Final Clinical Survey

Clinical Experience Survey

This form should be completed at the end of the clinical experience. The below questions are focused on your ENTIRE clinical experience.
Student's Name*

First NameLast Name
Student's Email*
Date submitted

MonthDayYear
Date Submitted*

MonthDayYear
Date
How long did it take you to locate, contract, and receive final approval for your site and/or supervisor?

Less than 6 weeks6-12 weeks12-18 weeks18-24 weeksMore than 24 weeks
How many University faculty supervisors did you have throughout your clinical experience?
How many Local Clinical Supervisors did you have throughout your clinical experience?
Was your Local Clinical Supervisor(s) AAMFT Approved?

YesNoHad multiple; at least one was
How many sites did you have throughout your clinical experience?
Did you engage in telesupervision with your LOCAL supervisor at any time?

YesNo
Did you engage in teletherapy at any time?

YesNo
Which University Clinical Courses did you take?

Practicum IPracticum IIInternship IInternship IICapstoneInternship IIIInternship IVInternship VInternship VIOther

Please indicate if you took advantage of any of the below resources:

Rows	YES	NO	UNSURE
CPP Q & A
One-on-One meeting with a member of the Clinical Administrative Team
Tips Sheets in MFT Clinical Support module (NCU One)
Reach out or Resume template in MFT Clinical Support module (NCU One)
Theoretical Resources in MFT Clinical Support module (NCU One)
Course Resources in MFT Clinical Support module (NCU One)
Clinical Development Committee (CDC) meeting

List 2-3 parts of the clinical experience that you found most helpful to your development as a MFT. What helped you grow?
List any issues that seemed to be barriers to your development during the clinical experience. What were challenges you faced?
What are your reflections of telesupervision with your LOCAL supervisor (pros, cons, benefits, challenges)?
What are your reflections of teletherapy (pros, cons, benefits, challenges)?

Please indicate your perceived level of competence in the following areas:

Rows	Not Competent	Somewhat Competent	Competent	Very Competent
Working with diverse populations in clinical settings.
Applying family systems oriented clinical skills across a variety of contexts.
Contrasting family systems theory oriented models of therapy.
Formulating a decision-making process for ethical dilemmas congruent with the AAMFT Code of Ethics.
Using the supervision process for the development of MFT clinical competence.

Please consider these two questions. What advice would you give to students who haven't started their clinical experience yet? What advice would you give to students on Day 1 of their clinical experience?
Do you plan on continuing your work with your supervisor post-graduation?

YESNOUNSURE
What are your plans for employment post-graduation?

Stay with site as hired post-graduatePursuing clinical position at different sitePursuing non-clinical position
Do you plan on pursuing another degree (e.g., PhD, Masters, Certificate)?

YESNOUNSURE
Related to licensure (check all that apply):

I have applied for limited or full licensureI am scheduled to take the exam(s)I have taken the licensing exam(s)I passed the exam
What state(s) do you plan on getting licensed in? If none, type N/A.
Do you plan to become an AAMFT supervisor in your state?

YESNOUNSURE
Please share any additional feedback or comments here:
Should be Empty:

Clinical Experience Survey