viu.ca. Criminal Record Check As an educational institution Vancouver Island University (VIU) requires all students entering a practicum with children, youth or vulnerable adults to complete a Criminal Record Check (CRC) through the Ministry of Public Safety and Solicitor General in accordance with legal requirements. VIU facilitates the application process for student CRCs. The student is aware that completed CRC documentation must be provided to your agency. Handling Performance Concerns with Students The practicum is different from most other educational courses. Students engage in important ethical and service delivery responsibilities within the placement organization. It is important that concerns and issues with regard to performance and professional conduct and behavior be responded to quickly. Recommended Guidelines Early recognition and feedback is important. The Practicum Mentor / Supervisors and University faculty should communicate their concerns and observations as soon as they are identified, particularly those of a serious nature. Early intervention can often provide the student with a better understanding of exactly what to address and can prevent future problems. A meeting of all concerned parties, including the student, should be set up to bring forward concerns and clearly define the problem(s) in behavioural terms so that the student understands the area(s) needing improvement. Page 11

12 Suggestions and options should be explored to assist the student to address issues and come up with ideas and solutions. Various limitations and external demands may impede the performance of the student. Most students will perform well given the opportunity and appropriate support. There are sufficient resources and program flexibility within the University to give students assistance in dealing with personal and professional struggles that affect their education. Career and personal counseling, additional work, exploration of career goals, etc., can all be part of a supportive response to problems. Setting goals and follow up enable the student to develop a plan of action within a specific time frame. Follow up meetings for review, on going monitoring, discussion and feedback should be set up for the Practicum Instructor, Practicum Mentor / Supervisor and the student. Key points should be documented in writing as this feedback allows the student to review observations, goals and comments. A written contract may be useful for clarity and clear communication. Tips on Field Placement Most students are a little nervous about beginning practicum and are sometimes unclear about what is expected of them. Here are some ideas for enhancing the learning experience of the student and enabling both the Mentor and the student to have a clear understanding of expectations. Orientation: The student needs to become familiar with the setting and meet other staff. This enables him / her to begin work and feel at ease to ask questions and express ideas. Information regarding agency philosophy, confidentiality, policies and procedures should be discussed with the student. It helps if everyone involved (staff, parents, and children) are informed that a student will be joining the team. Task Setting: Involvement of the student in a full range of activities, including board meetings, committee meetings, program planning, implementing and evaluating, staff meetings and discussions with other professionals is helpful to broaden the scope of his / her knowledge and experience. Responsibility: If possible, give the student one or more definite pieces of work which s/he can do relatively independently. Tasks related to specific learning goals and objectives are appropriate. Page 12

13 Building Relationships: Building meaningful relationships is an essential component of the student s practicum experience. This important aspect of the placement is an area that is emphasized in the evaluation of the student s overall performance. Supervision: The student needs feedback and support. It is necessary that a specific time be set aside each week (approximately one hour) for informal discussion and debriefing. This is a time to answer questions and help the student evaluate his / her skills and assist him / her to transfer knowledge into practice. Observing and Being Part of a Community Agency: Whenever possible, the student should be involved in case conferences, discussions regarding approaches, problems and social issues. Students will increase their awareness in these areas by listening to people who are working in the field. Conducting Interviews: Where possible, it would be helpful if students could participate with the Practicum Mentor/Supervisor when family visits or interviews take place. Observing tasks of this nature is very important in student s learning. Communication Both Verbal and Written: Personality factors occasionally enter into the picture and some students are quite shy when entering the University. With encouragement, all students have the ability to communicate verbally and in writing. The field placement can assist students to further develop these skills. Thank you for your participation and support! Page 13

