Content Comparison

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Students wishing to secure an employed placement meet with the PHP 667 Instructor to discuss if the placement fulfills the minimum requirements above. The constraints of an employed placement are reviewed, other options are discussed, and a decision on the appropriateness of the placement is made.

Chapter 5: Forms and Documents

Practicum Proposal Document

General Information 

Student Name: 

Practicum Site:

Practicum Location:

Site Supervisor Name:

Site Supervisor Contact Information (email, phone number):

Site Supervisor Title:

Site Supervisor Credentials:

Practicum Arrangements

Start Date:

End Date:

Site Specifics

Agency:

Mission of Agency:

Organizational Structure of Agency:

Agency Programs (short description):

Programs Student Will Be Involved In (list):

Public Health Competencies and Portfolio Products

Identify 5 competencies to be achieved during the practicum and at least 2 portfolio products to be created. Please include a narrative justifying the selected competencies and products, including an explanation of how the selected competencies will be achieved through the practicum work.

Public Health Competencies and Portfolio Products Mapping (competency, number, and product) :  

Student Evaluation – Midterm

 Supervisor Information

Name:

Organization’s Name:

Phone Number:

Email Address:

Student Information

Name:

Evaluation

Please evaluate your graduate intern on the following items. Please indicate a “Pass” if the student was satisfactory for the majority of their time with your organization. Indicate “Fail” if the student needs significant improvement and/or was unsatisfactory for the majority of their time with your organization.

Evaluation Item (Pass, Fail, NA)

1. Student is making steady progress towards completion of all assigned projects.
2. Student is making steady progress towards completion of required practicum hours.
3. Student is engaged in the site activities as an active participant and contributor to the particular project or organizational goals.
4. Student communicates effectively, both orally and written.
5. Student interacts with individuals, groups, and/or communities across diverse setting competently
6. Student respects rights of others and maintains confidentiality

Comments

Please provide any commentary on your evaluation of this student.

Student Evaluation – Final

Supervisor Information

Name:

Organization’s Name:

Phone Number:

Email Address:

Student Information

Name:

Evaluation

Please evaluate your graduate intern based on the following items. Please indicate a “Pass” if the student was satisfactory for the majority of their time with your organization. Indicate “Fail” if the student needs significant improvement and/or was unsatisfactory for the majority of their time with your organization.

Evaluation Item (Pass, Fail, NA)

1. Student actively worked towards completion of all assigned projects.
2. Student actively worked towards completion of required practicum hours.
3. Student was engaged in the site activities as an active participant and contributor to the particular project or organizational goals.
4. Student communicated effectively, both orally and written.
5. Student interacted with individuals, groups, and/or communities across diverse setting competently
6. Student respected the rights of others and maintains confidentiality

Comments

Please provide any commentary on your evaluation of this student.

Applied Practice Experience Portfolio Rubric

Name:

Required Elements

Mark the areas below as  Satisfactory, Minimally Satisfactory or Unsatisfactory. Also add any comments.

Cover Page:

Table of Contents:

Mapping Document:

Reflection (includes title, aims/goals for the experience, and significance of work):

Product 1 (CEPH Competency #):

Product 2 (CEPH Competency #):

Organization, Spelling, Grammar, Format (organized per instructions with APA format, free of spelling and grammatical errors ):

Approved: ____
Revisions needed: ___

Competency/Pass:  Students must earn a rating of ‘satisfactory’ or ‘minimally satisfactory’ in all.   Revisions are required for students who fail to meet these expectations.

AppendixAppendix

Forms and Documents for APE can be found on the APE Milestone Blackboard Organization, of which all MPH students have access.

PHP 667: Graduate Practicum in Public Health (Graduate Course Syllabus)

Instructor:
Email:
Phone:
Office:
Office Hours:

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