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Program in Nutrition and
Exercise Physiology
(NEP)
CLINICAL EXERCISE
INTERNSHIP MANUAL
2013-2014
Program in Nutrition and Exercise Physiology
Washington State University
College of Pharmacy
P.O. Box 1495
Spokane, WA 99210-1495
Last Revision: November 2013
TABLE OF CONTENTS
Preface…………………………………………………………………………………….
Purpose……………………………………………………………………………………
Preparation for a Clinical Exercise Internship…………………………………………....
BS NEP Advising Checklist…………………………………………………………..
E-Value Account………………………………………………………………………
Acknowledgement of Understanding………………………………………………….
Completion of All Required Didactic NEP Courses…………………………………..
Pre-Internship Process…………………………………………………………………....
Internship Timeline…………………………………………………………………….
Identification of Internship Sites……………………………………………………….
Completion of the Resume and Goals Statement………………………………………
Application Process for an Internship………………………………………………….
Internship Offer………………………………………………………………………..
Acceptance of an Internship……………………………………………………………
Site-specific Requirements…………………………………………………………….
Registration for NEP 490………………………………………………………………
Additional Guidelines for a Clinical Exercise Internship…………………………………
Ethical Standards of Conduct of a Student Intern…………………………………….
Computer Access……………………………………………………………………...
Communication with University Personnel……………………………………………
Expectations of the Internship Preceptors …………………………………………....
Communication with the Internship Preceptor ……………….……...………………..
Internship Reassignment Process……………………………………………………....
Sexual Harassment………………………………………………………..……………
Requests for Accommodations………………………………………………………...
Assessment of the Student During the Clinical Internship………………………………..
Internship Reports………………………………………………………………………
Midterm and Final Assessment Forms…………………………………………………
Rating Scale for Midterm and Final Assessments……………………………………..
Student Assessment Forms…………………………………………………………….
Final Grade for a Clinical Exercise Internship…………………………………………
ACSM Clinical Hour Verification Form…………………………………………….....
Information Regarding the ACSM Certification Exam…………………………………..
ACSM Certified Exercise Specialist Exam Requirements…………………………….
ACSM Audit…………………………………………………………………………..
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APPENDICES
Appendix A: Acknowledgement of Understanding……………………………………….
Appendix B: NEP Clinical Exercise Internship Memorandum of Understanding………...
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Appendix C:
Appendix D:
Appendix E:
Appendix F:
New Clinical Exercise Internship Site Request Form………………………...
Description of Clinical Hours ………………………………….…….………
ACSM Certified Clinical Exercise Specialist Clinical Hour Verification……
NEP Assessment Forms………………………………………………………
Preceptor’s Mid-term Assessment of Intern………………………………….
Preceptor’s Final Assessment of Intern………………………………………
Student’s Assessment of NEP Curriculum and Internship…………………...
Student’s Assessment of Internship Preceptor and Internship Site…………..
Preceptor’s Assessment of the Program’s Academic Preparation
of the Student…………………………………………………………………
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Appendix G: NEP 490 Clinical Competency List…………………………………………..
Appendix H: Clinical Internship Case Study…………………………………………..……
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
PREFACE
The BS in Nutrition and Exercise Physiology (NEP) at Washington State University (WSU), College of
Pharmacy, has as its central and unique focus the preparation of students for exercise-and-nutrition-related
careers in disease prevention, and rehabilitation, as well as corporate, private health and fitness industries. In
addition, it provides students with the basic scientific preparation necessary for the pursuit of advanced
degrees in exercise, nutrition, and other allied health fields.
An important aspect of a students’ professional course work is the supervised clinical exercise internship
experience. The internship is designed to provide the students with the knowledge and skills required for a
lifetime of responsible service in their desired profession. Students must complete a minimum of 400 clinical
hours to satisfy the requirements for the internship, which can only be done after satisfactory completion of
all didactic coursework required for the BS NEP degree.
During the internship, each student works under the supervision of a clinical Internship Preceptor at an
approved Internship site Students are strongly encouraged to actively be involved in their own learning to
gain the most from the internship. Assessment forms have been developed to facilitate this learning process.
Additionally, each student will have an opportunity to assess the Internship Preceptor, the Internship Site,
and the didactic program. This constructive feedback guides future improvement in these learning
experiences and of the Program in Nutrition and Exercise Physiology.
The NEP Clinical Exercise Internship Manual, hereinafter called the Internship Manual in this document, is
intended to provide guidelines for a clinical exercise internship. It will assist the NEP Clinical Internship
Coordinator, hereinafter called the Internship Coordinator, the student, the Internship Preceptors, and other
WSU NEP faculty in understanding the purpose and logistics of the internship experience and the policies
and procedures that govern each party’s responsibilities.
PURPOSE
Specific purposes of the NEP clinical exercise internship for the student, the Internship Site, and WSU are to:
1. Provide the student with experiences upon which to build his/her professional career; to make
practical application of theories and techniques; to bring the student into contact with
practitioners; to provide an opportunity to discover and evaluate professional strengths and
weaknesses; to improve the student’s professional preparation; and to offer entry into the work
place or graduate school;
2. Broaden the student’s concepts of health, wellness, physical fitness, exercise physiology,
nutrition, and medical fields, and to provide experiences that will enhance the student’s practical
knowledge of the fields of exercise physiology, nutrition, rehabilitation, medicine, and/or allied
health;
3. Offer the Internship Preceptor an opportunity to share in the education and preparation of a
young professional;
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4. Establish and enhance communication between the Internship Site and WSU in order to facilitate
problem solving, sharing of knowledge, mutual understanding of each others’ programs, and
employment opportunities;
5. Provide WSU (in collaboration with the Internship Preceptor) with a practical setting for
assessing the student’s preparation and performance; and
6. Enable NEP faculty to appropriately update and revise the curriculum based on feedback from
the Internship Preceptors and student interns.
PREPARATION FOR A CLINICAL EXERCISE INTERNSHIP
The following are requirements that the student must complete prior to applying for an internship. These
requirements are in addition to any site-specific onboarding requirements, which are listed in E-Value.
A. BS NEP ADVISING CHECKLIST
The BS NEP ADVISING CHECKLIST should be completed prior to the beginning of the junior and
senior year (see the NEP Undergraduate Student Handbook: BS NEP Advising Checklist). It is the
responsibility of the student to provide documentation of all the requirements (trainings,
immunizations, criminal background check, professional liability insurance, etc.) to the NEP
Program Academic Coordinator during the NEP Fall Orientation session. Additionally, it is the
student’s responsibility to monitor his/her E-Value account regularly to confirm that all information
is accurate and up-to-date. Verification of these completed requirements will be accessible in the EValue Immunization and Certification (Immuns & Certs) tracking section under the My Profile icon.