14 Appendix I Social Worker Declaration Excerpt from Code of Ethics, British Columbia College of Social Workers* Social Worker Declaration As a member of the profession of social work I commit myself to fulfill to the best of my ability the following obligations: 1. I will regard the well being of the persons I serve as my primary professional obligation. 2. I will fulfill my obligations and responsibilities with integrity. 3. I will be competent in the performance of the services and functions I undertake on behalf of the persons I serve. 4. I will act in a conscientious, diligent and efficient manner. 5. I will respect the intrinsic worth of persons I serve in my professional relationships with them. 6. I will protect the confidentiality of all professionally acquired information. I will disclose such information only when properly authorized or when obligated legally or professionally to do so. 7. I will ensure that outside interests do not jeopardize my professional judgment, independence or competence. 8. I will work for the creation and maintenance of workplace conditions and policies consistent with the standard of practice set by this Code. 9. I will act to promote excellence in the social work profession. 10. I will act to effect social change for the overall benefit of humanity. *See BC College of Social Workers website for the full text of the Code of Ethics and Standards of Practice: of ethicsstandards of practice Accessed January 4, 2016 Page 14

15 Appendix II Social Work Code of Ethics Declaration: Signature Form for Social Services Diploma Students Excerpt from Code of Ethics, Canadian Association of Social Workers Social Work Code of Ethics As a member of the profession of social work I have read in full the Canadian Social Work Code of Ethics and I commit myself to fulfill to the best of my ability the following obligations as detailed in the code: Value 1: Respect for Inherent Dignity and Worth of Persons Value 2: Pursuit of Social Justice Value 3: Service to Humanity Value 4: Integrity of Professional Practice Value 5: Confidentiality in Professional Practice Value 6: Competence in Professional Practice *See Canadian Association of Social Workers website for a full description of the Code of Ethics: Values and Principles. Student Name: Student Number: Student Signature: Date: Return original signed form to Holly Bradley, Practicum Coordinator in B180, Rm520 Page 15

16 Appendix III Learning Plan A Guide for Setting up Your Learning Plan For Social Services Diploma Students Embarking on Practicum Prepared by Tina Jennissen and Patrick Konkin, SSER faculty Created September 2005 Revised Feb 2016 Page 16

17 Developing Your Learning Plan The Learning Plan is a tool you will develop to guide your practicum learning experience. It identifies what you hope to gain from your practicum (goals) as well as the specific steps (activities) you will take to achieve your goals. It also serves as a tool to measure and evaluate how you are progressing with meeting your practicum goals. You will develop your learning plan in stages. 1. The first stage in developing your learning plan is related to determining where you will experience your practicum (which agency, client group, area of practice etc). In the beginning of the placement process you will attend a Practicum Orientation and be asked by the Practicum Coordinator to submit three requests of placements in order of preference. When considering your requests, reflect on what it is you hope to gain (what skills, knowledge, experience, contacts, etc.) in your practicum. Once you have an interview arranged you will be asked to further consider your general goals for a practicum at this specific agency, as part of your interview preparation. This can serve as a basis for discussion during your interview. It also assists the agency in understanding your learning needs in order to arrange an appropriate practicum experience. The feedback from the interviewer may help you further develop your ideas for your learning goals. 2. Prior to practicum starting there will be a second practicum orientation. During this second orientation, the practicum instructors will discuss their expectations regarding the Learning Plan in more detail. Once your specific instructor is assigned, you will be asked to submit a written copy of your initial learning goals and activities to your practicum instructor in advance of starting your practicum. The instructor will review your initial goals and activities as well as provide you with feedback in advance of starting your practicum. These general goals and activities will serve as a basis for discussion during the initial three way meeting you will arrange with yourself, your Instructor and your Agency Mentor, within the first week of practicum. Remember, the activities will be reflective of the functional tasks that you will be performing in the agency that will serve the purpose of meeting your goals (e.g. discussing with your agency mentor, reading the agency s these are actual activities you will be performing to achieve your goals). 3. Initially, your Learning Plan can be loosely formulated as you may not be fully aware of additional goals you wish to include in your learning experience. In working on your learning activities under each of your goals, you may not be fully aware of the work tasks you would be performing that would assist in achieving your goals. Once you have begun your practicum, are oriented to the setting, and have a better understanding of the learning opportunities at the agency, you may find that your goals will change or become more consolidated, and you will better be able to identify the steps you will take to achieve your goals. The important thing is that your DRAFT practicum goals be clearly articulated and written out for yourself, your Mentor and your Practicum Instructor prior to placement in the agency. During your meeting with your Instructor and Mentor within the first week of placement you will review your learning goals, solicit feedback from the mentor and agree to an initial learning plan. This will form the basis for supervision and for your evaluation in practicum. If your learning goals change, you must inform both your Agency Mentor and Practicum Instructor to review the changes. As previously Page 17

