a diary

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

internship diary

________________________________

 

(type of practicum: educational internship, on-the-job training)

 

Student of medical faculty

 

 

            Student’s Full Name ______________________________

                                                                                                              Surname, first name, patronymic (if any)

 

            Specialty ________________________________

               

               

            Year of study_________________Group_______________

                                     

               

 

 

 

 

Practicum Instructions

 

Student’s Full Name ______________________________________________________

                                                               Surname, first name, patronymic (if any)

 

is assigned to _______________________________________ practical training

 (type of practical training: filed, hospital)

in _________________________ _______________________________

                            city                                                                        hospital

 

Duration of practical training from_________________________till______________________________

 

 

Manager (UlSU)

__________________________________________________________________________________

 

 

 

seal here                           Dean of the department_____________________

                                                                                                                                                                    (signature)

 

 

seal here                             Arrived at hospital

 

                                             «_____»______________________20______г._____________________

(signature)

 

 

Preceptor

______________________________________________________________________

(position held, surname, first name and patronymic)

 

is assigned ___________________________________________________

(Order number, date)

 

 

seal here                               Left hospital

 

                                             «_____»______________________20______г._____________________

(signature)

 

 

 

resource pack of information

Basic provisions for practical training

 

Before practical training the Manager (UlSU):

  • instructs the students;
  • gives each student an internship diary, personal tasks for practical training and two copies of practical skill list per group (one for students and one for the preceptor).

 

On arrival at the place of internship the student is obliged:

  • to come to the organization where he/she is to do an internship strictly in accordance with the terms of practical training and the order of the rector;
  • the student who voluntarily changed the place of internship is considered to be absent;
  • to meet the person who is responsible for practical training at the organization;
  • to submit a health permit to practical training;
  • to submit a program of practical training and a practical skill list;
  • to get an understanding of the workplace and equipment operating rules;
  • to get through workplace-related training;
  • to set up a schedule, which should be held at the place of work.

 

During the internship, the student is obliged:

  • to comply fully with the rules of internal regulations of the organization where the practical training is held;
  • to leave the workplace, only after notifying the Preceptor and the Manager (UlSU);
  • to submit an internship diary for review on demand of the Preceptor/ Manager (ULSU); the diary is the main student’s document during the practical training, he/she should write down all the work performed, in accordance with the program of practical training; the diary is held at the workplace;
  • during practical training, the student is obliged to master at least 80-90 % of the practical skills specified by the program of practical training;
  • to follow the rules of deontology;
  • to participate in scientific and rationalization activity in accordance with the personal task.

 

Internship results summarizing:

At the end of the practical training, the student is obliged to submit a completed internship diary and records on the practice for signature to the Preceptor and the Group manager, who also write a final report and evaluate the training practice results.

The report on the practical training and submission of the internship diary are held at the Department immediately on completion of internship. Then the student is to submit his/her internship diary and records to the Department.

A student who has not completed the internship program, or received a negative feedback about his/her work, or interrupted it without permission, or received a low grade, is sent to practical training again or can be expelled from the institution because he/she has unfulfilled program requirements as written in local University regulations.

The graded test (differential pass-fail exams) is considered to be the end-of-the-course result. Training practice grade is taken into account when summarizing the overall student’s performance.

 

II. General rules for keeping the internship diary

 

1. The internship diary is the main student’s document during the internship.

2. During practical training, the student briefly writes down in his/her internship diary everything that he/she has done over a certain period of time and describes the completion of practical training program and personal tasks.

3. The student is to submit an internship diary for review on demand of the Preceptor/Manager (ULSU). The Preceptor and Manager (ULSU) sign the internship diary, make their comments and give students additional tasks.

4. On completion of internship the internship diary and the report should be reviewed by the Preceptor/ Manager (ULSU). The Preceptor and Manager (ULSU) also write a final report and sign the internship diary.

