Case Conference Evaluation Form

Name of Student: Date:

Student’s Year in Program: Semester:

1. The presentation was generally well-organized. The speaker included relevant background information
and presented it professionally.

1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

2. The speaker made use of pertinent research findings (e.g., EBBP, other reference to literature) and
current literature regarding psychopathology and treatment/assessment in supporting their assertions.

1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

3. The speaker made use of data (multiple sources) to illustrate presenting problem, response to treatment,
clinical decision making.
1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

4. The speaker successfully integrated all aspects of this case, such as background information, presenting
problem, diagnostic interviews, interactions with patient, and testing results (if applicable).

1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

5. The speaker clearly presented a well-supported case formulation.

1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

6. The speaker fielded questions well.

1 2 3 4 5
far below below meets above far above
expectations expectations expectations expectations expectations

Overall Evaluation Comments:

Pass
High Pass
Fail

Evaluator’s Signature: