Health Education Responsibilities and Competencies Evaluation Form University of Cincinnati MPH Program. Student's Name: Date:
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1 Attachment F Health Education Responsibilities and Competencies Evaluation Form University of Cincinnati MPH Program Student's Name: Date: Internship Site (Name of Agency/Organization): Site Supervisor's Name: RETURN THIS FORM TO: Keith King, kingkt@ucmail.uc.edu MPH Practicum Coordinator Health Promotion and Education Program PO Box University of Cincinnati Cincinnati, OH RETURN THIS FORM BY THE END OF FINALS WEEK Evaluate the student intern on each of the competencies on the following page as compared to other entry level health education professionals with whom you have worked. If you do not feel you have the information to evaluate any given indicator, circle the not applicable (N/A=0) column. 5 = Excellence - Student is consistently demonstrating this skill at a level well above that of most entry-level professionals. Outstanding work - there is little room for improvement in this area. 4 = Proficiency - Student is usually demonstrating this skill at a level better than that of most entry-level professionals. Very good, high quality work. 3 = Adequacy - Student is frequently demonstrating this skill at a level consistent with that of most entry-level professionals. Average work 2 = Below Average/Limited Student is only occasionally demonstrating this skill at a level consistent with that of most entry-level professionals. Significant improvement needs to occur. 1 = Deficiency - Student is rarely or never demonstrating this skill at a level consistent with that of most entry-level professionals. Unacceptable work 0 = N/A = Not Applicable - Unable to make a determination of a student s skills related to a given indicator.
2 Area I: Assess Individual and Community Needs for Health Education Competency A: Access Existing health-related data Competency B: Collect health related data Competency C: Distinguish between behaviors that foster or hinder well-being Competency D: Deter mine factors that influence learning Competency E: Identify factors that foster or hinder the processes of health education Competency F: Infer needs for health education from obtained data Area II: Plan Health Education Strategies, Interventions and Programs Competency A: Involve people and organizations in program planning Competency B: Incorporate data analysis and principles of community organization Competency C: Formulate appropriate and measurable program objectives Competency D: Develop a logical scope and sequence plan for health education practice Competency E: Design strategies, interventions, and programs consistent with specified objectives Competency F: Select appropriate strategies to meet objectives Competency G: Assess factors that affect implementation Area III: Implement Health Education Strategies, Interventions and Programs Competency A: Initiate a plan of action Competency B: Demonstrate a variety of skills in delivering strategies interventions and programs Competency C: Use a variety of methods to implement strategies, interventions and programs Competency D: Conduct training programs
3 Area IV: Conduct Evaluation and Research Related to Health Education Competency A: Develop plans for evaluation and research Competency B: Review research and evaluation procedures Competency C: Design data collection instruments Competency D: Cary out evaluation and research plans Competency E: Interpret results from evaluation and research Competency F: Infer implications from findings for future health-related activities Area V: Administer Health Education Strategies, Interventions and Programs Competency A: Exercise organizational leadership Competency B: Secure fiscal resources Competency C: Manage human resources Competency D: Obtain acceptance and support for programs Area VI: Serve as a health Education Resource Person Competency A: Use health-related information resources Competency B: Respond to requests for health information Competency C: Select resource materials for dissemination Competency D: Establish consultative relationships Area VII: Communicate and Advocate for Health and Health Education Competency A: Analyze and respond to current and future needs in health education Competency B: Apply a variety of communication methods and techniques Competency C: Promote the health education profession individually and collectively Competency D: Influence health policy to promote health
4 PLEASE COMMENT ON EACH OF THE FOLLOWING AS RELATED TO HEALTH EDUCATION (Use back of page if necessary) Comment on the student s professionalism (dress, attitude toward profession, ethics, dependability, etc.) What are the student s apparent strengths? What areas of improvement are needed by the student? If your agency/organization currently had a health education position open, would you consider hiring this practicum student? Why? Why not?
5 Please list any comments, concerns, criticisms, and/or suggestions regarding the professional preparation of MPH students in the health education concentration.
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