Supervisory Candidate Certification Interview Assessment
DATE REVIEW COMPLETED
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
NAME OF APPLICANT
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First Name
Last Name
NAME OF THE REVIEWER
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First Name
Last Name
List Names of Additional Reviewers (Click + to add Additional Ones)
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Review each of the items below and state whether the candidate has met the requirements: Rate: 5-Strongly agree; 4-Agree; 3-Neutral, 2- Disagree; 10Strongly Disagree
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SC:1.1: Demonstrated an awareness of one's identity as a pastoral supervisor-educator.
SC:1.2: Articulated knowledge of key resources used in pastoral supervision, i.e., supervisory literature, ethical issues, and self-care resources.
SC:1.3: Demonstrated knowledge of a theory of human development (personality) and the ability to integrate insights of the theory into the practice of pastoral supervision.
SC:1.4: Demonstrated knowledge of an adult learning theory and the ability to insights of theory in the practice of pastoral supervision.
SC:1.5: Demonstrated knowledge of group dynamics and the ability to integrate insights into the practice of pastoral supervision.
SC:1.6: Articulated an awareness of multicultural issues and the ability to integrate insights into the practice of pastoral supervision.
SC:1.7: Articulated one's theology and the ability to integrate insights into the practice of pastoral supervision.
SC:1.8: Demonstrated knowledge of ethical issues in pastoral supervision and the abiity to address these in pastoral supervision.
SC:1.9: Demonstrated the ability to use critical relationships for consultation and support.
SC:1:10: Demonstrated an awareness of student learning needs and how to adequately evaluate their learning.
SC:1:11: Articulated one's self-care practices.
SC:1:12: Articulated the ability to effectively use Populi and an awareness of CPEI program management and administration.
SC:1:13: Demonstrated oral and written competency, reflecting graduate-level work, including the use of APA, Turabian, or a similar format.
SC:1:14: Presented in a professional manner which included non-defensive behavior, an awareness of self, appropriate attire and confidential setting for the review.
Type a question
Select One Below: (A Fee is assessed for each review. Review CPEI's Certification Guidance for Non-Approval Status).
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70-56: Passed without comments.
55-40 Provisional Certification: The applicant must schedule a follow-up meeting with the Certification Committee within the year to address the concerns identified.
39-Below: Did not pass with comments. The applicant must schedule a follow-up meeting with the Certification Committee within the year to address the concerns identified.
Comments and/or Recommendations
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Candidates that Successfully Met the Review Committee will be assigned the following CPEI Mentor.
Did the candidate agree to these terms?
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