If there is an error or the student has any questions about these requirements, he/she should make an
appointment with the NEP Program Academic Coordinator or the Experiential Program Assistant for
assistance. A student cannot apply for an internship until these requirements have been met. By not
completing all the requirements by the deadline, the student risks delaying the start of an internship
for another semester (see the “Internship Timeline” in the following section). The following
requirements MUST be current throughout the entire length of the internship:
•
•
•
•
•
•
Criminal background check
Professional liability insurance
Immunizations
CPR w/AED, first aid
Blood-borne pathogen training
HIPAA training
If any requirement lapses during the internship, the Experiential Program Assistant will notify the
Internship Coordinator who will then notify the Internship Preceptor; the internship will be
suspended until the requirement has been updated. However, the Internship Site and/or Internship
Preceptor are under NO obligation to continue the student’s internship once suspended. If the
Internship Site terminates the internship, the student will receive an incomplete for the internship and
will be required to complete another 400-hour internship.
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B. E-VALUE ACCOUNT
The student will be given E-Value account information and access during his/her senior year
orientation. This all-in-one account will help simplify processes and procedures, and help the student
to have an optimal internship experience. It is the responsibility of the student to keep contact
information accurate and current in the E-Value account at all times.
The student will have access to the following in his/her E-Value account:
1. Home Page: The Home page will be utilized for announcements to the student and student
access to specific documents such as:
•
•
•
•
•
2.
NEP Clinical Exercise Internship Manual
New Clinical Exercise Internship Site Request Form
Link to SignUp Genius
Memorandum of Understanding
Acknowledgment of Understanding
Schedules: The Schedules icon is where the student will be able to check and confirm
his/her final internship placement. To access placement:
•
•
•
•
•
•
Click on the “Schedules” icon
Click on “Reports”
Click on “Rosters”
Next to “Curriculum” in the dropdown box, click on “NEP 490”, then “Clinical” with
the appropriate year
Next to “Start Date” enter any date prior to the actual start date of the internship
Click “Next”
3. My Profile: Under My Profile icon the student will be able to access and change personal
contact information, and confirm completion of all WSU NEP requirements.
4. Evaluations: All assessment forms will be available under the Evaluation icon. The student
will be able to access and review the mid-term and final assessments, and complete
assessment forms on the Internship Site, Internship Preceptor, and NEP curriculum.
5. Sites and Affiliations: This section will allow a student to browse through several approved
sites that have finalized Affiliation Agreements. The student will be able to filter the search
for specific geographical areas and/or clinical areas of interest. To access Internship Sites,
follow these steps:
•
•
•
•
Click on the “Sites & Affiliations” icon
Click on “Site Reports”
Click on “Site Listing”
Under “Site Group,” in a dropdown box, click on “NEP Clinical Internship Sites” for
a listing of all approved Clinical Internship Sites
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•
•
Click “Next”
Click on any site name to see site location, description, expectations, requirements,
Internship Preceptor contact, etc.
6. MyFolio: The student will be able to upload the following documents into the MyFolio
section for both the Internship Coordinator and Internship Preceptor to review:
•
•
•
•
•
•
•
Signed Acknowledgment of Understanding
Approved Resume
Approved Goals Statement
Signed Memorandum of Understanding
Acceptance Letter
Completed ACSM Certified CESSM Clinical Hour Verification Form
Updated Immunizations & Certifications (Immuns & Certs)
To upload or edit documents in MyFolio, the student should follow these steps:
• Click on the “MyProfile” icon (top left side of the webpage)
• Click on “MyFolio”
• Click on “MyFolio” again
• Click on the “Folder Tools” tab located on the top right of the page
• Click on “Edit MyFolio”
• The student can choose to edit or upload documents under the “Resume/Goals
Statement” tab or “Immunization and Certifications” tab on the left sidebar
• Click on the picture of a piece of paper and pencil under the heading in which you are
uploading the document
• After uploading the document click on the “Folder Tools” tab again
• Click on “Preview MyFolio” to save
If a student cannot find specific information after reading the Internship Manual and attending the
Internship Orientation, he/she may contact the Experiential Program Assistant regarding specific
questions about E-Value access (e.g., passwords) and additional onboarding information. It is the
student’s responsibility to email a notification to the Experiential Program Assistant when any
changes to E-Value are made.
C. ACKNOWLEDGEMENT OF UNDERSTANDING
The student is responsible for reading the Internship Manual prior to the fall Internship Orientation.
The student is encouraged to bring any question not clarified in the manual to the meeting. After the
Internship Orientation, the student has one week to sign the Internship Manual Acknowledgment of
Understanding form. This form is an acknowledgment that the student has read and understands the
current Internship Manual (see Appendix A) and has had an opportunity to ask questions for
additional clarification during the orientation. The student should print, sign and upload this form
onto MyFolio in E-Value.
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D. COMPLETION OF ALL REQUIRED DIDACTIC NEP COURSES
The internship is the final experience and requirement of the NEP undergraduate degree. It is
suggested that a student receive a “C” or above in all NEP coursework to apply for, or participate in,
a clinical exercise internship (see the NEP Undergraduate Student Handbook for a list of required
didactic NEP coursework).
PRE-INTERNSHIP PROCESS
A. INTERNSHIP TIMELINE
Shown in the table below are the internship dates and deadlines for each school semester. The
internship can be completed during any school semester (spring, summer, or fall), but must be
finalized in the semester in which the student is enrolled. If the student does not meet the deadlines in
the table below, he/she runs the risk of postponing the start date of the internship until the following
semester.
Dates and
Deadlines
Spring Semester
Review Site
Descriptions:
Available on E-Value under Site & Affiliations icon
Summer Semester
Fall Semester
Interview Sites
SignUp Genius
Available:
Interview and
Receive an
Offer:
Accept an offer
by:
Internship
Placement in
E-Value:
1st week of July
1st week of November
1st week of March
2nd week of July
through the end of
September
2nd week of November
through the end of
January
2nd week of March
through the end of May
October 14th
February 14th
June 15th
November 1st
March 1st
July 1st
September 15th –
September 30th
January 15th –
January 30th
May 15th – May 30th
November 1st
March 1st
July 1st
Non-Interview Sites
SignUp Genius
Available:
Internship
Placement in
E-Value:
The 2nd Monday in
The 2nd Monday after The 2nd Monday in
January
Graduation
September
B. IDENTIFICATION OF INTERNSHIP SITES
A student may choose from a selection of approved sites listed in E-Value or search for a nonapproved site on his/her own; however, the student is strongly encouraged to choose from approved
sites. Approved sites already have a finalized Affiliation Agreement; a legal document that must be
executed between WSU and each Internship Site prior to beginning an internship. The negotiation
Start Date:
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can take over six months and some Affiliation Agreements are never finalized. If an agreement is
never signed, the student’s internship experience may end up being postponed until the next semester
when another Internship Site can be found. The student is also strongly encouraged to identify and
apply for more then one internship.
1. APPROVED SITES
After signing into his/her E-Value account, a student can access a current list of approved sites.
See “E-Value Account” section above for more details on how to access these sites.