18 mentioned, the goal setting exercise is the yardstick by which successful completion of your practicum is measured. An important question to be asking yourself, in developing your learning plan is What is it I hope to achieve by the end of my practicum? Your thoughts then need to be translated into goals and activities. Goals are broad statements that demonstrate a desired end. For example, all students would likely have understanding the organizational structure of their agency as one of their goals. Activities are tasks that outline the steps or actions that need to be performed in order to achieve the goals. In establishing your goals, apply the SMART principles: Specific Measurable Attainable Relevant Time limited You may want to consider three key categories when developing your learning plan knowledge, skills and personal development (Kiser, 2000): Knowledge relates to learning and understanding concepts, theories, ideas, information etc. (e.g. addictions, mental health, corrections) Skills these can include interpersonal communication skills (e.g. active listening, attending), or other skills such as record keeping, team skills, leadership, program planning and development Personal development refers to personal values, beliefs, attitudes and ethics To help you work through the process of developing your learning plan and articulating goals and activities, we have provided a small example of the format required in setting up your goals and activities. As already mentioned, having your goals clearly identified from the outset helps to guide you, your mentor and your Practicum Instructor while you are in practicum. You are embarking on an important growth experience. Enjoy the journey! (Source: Kiser, P. M. (2000). Getting the Most from your Human Service Internship. Belmont, CA: Wadsworth/Thomson Learning, Brooks/Cole) Page 18

19 Developing your Learning Goals and Activities In developing your learning goals and activities, it is important to be thinking about what it is you hope to achieve by the end of your practicum (i.e., the outcomes of your individual learning). Part of developing a learning plan requires thinking about what goals and activities you hope to achieve. Goals: are broad statements that demonstrate a desired end. For example: Learn about the agency s mandate and structure your learning plan is a work in progress, therefore goals can be adapted, adjusted etc. as your practicum progresses, particularly in the early stage of a practicum your goals should fit within the mandate and context of the agency within which you are doing your practicum Activities: Activities are tasks that outline the steps or actions that need to be performed in order to achieve your goals. Examples of activities are: Meet with the manager of the organization within the first week to determine what the governance structure of the agency is comprised of and where the agency gets its mandate to operate its program(s). Describe to my mentor who or what body at the top of the authority structure of the organization determines the overall vision and mission of the organization and its mandate. Read the agency policy and procedure manual bring any questions forward to my supervisor for discussion. Talk to one staff member in each program within the agency and discuss my findings in a weekly supervision meeting with my mentor. Page 19

20 Appendix IV Sample Affiliation Agreement THIS AGREEMENT made effective as of this <date>. BETWEEN: Institution: Vancouver Island University (Hereinafter called the University ) ADDRESS: 900 Fifth Street Nanaimo, BC V9R 5S5 Phone Fax (Please change for different Campus) INSTITUTION CONTACT: Dr. Carol Stuart, Dean Health & Human Services AND: Legal Name of Work Site Employer: <agency> (Hereinafter called the Agency ) ADDRESS: <address> Phone <phone> Fax <fax> AGENCY CONTACT: {Contact Name} {Title} BY SIGNING BELOW THE PARTIES AGREE TO BE BOUND BY THIS AGREEMENT: DEAN SIGNATURE: <Name, Title> Date AGENCY S SIGNATURE: <Name, Title> Date Page 20