 

 

 

Work schedule (plan) and internship dates

Work period

Student’s work place

 

Department:

 

 

 

 

 

 

 

 

 

R&D abstract topic

 

 

 

 

 

 

 

 

 

Work in diagnostic (imaging) rooms

 

 

 

 

 

 

 

Duty shifts:

 

 

 

 

 

 

 

 Signature:

 

 Manager (UlSU)                   _________________________________ 

 

 Preceptor                              _________________________________

 

Personal tasks for practical training

 

The content of the personal task and the anticipated results

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Signature:

 

 Manager (UlSU)                   _________________________________

 

Approved:

 Preceptor                              _________________________________

 

 

 

I have read and acknowledged the internal regulations, requirements of labor protection, safety and fire safety in _____________________________________________________________

(the name of the organization and the workplace)

_______________________________________________________

 

Student ___________________________________________

(signature, name, date)

The briefing was conducted by the Preceptor _____________________________________________________________

(signature, name, date)

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF PRACTICAL SKILLS, WITH THE LEVEL OF DEVELOPMENT

 

Practical skill

Observed

Assisted

Performed independently

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

 

  1.  

 

 

 

 

 

 

LIST OF PRACTICAL SKILLS, WITH THE LEVEL OF DEVELOPMENT

 

Practical skill

Observed

Assisted

Performed independently

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

 

 

 

Preceptor review on student’s internship

 

Practical skills are fully, incompletely or partially mastered.

(underline as applicable)

 

The rules of deontology are fully, incompletely or partially mastered.

(underline as applicable)

Preceptor

 

Signature ______________

Surname, first name, patronymic _____________________________

 

Manager review on student’s internship

 

Theoretical knowledge and practical skills are fully, incompletely or partially mastered.

 

(underline as applicable)

Research work: the student demonstrated such personal qualities as sociability, initiative, responsibility, personal interest

 

Internship reprimands ________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Credit grade _____________________________________________________________

 

«____»_____________________20___г.

 

Manager (UlSU)

 

Signature______________

Surname, first name, patronymic _________________________________

 

«____»_____________________20___г.

 

 

 

 

 

 

 

 

 

 

 

 

 

internship diary

________________________________

 

(type of practicum: educational internship, on-the-job training)

 

Student of medical faculty

 

 

            Student’s Full Name ______________________________

                                                                                                              Surname, first name, patronymic (if any)

 

            Specialty ________________________________

               

               

            Year of study_________________Group_______________

                                     

               

 

 

 

 

Practicum Instructions

 

Student’s Full Name ______________________________________________________

                                                               Surname, first name, patronymic (if any)

 

is assigned to _______________________________________ practical training

 (type of practical training: filed, hospital)

in _________________________ _______________________________

                            city                                                                        hospital

 

Duration of practical training from_________________________till______________________________

 

 

Manager (UlSU)

__________________________________________________________________________________

 

 

 

seal here                           Dean of the department_____________________

                                                                                                                                                                    (signature)

 

 

seal here                             Arrived at hospital

 

                                             «_____»______________________20______г._____________________

(signature)

 

 

Preceptor

______________________________________________________________________

(position held, surname, first name and patronymic)

 

is assigned ___________________________________________________

(Order number, date)

 

 

seal here                               Left hospital

 

                                             «_____»______________________20______г._____________________

(signature)

 

 

 

resource pack of information

Basic provisions for practical training

 

Before practical training the Manager (UlSU):

  • instructs the students;
  • gives each student an internship diary, personal tasks for practical training and two copies of practical skill list per group (one for students and one for the preceptor).

 

On arrival at the place of internship the student is obliged:

  • to come to the organization where he/she is to do an internship strictly in accordance with the terms of practical training and the order of the rector;
  • the student who voluntarily changed the place of internship is considered to be absent;
  • to meet the person who is responsible for practical training at the organization;
  • to submit a health permit to practical training;
  • to submit a program of practical training and a practical skill list;
  • to get an understanding of the workplace and equipment operating rules;
  • to get through workplace-related training;
  • to set up a schedule, which should be held at the place of work.

