EVALUATION OF ATU SUPPORT AND SUPERVISION FORM

By Mentor Teachers (Field-Based Supervisors & CPIs)

Check the descriptor that applies:

________ Clinical Practice Instructor (CPI)

________ Field-Based Supervisor

Please rate each item below according to the following scale:

1 = Not Rated, 2 = Lowest Rating, 5 = Highest Rating

1. I was treated like a professional by university support staff and supervisors.	1 2 3 4 5
2. I was given a clear vision of the process of internship and my mentoring role.	1 2 3 4 5
3. University supervisors were accessible and available for discussions, conferences, resources, etc., especially when concerns arose.	1 2 3 4 5
4. University supervisors provided effective leadership and modeled clinical supervision.	1 2 3 4 5
5. University supervisors modeled appropriate communication and interpersonal skills while working with CPIs, interns and administrative personnel.	1 2 3 4 5
6. University supervisors provided guidance for specific experiences for the intern (techniques, methods, procedures) as needed.	1 2 3 4 5
7. University supervisors established a good relationship with you as a professional equal.	1 2 3 4 5
8. University supervisors communicated information from and to ATU effectively.	1 2 3 4 5
9. University supervisors were knowledgeable of curriculum, students at this level, and the demands on schools.	1 2 3 4 5
10. University supervisors provided additional resources when needed.	1 2 3 4 5

What would make ATU’s support and supervision more effective and useful to you?