21 In consideration of mutual covenants provided herein, the parties agree as follows: PRACTICUM A Practicum means that part of a student s educational experience takes place in the workplace. It may involve a range of Agency supported interventions and activities commensurate with student educational learning objectives and skill level. Client participation is self determined or alternate as appropriate, (e.g., guardian, court, loco parentis). The student may provide services to and for the benefit of clients/families and communities. The student provides such services under the direction of Agency employees and indirect supervision of University faculty. The Agency has the discretionary right to accept a student or permit Practicum activities at any of its facilities. TERM This agreement will commence <start date> and <shall continue thereafter until terminated>. The parties shall review this Agreement from time to time and revise if necessary by mutual agreement. TERMINATION AND AMENDMENT Either party may end the agreement at any time by giving a 90 day written notice to the address shown on the Agreement. This agreement shall not be amended unless such amendment is in writing signed by the two (2) parties. SUSPENSION OR REMOVAL (a) The Agency reserves the right to suspend, temporarily pending investigation, or terminate a Practicum in circumstances where the Agency determines the Practicum Student has, or there are reasonable grounds to believe that the Practicum Student has: (i) (ii) failed to comply with the legislation, rules, regulations and policies of the agency failed to meet licensing requirements e.g., first aid (annually), criminal record check (every five years or as required), as outlined in admission notes (iii) endangered the mental or physical health or safety of any person; or (iv) otherwise interfered with or compromised the operations of the Agency and/or the best interests of the people served by the Agency; (b) The Agency will work in partnership with the University to investigate those incidents which result in suspension or removal. The Agency and the University will make good faith efforts to resolve any concerns, but the decision to terminate Practicum will ultimately be that of the Agency. PRIVACY AND CONFIDENTIALITY (a) The University acknowledges that while participating in Practicum, University staff and Practicum Students will have access to Confidential Information and that such information is subject to obligations of privacy and confidentiality including the provisions of FOIPPA. Page 21

22 (b) The University acknowledges and agrees that all Confidential Information is deemed to be the property of the Agency and this Agreement does not grant the University staff and/or Practicum Students any authority to use, disclose, collect or retain Confidential Information except to the extent strictly required for participation in the Practicum. Without limiting the foregoing, in no case will Practicum Students or University Staff be permitted to retain or remove records in the custody of the Agency without the express written consent of Agency staff. (c) The University agrees: (i) to immediately report to Agency staff any breaches or potential breaches of any Agency policy respecting privacy or confidentiality and provide assistance and cooperation with any investigation conducted by the Agency into such breach; and (ii) upon request, to immediately return any Agency records or Confidential Information in the possession of the University and exercise due diligence to facilitate the return of any Confidential Information in the possession of the University staff or Practicum Students. (d) The University acknowledges that this Agreement requires the University to disclose personal information of Practicum Students and contact information of University staff to the Agency. The University shall obtain all necessary consents from Practicum Students and University staff to permit such disclosures. (e) The Agency will protect the personal information of Practicum Students and University staff that is in the custody and control of the Agency in accordance with FOIPPA. AGENCY The Agency will make available to the student and the University the Agency s rules and all applicable safety regulations. UNIVERSITY The University will ensure the students are aware that they are obliged to comply with the Agency s rules and all applicable safety regulations, as well as perform without payment those duties assigned by the Agency in consultation with the University s representatives. SUPERVISION The student will be supervised by an approved Agency Mentor/Field Education Instructor, and will report to their assigned VIU Practicum Instructor responsible for the student s practicum course evaluation. The agency is the primary supervisor of the student while onsite at practicum. The Agency agrees that it will not require the student to perform any task unless such task might reasonably be expected to be within the scope of the student s training and abilities. SITE SAFETY ORIENTATION The Agency will provide to the student, site and work specific safety training and will not permit the student to perform any duties, unless the student has all safety equipment required for the tasks to be performed by the student. Page 22