2. NON-APPROVED SITES
If the student wants a unique clinical internship experience, the student can identify one or
more possible Internship Site(s) in the area of interest (rehabilitation program for patients
with heart failure, conducting pulmonary function tests, research, etc.) and contact the site to
find out what internship opportunities may exist. The following information will guide the
student in how to search for a specific clinical exercise internship:
a. Make an appointment with the Internship Coordinator: Prior to meeting with the
Internship Coordinator, the student should complete and be prepared to discuss Part
1 of the “New Clinical Exercise Internship Site Request Form,” which is located on
the Homepage of E-Value (see Appendix C for an example of this form).
b. Find an Internship Site: The following are resources to assist a student in identifying
a potential Internship Site:
•
•
•
•
The world-wide web
The WSU Career Services office
The NEP Clinical Exercise Internship Coordinator
On Angel® – click on the “Continuous NEP 490 Course” and search in the
“Lesson” folder
c. Gather Information: After identifying internship sites of interest, the student may
contact the agencies and arrange to speak with a person responsible for internships at
each site about the possibility of obtaining an internship. If the contact person
indicates that there is an internship available, the student should complete Part 2 of
the “New Clinical Exercise Internship Site Request Form,” by filling out specific
information obtained from the potential site.
d. Make another appointment with the Internship Coordinator: The student is
responsible for emailing the Internship Coordinator the completed “New Clinical
Exercise Internship Site Request Form,” prior to this appointment. The Internship
Coordinator will review the information and contact the site to determine if it is a
suitable site for an internship. During the appointment, the student will be notified
whether the site has been approved and, if approved, may then begin the application
process.
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However, this does not guarantee that the legal document, the Affiliation Agreement,
will be finalized in time for the student to begin an internship in the desired semester.
The student is strongly encouraged to have identified one or more Internship Site
options if the legal document is not finalized.
C. COMPLETION OF RESUME
Prior to applying for an internship, the student is responsible for making an appointment with the
Internship Coordinator to present a professionally acceptable resume, specific for the type of
internship desired by the student. The WSU Writing Center is available to assist the student with the
development of a professional resume. The Internship Coordinator will approve the resume or will
request changes be made to make it an acceptable resume.
The student MUST receive approval of the resume from the Internship Coordinator before applying
for an internship. It is highly recommended that the student begin working on this document
immediately after the Internship Orientation. Once the Internship Coordinator has approved the
resume, the student will then upload the document onto E-Value. See “E-Value Account” section in
this Internship Manual for directions on how to upload these documents.
D. APPLICATION PROCESS FOR AN INTERNSHIP
The student is strongly encouraged to read through Internship Site descriptions and expectations on
E-Value prior to applying for an internship. It is the student’s responsibility to understand the sites’
expectations, any additional onboarding requirements and expenses that may be incurred prior to, or
during, the internship.
1. APPLICATION WITH AN INTERVIEW
Some Internship Sites will require the student to apply and will conduct an interview either
on-site or over the phone before the site makes its choice of an intern. The student is
responsible for confirming the site’s application process and providing the site with all
required documentation (review site information under the Sites & Affiliations icon) prior to
the interview.
The student may sign up to interview with three different internship sites by accessing the
link to SignUp Genius on E-Value’s Homepage. These interview time-slots will be opened at
a specific time and will be available for a limited time. You will be notified electronically
prior to this opening date/time. Sign-up is on a first-come, first-serve basis. For example: a
student interested in completing an internship during the summer semester can access the link
on E-Value during the first week of November to sign up for preferred interview time-slots.
(See “Internship Timeline” section above.)
After signing up, the student may interview with the selected internship site(s). Please refer to
the “Internship Timeline” for specific dates to interview and to receive and accept an offer
for an internship.
2. APPLICATION WITN A NON-INTERVIEW SITE
Some Internship Sites will not require an interview and will allow a student to select their site
as the student’s first choice. Through SignUp Genius on E-Value, the student can select
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his/her preferred site. For example, a student interested in completing an internship during
the summer semester can access the link on E-Value during the last two weeks in January
(see “Internship Timeline” section above).
After a student has selected an Internship Site through SignUp Genius, he/she can confirm
the final internship placement through E-Value under the Schedules icon (click on “Reports”,
then “Rosters”). The student is responsible for checking in with the site and Internship
Preceptor prior to the start date for any additional requirements.
E. INTERNSHIP OFFER
A student must receive an internship offer by the deadline listed in the “Internship Timeline” for the
semester the intern is planning to complete his/her internship. Most internship sites will contact the
student via phone or email with an internship offer. The student can express a tentative acceptance
of the internship offer, but final approval is pending until the student has met with the Internship
Coordinator and received final approval to accept the internship. It is the responsibility of the student to
make an appointment with the Internship Coordinator after receiving an internship offer. During the
meeting:
1. The student will:
• Read, print, and provide the Internship Coordinator with a signed Memorandum of
Understanding. This document is located on the Homepage of E-Value
• Provide the Internship Coordinator with the site name and the name of the person who
offered an internship, as well as any new additional information provided by the
Internship Preceptor (e.g., start date, location, work hours, direct supervisor, etc.)
2. The Internship Coordinator will:
• Initiate the Affiliation Agreement process if there is not a current document finalized
with the University for this site
• Confirm that the student has completed all of the University requirements and that the
requirements will be current during the internship
• Send the Internship Site name to the Experiential Program Assistant
• Sign the Memorandum of Understanding once all requirements are completed
If the student has not received an offer from an Internship Site by the deadline, or the Affiliation
Agreement is not finalized by the internship start date, the student must begin the application process
for a new internship and the internship start date will be postponed until at the least the following
semester.
F. ACCEPTANCE OF AN INTERNSHIP
The student may indicate a formal acceptance of the internship offer by emailing or mailing a letter
to the Internship Preceptor after the meeting with the Internship Coordinator. The formal acceptance
letter should include:
1. Appreciation for the offer of an internship opportunity
2. Anticipation of a productive internship that contributes to the needs of the site and also meets
the student’s educational goals
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3. Confirmation of the start date, as agreed upon by the student and Internship Preceptor (only
for students accepting an offer from a new site)
The student should also attach the Memorandum of Understanding with the letter and request a
signature from the Internship Preceptor. Once the student has received the signed Memorandum of
Understanding from the Internship Preceptor, the student is responsible for uploading both the
acceptance letter and the Memorandum of Understanding on the MyFolio section in E-Value.
Sending an acceptance letter to the Internship Preceptor does not guarantee that the student will be
able to complete the internship if the Affiliation Agreement is not finalized prior to the start date.
Additionally, the student is strongly encouraged to send a thank you letter to each Internship Site
who has offered him/her an internship in which was not accepted.
G. COMPLETION OF GOALS STATEMENT
After accepting an internship offer, the student should develop the Goals Statement based on the
focus of the internship. Once the Internship Coordinator has approved the resume, the student will
then upload the document onto E-Value. Refer to the “E-Value Account” section in this Internship
Manual for directions on how to upload this document.
