CPE SUPERVISOR EVALUATION OF STUDENT - CPE 100
This evaluation is a confidential document containing observations and reflections of the student named above and their educational experience during this course of Clinical Pastoral Education. It will only be released with the student’s written permission. This evaluation should be read in conjunction with the student’s final self-evaluation in order to receive a full picture of the educational process. which was engaged.
Student:
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First Name
Last Name
Email
example@example.com
Supervisor/Educator
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First Name
Last Name
CPE Course Dates
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CPE Center ID #
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Student Membership #
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IACET CEUs Awarded
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Introduction of Student
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Student's Internship Assignment
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CPE Program Description
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Student's Learning Goals
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Peer Group
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Student's Accomplishment of Learning Outcomes
Exemplary (Exceeded) - Competent (Met) - Developing -(Making Progress) - Beginning
CPE 101: To identify concepts in self that influence one’s pastoral care.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 102: To describe the elements of an initial pastoral visit
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 103: To recognize specific cultural, gender, and spiritual needs among individuals and groups.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 104: To describe personal and professional challenges and growth opportunities in the group and individual supervision.
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10-Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 105: To identify a variety of spiritual assessment options.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 106: To define the difference between embedded and deliberative theology.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 107: To define personal and pastoral authority and the impact it has on one’s ministry.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 108: To identify critical ethical/medical issues in pastoral care and the role of pastoral advocate.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 109: Effectively accesses one’s peer group for consultation and support.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9.0-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
CPE 110: Effectively accesses one’s CPE Supervisor/Educator for consultation and support.
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10- Exceeded the learning outcome.
9.5-Nearly exceeded the learning outcome.
9-Met the learning outcome.
8.5-Nearly met the learning outcome.
8.0-Making progress toward the learning outcome.
7.5-Making some progress toward the learning outcome.
7.0-Beginning to meet the learning outcome.
Comment
Total Score
Grade
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100-96.0 A+
9.5-91.0 - A
9.0-84.0 -B+
8.5-81.0- B
8.0-76.0 B-
7.5-71.0 C+
7.0- C
Final Comments
Summary
This evaluation reflects the student's ability to engage the standards, objectives, and expected outcomes for Clinical Pastoral Education as set forth by the Standards for Clinical Pastoral Education International (CPEI). The student has had the opportunity to review this final evaluation and is free to add an addendum to this document. This document will be on file with the center for seven years in accordance with CPEI Standards and will not be released to anyone without permission. Site members for CAPE accreditation may have access to confirm compliance with policies.
Certification
I certify the student has successfully met the requirements for one course of Clinical Pastoral Education as certified by Clinical Pastoral Education International (CPEI). This evaluation should be read in conjunction with the student’s final self-evaluation in order to receive a full picture of the educational process which was engaged.
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