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PRACTICE EXPERIENCE (Internship) REQUIRED FORMS 2008-09

Community Health Practice Experience

and Master of Science in Public Health (MSPH) Research Project


ATTENTION: Be sure you have received approval from the faculty Practice Experience Advisor (PEA)
for your concentration for your practice experience preceptor and site
before completing forms or beginning your experience. 
If you have questions, contact Catherine Nolan nolanca@slu.edu or 314-977-8220.

Practice experience paperwork should be returned to Catherine Nolan, MPH Practice Experience Coordinator, for students' files.
Email to nolanca@slu.edu or bring to Salus Room 472.  Thanks.

Community Health Practice Experience Required Forms

1
 Student Checklist (PDF) (Word)
2 Agreement and Learning Plan (PDF) (Word)
3 Competency to Activity Form (PDF) (Word)
4
Practice Experience Timeline:

  * Timeline Examples (use as guide to complete yours)

    • Sample Full Time Timeline (PDF)
    • Sample Part Time Timeline (PDF)
5

Guided Progress Report (PDF) (Word)

    • Example of Guided Progress Report (PDF)
6
Preceptor Final Practice Experience Evaluation (PDF) (Word)
7

Practice Experince Final Poster Template (submitted as one

   PowerPoint slide)(template) (PPT)

  • Fill in your own information where there are parentheses
  • Guidelines for Final Poster (PDF) (Word)
    • Example of Practice Experience Poster (PDF)

IRB / HIPAA On-Line Training

CITI (Collaborative Institutional
Training Initiative)

https://www.citiprogram.org/default.asp

Register as a new user and proceed
with training at your own pace. 

Training should be completed before
beginning practice experience.

 

HIPAA Information

Practice Experience Supporting Forms (please review)

    • Competencies for the Practice Experience (PDF) (Word)
    • Practice Experience Syllabus  (PDF) (Word)
    • Practice Experience Faculty Advisors 2008-09 (PDF) (Word)
    • Guide for Student Interview of Potential Preceptor (PDF) (Word)
    • Preceptor Expectations Guide (PDF) (Word)

Master of Science in Public Health (MSPH)

Reseach Project

  • Guidelines for MSPH Research Project
    (PDF) (Word)
  • MSPH Research Project Description Form
    (PDF) (Word)