Guidelines for writing a Goals Statement include:
a. One (1) to Two (2) pages in length (11-pitch font, 1” margins all around)
b. Prepare a list of specific professional goals and performance objectives for the internship
experience, i.e., what the student wants to accomplish during the internship such as (utilize
ACSM's KSAs as a resource):
• Obtain and recognize normal and abnormal physiologic and subjective responses to
exercise (e.g., symptoms, ECG, blood pressure, heart rate, RPE and other scales, and
oxygen saturation)
• Identify and describe the significance of ECG abnormalities in designing the exercise
prescription and in making activity recommendations
• Use motivational interviewing to help a patient plan for lifestyle changes
c. List activities the Internship Site may be able to provide that will help meet these objectives
(e.g., observation of an open heart surgery or heart catheterization procedure; develop and
deliver an educational presentation, develop handout materials, etc.)
d. Prepare a list of the personal strengths that will be brought to the internship (e.g.,
enthusiastic, professional, team player, auscultate accurate blood pressures, etc.)
e. Identify desired areas of weakness to strengthen during the internship (e.g., shy, impatient,
passive, lack of medication knowledge, etc.)
f. Provide a rationale (at least a paragraph) for selecting the Internship Site as related to the
goals and performance objectives
H. SITE-SPECIFIC REQUIREMENTS
Some Internship Sites have additional onboarding requirements for the student intern, which are
listed in E-Value. It is the student's responsibility to complete the site's requirement deadlines prior
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to the start of an internship. The student must contact the Experiential Learning Assistant to
document the completion of the requirements. If the student has not completed these additional
onboarding requirements prior to beginning the internship, the Internship Coordinator will notify the
Internship Preceptor immediately and the internship will be suspended until the requirements have
been completed. Delayed completion of the requirements does not guarantee that an Internship Site
or an Internship Preceptor will permit the student to continue the internship. The student is strongly
encouraged to pay close attention to these additional requirements prior to interviewing with a
potential Internship Site
1. HEALTH/MEDICAL INSURANCE COVERAGE
It is highly recommended that the student intern maintain health/medical insurance coverage
during the internship experience, although not all Internship Sites require it. Some sites
require proof of medical insurance coverage by the student intern prior to starting an
internship. A student is eligible to purchase a student health insurance plan through WSU
Spokane if enrolled in 7 or more credit hours a semester (see
http://Studentinsurance.wsu.edu/ and the WSU Spokane Student Handbook for more
information).
2. DRUG TESTS
Sites may require a drug test prior to the start of an internship. Sites may also require random
drug tests throughout the internship. The costs of these drug tests are the responsibility of the
student. A positive test result could serve as the basis for dismissal from the internship and a
failing grade. The student will be required to apply for a new internship following the
procedures outlined in this manual.
3. CRIMINAL BACKGROUND CHECK
Some sites may require an additional criminal background check be completed 30-60 days
prior to an internship start date. The student is responsible for obtaining this background
check along with any additional costs.
I. REGISTRATION FOR NEP 490
Students must register for at least 10 hours of internship credits (NEP 490) before beginning a 400hour (10-week) internship. If the student needs to accumulate additional hours to sit for the
American College of Sports Medicine Certified Clinical Exercise Specialist Exam (see Appendix E),
they must enroll for an additional credit for each additional 40 hours needed at the Internship Site.
The Internship Coordinator must confirm that the student has registered for the appropriate number
of credits based on the number of clinical hours needed. The student must make an appointment with
the Internship Coordinator and bring a description of clinical hours accrued during the NEP program
with the appropriate NEP faculty’s signature (see Appendix D). The Internship Preceptor and
Internship Coordinator must approve these extra hours prior to registering for the internship credits.
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ADDITIONAL GUIDELINES DURING A CLINICAL EXERCISE
INTERNSHIP
A. ETHICAL STANDARDS OF CONDUCT OF A STUDENT INTERN
While the University must create an environment in which professional attributes may be cultivated,
each student, as a future member of the profession, also has the duty to observe the laws, uphold the
honor of the profession and practice its ethical standards of conduct as it is an important component
of professional behavior and of the overall assessment of the student’s performance. The student
intern will be held, at a minimum, to the standards of conduct expected of the employees in all areas
of the internship facilities and to those of the profession.
The student intern is expected to exhibit a professional appearance and attitude, as well as follow the
WSU Student Conduct Code. Repeated and/or serious violations of professionalism standards, or any
conduct that poses a threat to patients or clients, may lead to probation, removal from the internship,
and/or dismissal from the BS NEP degree program. Each student should refer to the NEP
Undergraduate Student Handbook under “Student Standards of Conduct Code and Standard of
Professionalism,” the “Professionalism” section, the Office of Student Standards and Accountability,
as well as the WSU Spokane Student Handbook, which is available at:
http://www.conduct.wsu.edu/default.asp?PageID=338 (Chapter 504-26 WAC).
B. COMPUTER ACCESS
The student must maintain an active WSU email account and promptly notify the Internship
Coordinator and the Internship Preceptor of any account changes. This email account should be
checked daily as this method of communication will be used for announcements and correspondence
related to the internship. (Refer to the “Expectations with Respect to Electronic Communications”
section in the NEP Undergraduate Student Handbook.)
The current Learning Management System (i.e., Angel®) will be used for the student to access the
NEP 490 syllabus, to upload the weekly reports and the Exit Report, and to review the assigned
grades from the internship. Additional information may be sent through Angel’s course mail to the
student’s WSU email account.
Lastly, it is highly recommended that the student check E-Value weekly to maintain a clear
understanding of internship requirements and expectations. All internship assessment forms are
located under the “Evaluations” icon in E-Value.
C. COMMUNICATION WITH UNIVERSITY PERSONNEL
The student is required to maintain close communication (via phone or email) with the Internship
Coordinator regarding any issue/concern pertaining to the internship. Examples include:
1.
2.
3.
4.
5.
Extended absence from Internship Site ( e.g., illness, jury duty, military service)
Need for conflict resolution
Personal issues that will impact the internship experience
Student assessments (midterm and final)
Site-specific documentation needed
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
6. Course enrollment
7. Letters of recommendation
D. EXPECTATIONS OF INTERNSHIP PRECEPTORS
The student will be guided and assessed during the internship experience by an assigned Internship
Preceptor. Each student has an Internship Preceptor who is the key contact during the internship.
However, that does not mean a student will spend the majority of the time with this Internship
Preceptor. Other clinical staff may supervise the majority of the intern’s learning. Acquisition of
clinical information will come from the student’s own observations, self-study and the practitioners
and patients the intern will encounter. Please refer to Appendix B to review the responsibilities of
the Internship Preceptor.
E. COMMUNICATION WITH THE INTERNSHIP PRECEPTOR
It is the student’s responsibility to contact (via email or phone) the assigned Internship Preceptor and
any relevant additional contacts pertaining to onboarding requirements no later than four weeks*
prior to the start of the scheduled internship. Contact information can be accessed in E-Value. This
allows the student to first introduce themselves to the assigned preceptor (if the student has not
already met the Internship Preceptor) and/or site contact to obtain any additional information in
preparation for the internship such as:
1.
2.
3.
4.
5.
6.
7.
Parking access
Computer access
Orientation information
Reading assignments
Dress code
Date and time of first day of internship
Place to meet representative of site on the first day
If a student has difficulty having the Internship Preceptor to respond to emails or phone calls before
starting the internship, the student should notify the Internship Coordinator no later than two weeks
prior to the scheduled internship start date so the problem can be resolved prior to the start of the
internship.
*Please note: Many sites require students to contact the Internship Preceptor and/or additional site
contacts before the WSU four-week time frame above. Please make sure this requirement is met or
the scheduled internship potentially could be delayed or cancelled. Pre-Internship Site requirements
are listed in E-Value and have specific details concerning special communication and timelines.
