CPE Internship Coordinator Assessment
You are requested to provide an assessment regarding the development of the CPE Intern.
Date
*
-
Month
-
Day
Year
Date
Internship Coordinator
*
First Name
Last Name
Internship Coordinator Email
*
example@example.com
CPE Student
*
First Name
Last Name
CPE Student's Email
*
CPE Supervisor-Educator
*
First Name
Last Name
CPE Supervisor-Educator Email
*
Rate the CPEI Intern using the scale: 5=Strongly Agree; 4=Agree; 2=Disagree; 1+ Strongly Disagree. Feel to add comments, but not necessary.
*
5
4
2
1
Comments
The CPE Intern demonstrated the ability to recognize personal issues that could potentially affect one's pastoral care.
The CPE student demonstrated sensitivity to diverse populations such as gender, race, religion, etc.
The CPE Intern demonstrated the ability to establish a meaningful and collaborative relationship with patients, clients, staff, etc.
The CPE student demonstrated the to track with patients, clients, staff, or others by using open-ended questions and listening for conversational themes.
The CPE student demonstrated the ability to be a compassionate presence to family and staff during the death and dying process.
The CPE student demonstrated the ability to share pastoral or spiritual assessments with interdisciplinary or ministry staff while maintaining appropriate confidentiality.
Comments (Feel free to share additional comments).
As the Internship Coordinator, I verify the student met the required hours for this course of CPE.
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