 

During the internship, the student is obliged:

  • to comply fully with the rules of internal regulations of the organization where the practical training is held;
  • to leave the workplace, only after notifying the Preceptor and the Manager (UlSU);
  • to submit an internship diary for review on demand of the Preceptor/ Manager (ULSU); the diary is the main student’s document during the practical training, he/she should write down all the work performed, in accordance with the program of practical training; the diary is held at the workplace;
  • during practical training, the student is obliged to master at least 80-90 % of the practical skills specified by the program of practical training;
  • to follow the rules of deontology;
  • to participate in scientific and rationalization activity in accordance with the personal task.

 

Internship results summarizing:

At the end of the practical training, the student is obliged to submit a completed internship diary and records on the practice for signature to the Preceptor and the Group manager, who also write a final report and evaluate the training practice results.

The report on the practical training and submission of the internship diary are held at the Department immediately on completion of internship. Then the student is to submit his/her internship diary and records to the Department.

A student who has not completed the internship program, or received a negative feedback about his/her work, or interrupted it without permission, or received a low grade, is sent to practical training again or can be expelled from the institution because he/she has unfulfilled program requirements as written in local University regulations.

The graded test (differential pass-fail exams) is considered to be the end-of-the-course result. Training practice grade is taken into account when summarizing the overall student’s performance.

 

II. General rules for keeping the internship diary

 

1. The internship diary is the main student’s document during the internship.

2. During practical training, the student briefly writes down in his/her internship diary everything that he/she has done over a certain period of time and describes the completion of practical training program and personal tasks.

3. The student is to submit an internship diary for review on demand of the Preceptor/Manager (ULSU). The Preceptor and Manager (ULSU) sign the internship diary, make their comments and give students additional tasks.

4. On completion of internship the internship diary and the report should be reviewed by the Preceptor/ Manager (ULSU). The Preceptor and Manager (ULSU) also write a final report and sign the internship diary.

 

 

 

Work schedule (plan) and internship dates

Work period

Student’s work place

 

Department:

 

 

 

 

 

 

 

 

 

R&D abstract topic

 

 

 

 

 

 

 

 

 

Work in diagnostic (imaging) rooms

 

 

 

 

 

 

 

Duty shifts:

 

 

 

 

 

 

 

 Signature:

 

 Manager (UlSU)                   _________________________________ 

 

 Preceptor                              _________________________________

 

Personal tasks for practical training

 

The content of the personal task and the anticipated results

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Signature:

 

 Manager (UlSU)                   _________________________________

 

Approved:

 Preceptor                              _________________________________

 

 

 

I have read and acknowledged the internal regulations, requirements of labor protection, safety and fire safety in _____________________________________________________________

(the name of the organization and the workplace)

_______________________________________________________

 

Student ___________________________________________

(signature, name, date)

The briefing was conducted by the Preceptor _____________________________________________________________

(signature, name, date)

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Working records

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF PRACTICAL SKILLS, WITH THE LEVEL OF DEVELOPMENT

 

Practical skill

Observed

Assisted

Performed independently

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

 

  1.  

 

 

 

 

 

 

LIST OF PRACTICAL SKILLS, WITH THE LEVEL OF DEVELOPMENT

 

Practical skill

Observed

Assisted

Performed independently

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

  1.  

 

 

 

 

 

 

 

Preceptor review on student’s internship

 

Practical skills are fully, incompletely or partially mastered.

(underline as applicable)

 

The rules of deontology are fully, incompletely or partially mastered.

(underline as applicable)

Preceptor

 

Signature ______________

Surname, first name, patronymic _____________________________

 

Manager review on student’s internship

 

Theoretical knowledge and practical skills are fully, incompletely or partially mastered.

 

(underline as applicable)

Research work: the student demonstrated such personal qualities as sociability, initiative, responsibility, personal interest

 

Internship reprimands ________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Credit grade _____________________________________________________________

 

«____»_____________________20___г.

 

Manager (UlSU)

 

Signature______________

Surname, first name, patronymic _________________________________

 

«____»_____________________20___г.