F. INTERNSHIP REASSIGNMENT PROCESS
If a conflict arises in which the learning environment is perceived as compromised or extenuating
circumstances occur that may prevent a student from completing the assigned internship, a request
from the student must first be submitted to the Internship Coordinator through either a written or
verbal request for consideration. The Internship Coordinator on a case-by-case basis will first review
this request. Once the request has been reviewed a final decision will be made in a timely manner. If
a student does not first submit the request to the Internship Coordinator and prematurely attempts to
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
involve any additional parties in the decision making-process (such as other clinical staff, faculty, or
students) the final decision from the University will be automatic denial of the request.
There are only a few situations that potentially warrant a site reassignment and the request is granted
based on extenuating circumstances of that situation. Examples of such circumstances are as follows:
1. Personal or immediate family medical emergency
2. Personal or immediate family crisis (legal issues or family conflicts)
3. Preceptor’s inability to precept assigned student due to a medical emergency, staffing
deficiency, employment relocation, personality conflict, etc.
4. Unsigned Affiliation Agreement between the Internship Site and the University
G. SEXUAL HARASSMENT
Detailed information regarding sexual harassment is available on the WSU website:
http://hrs.wsu.edu/dshp . If a student feels sexually harassed at the Internship Site he/she should talk
to the Internship Preceptor and notify the Internship Coordinator to help facilitate the appropriate
course of action.
H. REQUESTS FOR ACCOMMODATIONS
Reasonable accommodations are available for a student with a documented disability. If a student has
a disability and needs accommodations during the internship, please contact Liz West, Assistant
Director of Student Affairs, in Academic Center 130 ([email protected], 509-358-7534). Website:
http://spokane.wsu.edu/students/current/StudentAffairs/disability/disabilityguidelines.html
ASSESSMENT OF THE STUDENT DURING THE CLINICAL
INTERNSHIP
The following are additional requirements during the clinical exercise internship:
A. INTERNSHIP REPORTS
The student is required to write a one (1) or two (2) page (single-spaced; 11-pitch font) report every
week and upload it onto the current Education Management System (i.e., Angel®). The weekly report
must be submitted by midnight on the Monday following the week the report covers. A report is due
for each week of the internship, including the final week, which is in addition to the Exit Report (see
details below).
A face page in the format shown below should appear before each report and should be completed
with the relevant information. This face page does not count as one of the pages of the weekly report.
Also included on the face page are the weekly hours cut and pasted from an Excel spreadsheet. The
Excel spreadsheet will be available to download from Angel® at the beginning of the internship. The
spreadsheet documents time spent in general duties of an internship such as patient/client
administrative duties, direct patient/client care or education, professional educational opportunities,
or other site administrative activities.
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
FACE PAGE FORMAT
STUDENT INFORMATION
Student Name:
Internship Week #:
Dates Report Covers:
Weekly Hours:
Total Hours:
Home Address:
Home Phone:
Email Address:
INTERNSHIP SITE INFORMATION
Name and Title of Internship Preceptor:
Preceptor Mailing Address:
Preceptor Email:
Name of Approved Site:
Phone Number:
WEEKLY REPORTS
The weekly report should include the following topics:
Week 1 – 3
• A narrative summary of weekly activities and experiences evaluated in relationship to the
intern's Goals Statement
• A short discussion of personal impressions and observations regarding the internship
experience and the impact it is making on professional development and growth
• An analysis of areas/situations which were successful or that require further growth or
study
• A short discussion of whether the previous week's goals were met or not and, if not, what
prevented meeting the goals
• A projection of future week(s): activities, expectations
• A section defining two or more specific goals (numbered) for the next week
• Attach materials created for the Internship Site (i.e., flyers, education handouts, outcomes
spreadsheet, etc.)
Week 4-10 (11, 12, etc.)
• The narrative summary above is condensed to a paragraph covering new experiences
• A case study assignment beginning the fourth week (see Appendix H)
EXIT REPORT
The following guidelines should be used to write the Exit Report:
14
Nutrition & Exercise Physiology Clinical Exercise Internship Manual
a. Use the Goals Statement prepared prior to beginning the internship to comment on goal
achievement or non-achievement. What facilitated goal achievement? What hindered goal
achievement? What other learning took place in addition to the goals on the Goals
Statement? What objectives or goals were not accomplished? Explain why not
b. Comment on in-service opportunities that may have assisted in the enhancement of
knowledge, skills and abilities
c. Comment on the progress made in strengthening areas of weakness
d. Comment on how the experience affected professional development
e. Indicate whether the internship was a valuable experience, and why or why not
f. List career aspiration(s), future jobs or future education currently being considered or which
have been accepted
g. List future address (mail and email) and phone number and a permanent address and phone
number (such as parents)
The Exit Report should be about two (2) pages long (single-spaced, 11-pitch font, 1” margins).
Title the report "Exit Report" and include a face page like those used for the weekly reports (see
previous section). Complete and upload the Exit Report and the totaled weekly hour Excel
spreadsheet. Unless approved in advance, this will equal at least 400 hours (see Appendix D and
E for more information).
The final documents are due by noon on the following Tuesday after the completion of the
internship. If a student fails to complete this assignment by the deadline he/she will receive an
incomplete (“I”) grade (see “Criteria for Receiving an Incomplete” section below for more details).
B. MIDTERM AND FINAL ASSESSMENT FORMS
MIDTERM ASSESSMENT
A mid-term assessment is required for the internship experience. This assessment is to provide the
intern with a clear understanding of his/her performance and progression at the halfway point. If the
intern receives ≤ 2 on the midterm assessment in any section, the Internship Preceptor and the intern
must establish at least one specific goal for improvement in each area that the intern needs to
strengthen which will guide the intern towards competency. The assessment should also highlight
any areas of strength and/or excellent progression.
The Internship Coordinator will contact the Internship Preceptor at the midterm to discuss the
Intern’s progress. During this meeting or phone call, if there are areas needing improvement the
Internship Coordinator, Internship Preceptor and the student intern will review and discuss the goals
to ensure the student reaches competency before the final assessment.
FINAL ASSESSMENT
At the conclusion of the internship the student intern will receive a final assessment. Once the
Internship Preceptor submits the final assessment, the Internship Coordinator will be responsible for
reviewing the assessment. To successfully pass the internship, the student must receive a final
performance rating of 2.5 or higher on the final assessment in all areas applicable to the internship.
Receiving a 2.0 performance rating (or below) in any competency area, equates to an unsatisfactory
15
Nutrition & Exercise Physiology Clinical Exercise Internship Manual
internship. If a preceptor does select a final score of 2.0 or below in any category, E-Value will
request that the Internship Preceptor verifies the final score prior to submitting the assessment.
Depending on the type of internship experience, it may not be possible for an Internship Preceptor to
assess the student intern on all areas. In this case, the Internship Preceptor should submit a rating of
N/A for areas that do not apply to that specific internship.
C. RATING SCALE FOR MIDTERM AND FINAL ASSESSMENTS
The student intern will be assessed using the following five (5)-point performance rating scale. The
Internship Preceptor will be asked to select the appropriate number in the Rating Scale that best
describes his/her impression of the student intern’s overall competency (refer to Appendix G for a
detailed clinical competency list). The rating for each assessment must fall between the range of 1
and 5; a 0.5 decimal increment will be available between each whole number (see Appendix F for an
example of the midterm and final assessments).