23 ACCESS The Agency agrees to allow the University s representatives to have access during normal operating hours. STUDENT PRACTICUM EVALUATIONS The Agency shall at the request of the University evaluate the student in the performance of his/her duties and report that evaluation on the form provided by the University. WORKERS' COMPENSATION ACT INJURY COVERAGE A student in a practicum placement at a standard work site within British Columbia is covered by the WorkSafe BC and is considered to be workers of the Government of the Province of British Columbia for Workers' Compensation purposes only. This does not apply to work based practicums where students will normally be covered by the employer. Students in placements outside the province of British Columbia are not covered by WorkSafe BC, however, VIU has coverage against liability and loss under the University, College, and Institutes protection plan (UCIPP). NOTICE OF INJURY The Agency will, if the student is injured, immediately report the occurrence of injury to the University by contacting the Health and Safety Services Department at The injury will also be reported to the Practicum Supervisor and the VIU Instructor. INDEMNITY The University shall indemnify and save harmless the Agency from and against all claims, demands, losses, damages, judgments, costs, liability, expenses (including reasonable legal fees and expenses), actions and other proceedings made, incurred, sustained, brought, prosecuted or threatened to be brought or prosecuted that are based upon, occasioned by or arising out of any act or omission, error, deed or other matter on the part of the University, University employees, or students arising out of this Agreement, excepting always liability arising from the independent negligence of the Agency, Agency employees or anyone for whom the Agency is responsible at law. The Agency shall indemnify and save harmless the University from and against all claims, demands, losses, damages, judgments, costs, liability, expenses (including reasonable legal fees and expenses), actions and other proceedings made, incurred, sustained, brought, prosecuted or threatened to be brought or prosecuted that are based upon, occasioned by or arising out of any act or omission, error, deed or other matter on the part of the Agency, Agency employees or anyone for whom the Agency is responsible at law for arising out of this Agreement, excepting always liability arising from the independent negligence of the University, University Staff, or Students. INSURANCE The University agrees to maintain liability coverage of no less than $5,000, (Cdn) to cover claims brought against the University, University employees or students who are involved in the Practicum for injury to or death of a person or damage to or loss of property caused by any Page 23

24 negligent act or omission of the University, University employees, Students, while in attendance at the Agency work site. The Agency agrees to maintain comprehensive third party liability insurance of no less than $2,000,000 (Cdn) per occurrence, and maintain malpractice and/or professional liability insurance of no less than $2,000,000 (Cdn) per occurrence covering claims brought against the Agency, Agency employees or anyone for whom the Agency is responsible at law who are involved in the Practicum for injury to or death of a person or damage to or loss of property caused by any negligent act or omission of the Agency, Agency employees or anyone for whom the Agency is responsible at law. CONFIDENTIALITY The Parties agree to maintain in the strictest confidence, information that comes to their knowledge during the practicum experience. FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT (BRITISH COLUMBIA) (FOIPPA) All records and personal information (as defined in the Act) received, collected, created, used, disclosed, and disposed of by the University as a result of this agreement are subject to the provisions of this Act. Page 24

25 Appendix V Sample Student Evaluation Form Page 25

26 SOCIAL SERVICES STUDENT EVALUATION PRACTICUM MENTOR S EVALUATION Practicum Student: Placement: Mentor: Dates: From: To: Please provide a brief description of what your practicum entailed, using your learning goals as a framework from which to comment. (This portion of the form is to be completed by the student): Page 26

27 INITIATIVE SHOWN IN WORKING TOWARDS ATTAINMENT OF STUDENT S GOALS AND OBJECTIVES (LEARNING PLAN) needs work satisfactory well done NA The student demonstrates initiative and leadership in identifying and meeting their learning goals. The student uses supervision appropriately by seeking and accepting professional guidance, when needed. Comments: ETHICAL PRACTICE needs work satisfactory well done NA The student is able to establish clear professional boundaries between themselves and their clients and colleagues. The student relates to clients, staff and the public in a respectful and non judgmental manner. The student understands the importance of confidentiality and uses discretion in handling sensitive information. Comments: Page 27

28 RESPONSIBILITY AND ACCOUNTABILITY needs work satisfactory well done NA The student attends their practicum punctually and regularly, keeping to her/his committed schedule. The student informs the staff when they are unable to attend practicum due to illness or unforeseen circumstances. The student demonstrates sound judgment and common sense. The student understands her/his own limitations and adapts appropriately. The student follows agency policies and procedures. The student effectively carries out their learning plan that has been collaboratively developed with the mentor Comments: COMMUNICATION needs work satisfactory well done NA The student is able to develop relationships and establish rapport with clients and staff. The student is clear in their verbal communication and uses basic communication skills (e.g., empathy, questioning, attending, reflecting). The student is clear in their written communication. The student understands the importance of accurate and complete documentation. Comments: Page 28

29 TEAM BUILDING needs work satisfactory well done NA The student establishes positive and appropriate relationships with: clients team members other staff The student demonstrates a professional attitude with colleagues using tact, discretion, and flexibility. The student functions effectively as a team member and listens openly to others ideas. Comments: PROBLEM SOLVING SKILLS needs work satisfactory well done NA The student contributes ideas and solutions The student is able to assess a situation or client need and identify a plan of action to meet/resolve the situation or need. The student uses feedback in a constructive manner. Comments: Page 29

30 AGENCY FAMILIARITY needs work satisfactory well done NA The student has an understanding of their practicum agency, including its policies and programs. Comments: 2. What do you consider to be the major strengths of this student? 3. Any suggested areas for growth or further improvement? (i.e. Are there suggestions you could make to this student that would help them become more job ready?) Page 30

31 Mentor Signature: Student Signature: Date: Date: Thank you very much for mentoring this student and for completing this evaluation. Page 31

32 Appendix VI Website References Organizations, Ethics, Standards BC College of Social Workers Accessed January 4, 2016 BC Association of Social Workers (BCASW) Accessed January 4, 2016 Canadian Association of Social Workers (CASW) acts.ca/ Accessed January 4, 2016 Code of Ethics/Standards of Practice from BC College of Social Workers area/standards practice.htm Accessed April 17, 2012 British Columbia Laws Social Workers Act [SBC 2008] CHAPTER 31 Accessed January 4, 2016 Copyright (c) Queen's Printer, Victoria, British Columbia, Canada Freedom of Information and Protection of Privacy Act [RSBC 1996] CHAPTER Accessed January 4, 2016 Copyright (c) Queen's Printer, Victoria, British Columbia, Canada Page 32

33 Appendix VII Policies & Information on Safety Driving Clients Field placement experience is an important and integral part of student learning. The Social Work Department recognizes that the work that we do can place us at some risk to our safety. Every effort has been made to identify potential sources of risk and to provide you with clear direction on the policies and procedures that are in place to minimize the risks to you. STUDENTS DRIVING CLIENTS: VIU students must adhere to both the field placement agency and VIU policies with respect to the use of vehicles during practicum placement. VIU students are not permitted to use their own vehicles to transport clients under any circumstance. In some situations students may be eligible to drive an agency vehicle during the course of their field placement duties. In this instance the vehicle driven must have insurance coverage through the agency for transporting agency services users and/or staff, AND VIU students must be explicitly covered by this insurance policy. In such cases, the affiliation agreement between VIU and the organization must be amended to include the agency insurance policy information specific to student coverage to drive while on practicum. Students must consult with the Practicum Coordinator and agency for any additional clarification PRIOR to beginning the student practicum and may not transport others while engaged in placement related activities until the necessary liability coverage and documentation is in place. If the agency service user is a minor, then parental/guardian written consent must also be obtained. The student must inform his or her Field Instructor/mentor each and every time when a client will be in their vehicle, identify the route that will be taken and the length of time to the destination. Should there be an accident or incident while driving a client, the student must immediately make a report to: i. The Field Instructor from your practicum site ii. iii. The SSER instructor At this point the Faculty Filed Liaison will inform VIU s, Health and Safety Services, as well as the Associate Dean of the Faculty of Health & Human Services. The student will not drive clients until further notice. Hhsall\hsprac\sser\Mentor Supervisor Guide for SSER, Feb 2016.docx Page 33

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