RATING SCALE
5 = 100%
Performs above the expectations of an Intern.
4 = 90%
Performs within and frequently beyond the expectations of an Intern.
Performs within and sometimes beyond the expectations of an Intern in most areas.
3 = 80%
Some areas are still in need of growth.
Performs within the expectations of an Intern in only some areas. Several areas are still
2 = 70%
in need of growth; a passing grade cannot be given at this time.
The Intern has too many areas needing significant growth and development; a passing
1 = <70%
grade cannot be given at this time.
Not applicable to this internship.
N/A
D. STUDENT ASSESSMENT FORMS
At the end of the internship, the student will be expected to complete the following forms:
1. Student’s Assessment of NEP Curriculum and Internship
2. Student’s Assessment of Internship Preceptor and Internship Site
This requirement will be accessed, completed, and submitted through E-Value. Specific instructions
of how to access and submit these assessment forms in E-Value will be sent by email to the student
intern prior to the conclusion of the rotation. Sample of these assessment forms may be viewed in
Appendix F. These assessments are very important to the NEP Program, as the information a student
provides, can be very useful in evaluating an Internship Site and internship experience for quality
assurance purposes. This information will be returned to the Internship Preceptor after the internship.
Please keep in mind that these assessments are not meant to exclusively point out all the negative
attributes of the Internship Preceptor, Internship Site or internship experience. If a student did
encounter a negative situation during the internship, it is expected that the student would
constructively identify the situation but also provide a reasonable solution or suggestion on how the
situation/issue potentially could be resolved or improved. Negative information (if tactfully and
professionally written) can be very beneficial especially when the University assesses sites for
utilization in the future. Ultimately the primary purpose of this assessment is for the student to
identify the many positive experiences she/he obtained during the internship. This will be an
16
Nutrition & Exercise Physiology Clinical Exercise Internship Manual
opportunity to express gratitude and appreciation to the Internship Preceptors and solidify and reenforce a job well done.
The assessments will be due no later than one week (7 days) after completion of the internship. If a
student fails to complete this assignment by the deadline he/she will receive an incomplete grade of
“I” (see “Criteria for Receiving an Incomplete” section below for more details).
E. FINAL GRADE FOR A CLINICAL EXERCISE INTERNSHIP
The final grade for the internship is satisfactory (“S”) or fail (“F”). Graduation requirements for the
BS in NEP are not completed until all work for the internship is finalized, and a satisfactory grade
(“S”) has been assigned. If the intern has not completed all the required hours or has not met all
other requirements of the internship by the end of the semester in which the student is enrolled, a
grade of Incomplete (“I”) will be submitted. Once all requirements are met satisfactorily, the
Internship Coordinator will submit a “Change of Grade” form that goes to the Chair of the program
for signature and then to the Registrar for the grade to be officially changed to a “S”. The student
should ensure that a grade of “S” shows up on his/her transcript a few days after all requirements are
completed. If a student fails (“F”) the internship, he/she has one more opportunity to complete an
internship and pass it with a satisfactory grade. The student will begin the internship process again,
as outlined in this manual.
CRITERIA FOR RECEIVING A SATISFACTORY GRADE
A satisfactory grade (“S”) will be issued under the following circumstances:
1. A student achieved a 2.5 (75%) or higher in all areas on the final assessment
2. The cumulative internship grade is ≥ 75% (which included: weekly reports; case study;
Exit Report; Mid-term and Final assessments)
3. A student did not receive an incomplete or fail grade
4. Patient safety is not compromised. If compromised, the University will review the
severity of the offense and disciplinary action will be based on the severity of the
incident, which may result in failure of the internship
5. Professional standards are not breached. If professional standards are breached, the
University will review the severity of the offense and disciplinary action will be based on
the severity of the incident, which may result in failure of the internship
CRITERIA FOR RECEIVING A GRADE OF INCOMPLETE
If a student receives a grade of "I" for the internship, it is the student's responsibility to complete and
submit all reports to the Internship Coordinator, to follow up on whether all requirements are met
satisfactorily, and to determine whether the Internship Coordinator has submitted a grade of "S" to
replace the “I”. All outstanding incomplete work must be completed and posted to the official
transcript prior to the conferral of the BS NEP degree. The student has until the end of the following
semester to complete the course requirements. If the incomplete is not made up during the specified
time or if the student repeats the course, the "I" grade is changed to an “F” (see Rule 34 in the WSU
Spokane Student Handbook).
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
An incomplete (“I”) grade will be issued under the following circumstances:
1. The student has not completed all the hours by the time grades are due
2. The student intern fails to complete the assessment forms by the time grades are due
3. Patient safety is compromised by the actions of the student intern and depending on the
severity of the offense the University has the right to reassign the student intern to a
different site
4. Breach of professional standards. The University will review the severity of the offense
and disciplinary action will be enforced which may result in an incomplete grade for the
course
5. The student is unable to meet internship requirements as a result of an extended excused
absence and only if approved by the Internship Preceptor and the Internship Coordinator.
This may include: extended personal illness or injury, family crisis, as well as any other
circumstance that warrants an extended excused absence
CRITERIA FOR RECEIVING A GRADE OF FAIL
A grade of fail (“F”) will be issued under the following circumstances:
1. The student intern receives a 2.0 or lower in one or more performance areas on the final
assessment
2. The cumulative internship grade is < 75% (which included: weekly reports; case study;
Exit Report; mid-term and final assessments)
3. Patient safety is compromised by the actions of the student intern and due to the severity
of the offense, the University determines the student intern demonstrated an offense
which resulted in failure
4. The intern breaches professional standards. The University reviews the severity of the
offense and disciplinary action is enforced which results in failure of the internship
F. ACSM CLINICAL HOUR VERIFICATION FORM
It is the student's responsibility to complete the American College of Sports Medicine (ACSM)
Certified Clinical Exercise SpecialistSM (CESSM) Clinical Hour Verification Form and submit it with
the Exit Report (see Appendix D and E for the Clinical Hour Verification Form and a detailed list of
practical experiences that qualify as ACSM clinical hours). Below is a sequence of steps the student
should follow:
1. Approved clinical hours from NEP coursework should have been signed off by the faculty
supervisor at the end of each semester in which the hours were accrued
2. The Internship Preceptor should approve and sign off on the total number of internship hours,
which may include more than 400 hours if the internship was extended to accumulate the
total number of hours needed for the Clinical Exercise Specialist Exam
3. The student should scan and upload the completed ACSM Certified Clinical Exercise
Specialist Clinical Hour Verification Form onto Angel with the Exit Report for review by the
Internship Coordinator
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Nutrition & Exercise Physiology Clinical Exercise Internship Manual
4. After the Internship Coordinator has approved the ACSM Certified Clinical Exercise
Specialist Clinical Hour Verification Form, the student is responsible for uploading this
document onto E-Value in his/her MyFolio section for future access
INFORMATION REGARDING THE CLINICAL EXERCISE
SPECIALISTSM EXAM BY THE AMERICAN COLLEGE OF SPORTS
MEDICINE
American College of Sports Medicine (ACSM) certification exams are offered on-demand, in computerbased format at Pearson VUE® authorized testing centers. The student can visit
http://www.pearsonvue.com/acsm or call 888-883-2276 to schedule a time to take the ACSM certification
exam. The test may include pictures and/or video segments and all questions are multiple choice.
ACSM CERTIFIED CLINICAL EXERCISE SPECIALISTSM EXAM REQUIREMENTS
1. Review the following website http://certification.acsm.org/acsm-certified-clinical-exercise-specialist
to confirm that you have met all the requirements prior to taking the ACSM Clinical Exercise
SpecialistSM certifying exam. This website also provides information on study materials, workshops,
webinars, and cost for the study resources and the exam
2. Complete the ACSM Certified Clinical Exercise Specialist Clinical Hour Verification Form. (See
Appendix E.)
a. It is the responsibility of the student to have the NEP faculty sign the form at the end of the
semester in which any clinical hours were accrued. The following website clearly defines
what classifies as a clinical hour http://certification.acsm.org/ces-clinical-hours
b. It is the responsibility of the student to have the Internship Preceptor sign the form at the
conclusion of the internship
c. The Internship Coordinator must review the hours at the conclusion of the internship
ACSM AUDIT
In the past, ACSM has randomly audited at least one NEP student each year, which requires the student to
verify the clinical hours. The student is required to have each NEP faculty who supervised the clinical hours
submit a letter which assures ACSM that the clinical hours meet its requirements as detailed on the website
listed above (see Appendix D for more information on clinical hours). It is the responsibility of the student
to contact each NEP supervisor who has signed the ACSM Certified Clinical Exercise Specialist Clinical
Hour Verification Form and request a letter confirming that the hours met ACSM’s requirements. The
student is strongly encouraged to contact the faculty members as soon as possible to avoid a delay in
submission of the letters to ACSM. It is the student’s responsibility to submit these letters and the Clinical
Hours Verification Form for ACSM’s review. ACSM notifies the student directly if the submission for the
audit has been approved.
19
APPENDIX A
ACKNOWLEDGEMENT OF
UNDERSTANDING
20
ACKNOWLEDGEMENT OF UNDERSTANDING
2013-2014 Clinical Exercise Internship Manual
I
have read the current NEP Undergraduate Student Handbook and the current NEP
Clinical Exercise Internship Manual in their entireties. Additionally, I have attended the
Internship Orientation and received clarification regarding any question I asked.
I fully understand the content of both documents, and agree to abide by the policies and
procedures as outlined.
Student WSU ID #: _____________________________
Signature of Student: ________________________________________Date:____________
21
APPENDIX B
NEP CLINICAL
EXERCISE INTERNSHIP
MEMORANDUM OF
UNDERSTANDING
22
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
Clinical Exercise Internship
MEMORANDUM OF UNDERSTANDING
This agreement, made and entered into by and between the NEP Clinical Internship
Coordinator hereinafter called the Internship Coordinator, the student intern, hereinafter called
the Intern, and the Internship Preceptor, is for the purpose of arrangements for the Internship
Program at an approved Internship Site for students enrolled in the Bachelor of Science in
Nutrition and Exercise Physiology (NEP), Program in Nutrition and Exercise Physiology College of Pharmacy, Washington State University Spokane.
Nutrition and Exercise Physiology - College of Pharmacy adopts an equal opportunity,
affirmative action approach. Factors of race, color, sex, age, religion or handicap are not
considered in the placement of interns.
This Agreement shall be effective
semester of
(yr).
RESPONSIBILITIES OF THE INTERN
• To attend the Internship Orientation meeting given by the Internship Coordinator prior
to the internship experience
• To become familiar with all the expectations and guidelines in the Internship Manual
and to follow them
• To obtain and provide, prior to the internship, evidence of the required certifications,
training, health records, immunizations, satisfactory criminal background, student
professional liability insurance, and any other required documentation (as detailed in
the NEP Undergraduate Student Handbook) to the NEP Program Academic
Coordinator and/or Experiential Program Assistant; and to maintain each of these
requirements current during the entire internship experience
• To provide the Internship Site with site specific documents according to the site's
application process or site-specific requirements (i.e., if requested, letter of application,
resume, completed application, copies of current certifications, copies of proof of
immunizations, and any other materials required/requested by the Internship Site)
• To set up a meeting with the Internship Coordinator to sign the Memorandum of
Understanding and to obtain a signature from the Internship Preceptor and upload the
document into MyFolio
• To provide the Internship Site with all documentation required by WSU
• To confirm with the Internship Coordinator that the Affiliation Agreement between the
Internship Site and WSU has been finalized prior to the start date of the internship
• To meet with the Internship Preceptor
23
Prior to the internship to outline the internship and review the Goals Statement
At the mid-term of the internship to assess progress and performance
At the end of the internship to evaluate the entire experience and to review
with the Internship Preceptor the final assessment
o As otherwise needed, or when requested by the Internship Preceptor
To comply with all rules, regulations and policies of the Internship Site
To become familiar with the Internship Site information and materials, if available,
prior to the internship
To maintain confidentiality of information as required by law and by policies and
procedures of the Internship Site, including those governing the use and disclosure of
individually identifiable health information under federal law
To know the emergency procedures established for the Internship Site
To represent the BS NEP, the NEP Program, the College of Pharmacy and WSU
Spokane in a professional manner
To dress appropriately as established by the policy of the Internship Site
To use time, when not assigned a specific duty, to undertake self-initiated tasks or
projects if approved by the Internship Preceptor or to ask the Internship Preceptor for
suggestions of things that might need to be done
To undertake assignments willingly and to complete assignments and projects on time
in a manner which meets the criteria of the Internship Site
To seek help from the Internship Preceptor and/or the Internship Coordinator to deal
with problems which are not readily solvable by the Intern
To be punctual in arriving at work at the expected time and not leaving early unless
permission is obtained from the Internship Preceptor or his/her designated replacement
To call in as soon as the Internship Site opens and report to the Internship Preceptor if
sick or for some other unavoidable reason cannot be at work on a particular day
To observe the same regulations regarding working hours, unexcused absences and
excused absences, as employees of the Internship site The Intern may work longer than
40 hours a week due to the assigned work load and a prearranged agreement
To discuss with the Internship Coordinator and the Internship Preceptor any extended
absence due to illness or extenuating circumstances
To observe the same holidays as the Internship Site employees. The assigned exercise
internship dates may include days or weeks when WSU Spokane is not in session
To prepare all required reports and submit these reports on time to the Internship
Coordinator
To fill out all assessment forms through E-Value upon completion of the internship
To send a thank you letter to the Internship Preceptor for the internship experience at
the completion of the internship
o
o
o
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
RESPONSIBILITIES OF THE INTERNSHIP PRECEPTOR
• To confirm completion of all site specific onboarding requirements prior to the
internship
• To sign the Memorandum of Understanding and return the document to the student
prior to the start of the internship
• To meet with the Intern and determine goals, expectations, work assignments and other
details prior to the start of the internship
• To provide the Intern with materials related to the Internship Site, its expectations,
rules, polices, and procedures prior to the start of the internship and to ensure that the
student understands all expectations, rules, policies, and procedures
24
•
•
•
•
•
•
•
•
•
•
•
•
To provide the Intern necessary emergency healthcare or first aid for accidents
occurring in the Internship Site facilities or on its premises. Per a standard WSU
Affiliation Agreement, financial responsibility for such emergency care will be as
follows:
o The Internship Site reserves the right to bill the intern for the cost of initial first
aid care
o At the Intern's expense, the Internship Site may provide follow-up care, testing
and counseling, including HIV testing, and counseling associated with that
testing, in the absence of any similar service being immediately available from
WSU's health services
To exhibit collaborative professional and/or training relationships with other health
care providers
To maintain strong levels of commitment to the education of the Intern
To provide an environment that nurtures and supports the Intern’s learning experience
To be available (within a reasonable time frame) for the Intern to answer questions or
help solve any problems encountered
To provide the Intern with guidance on a daily and/or weekly basis to ensure the Intern
receives constructive feedback on progress and performance and has opportunities to
ask questions
To communicate with the Intern’s Internship Coordinator “as necessary” to ensure the
protection of the Internship Site and the quality of the Intern's experience
To assign specific projects for which the Intern is responsible and provide any input, if
needed, for successful completion
To provide educational or observational opportunities that support the Intern’s
professional goals
To complete and submit a mid-term and final assessment in a timely manner, through
E-Value, that addresses the Intern's strengths and weaknesses, to review the
assessments with the Intern and provide constructive feedback
To establish new goals for improvement in area(s) that the Intern needs to strengthen,
during the mid-term assessment, to help the student reach competency
To complete an assessment on of the NEP program’s academic preparation of the
Intern through E-Value at the end of the internship
RESPONSIBILITIES OF THE NEP INTERNSHIP COORDINATOR
• To sign the Memorandum of Understanding, prior to the internship start date
• To review the Goals Statement, Resume and intended career directions of potential
interns and to help students identify an appropriate Internship Site to meet these goals
• To approve the internship placement after the student has completed all WSU
requirements as detailed in this Internship Manual
• To provide the Experiential Program Assistant with the required documentation for
each new site Affiliation Agreement
• To maintain internship files and records prior to, during, and after completion of the
internship
• To maintain contact with the Intern and the Internship Preceptor prior to and during the
internship
• To be available to the Internship Preceptor and the Intern for consultation and to help
resolve with the Internship Preceptor and/or the Intern any issues that arise pertaining
to the Intern or internship
• To visit the Intern at the site and/or complete one or more phone conversations with the
Internship Preceptor
25
•
•
•
To facilitate termination of the internship (two-week written notice) if the Internship
Site fails in its responsibility to the Intern or the Intern fails to adhere to the Internship
Site’s rules and policies
To read all the Intern’s WSU required reports/documents
To assign the final grade for the internship experience
By signing this agreement, the undersigned agrees to all NEP internship responsibilities and
guidelines.
INTERN
Name:
Address:
Phone:
Email:
Signature/Date:
INTERNSHIP COORDINATOR
Name:
Address:
NEP – College of Pharmacy
Washington State University Spokane
P.O. Box 1495
Spokane, WA 99210-1495
Phone:
Email:
Signature/Date:
INTERNSHIP PRECEPTOR
Name:
Title:
Organization
Address:
Phone:
Email:
Signature/Date:
26
27
APPENDIX C
NEW CLINICAL EXERCISE INTERNSHIP
SITE REQUEST FORM
28
NEW CLINICAL EXERCISE INTERNSHIP SITE
REQUEST FORM
Please fill out Part 1 of this document prior to scheduling the initial meeting with the
Internship Coordinator. Bring the form with Part 1 filled out to the initial meeting. Part 2 may
be completed prior to the second appointment. See “Identifying Internship Sites” section in the
Internship Manual for more details.
Once this document is complete, email this form to the Internship Coordinator prior to the
second appointment; include in the subject line your first and last name and the Internship Site
(i.e., Jane Doe – Beach City Healthplex). This completed form must be submitted at least 4
weeks prior to the start of the interviews process (see the “Internship Timeline” in the
Internship Manual). For example, if the student would like a summer internship, this form
must be submitted by early October.
Full Name:
Email Address:
PART 1:
Please answer the following questions.
1. What is your rationale in selecting this Internship Site?
2. Provide a list of learning objectives for pursuing an internship at a non-approved site:
3.
What do you hope to gain personally and professionally as a result of this internship
experience?
4. If approved by WSU, in what semester will this internship be scheduled (spring,
summer or fall)?
5. Provide a list of possible Internship Sites:
PART 2:
Contact the agencies of interest and arrange to speak with a person responsible for internships
at each site (e.g., Manager, Director, Internship Preceptor, Human Resource Representative,
etc.) about the possibility of obtaining an internship. If the contact person indicates that there is
an internship available, collect the following information:
29
a. Determine if the site is interested in having a student intern in their program; and
whether they have had an intern before
b. Obtain information about their facility and what program(s) they have to offer (i.e.,
cardiac rehabilitation (phase 1, 2 and/or 3), clinical research, disease management
program, exercise stress tests, medical fitness facility, etc.)
c. Find out what the internship entails (i.e., what tasks and responsibilities the student
intern will be required/allowed to do; what expectations the site has for their
interns)
d. Ask how many hours the Internship Site will be able to offer per week; are those
hours considered clinical hours? (refer to the ACSM guidelines to verify)
e. Obtain the potential Internship Preceptor contact information (email), and ask if
he/she would be willing to fill out a Site Evaluation and Availability Form (the
form will request that the preceptor attach their resume)
f. Determine the willingness to take a student intern within the specified start date
and timeline of the student’s desired school semester; designate whether the
internship be 10-11 weeks
g. Determine all requirements needed to apply for an internship and the due date of
application submission. Ask where the information should be sent, to whom it
should be addressed, the title of that person, contact phone, email, and fax
information
30
APPENDIX D
CLINICAL HOURS DESCRIPTION
31
CLINICAL HOURS REQUIRED FOR THE ACSM CESSM EXAM
During certain NEP coursework, students may accumulate some clinical hours, which can be counted
as part of the 500-hour requirement needed prior to sitting for the ACSM certified Clinical Exercise
SpecialistSM exam. No student is allowed to accumulate more than 100 hours during coursework.
Moreover, it is unlikely that students will accrue a full 100 hours in the NEP Program. To obtain the
500 clinical hours required by ACSM, it may be necessary to extend the internship beyond 400 hours
or to acquire additional clinical hours on your own by volunteering or working in a clinical setting.
To ensure that the hours will be accepted, prior to doing the experiential hours, you should confirm
with ACSM that the hours will count as clinical hours. To qualify as ACSM clinical hours, ACSM
requires the practical experience in a clinical exercise program to be in one or more of the following:
•
•
•
•
•
•
cardiac/pulmonary rehabilitation programs
exercise testing and prescription
electrocardiography
patient education and counseling
disease management of cardiac, pulmonary, and metabolic diseases
emergency management
ACSM further states that:
Only hours associated with the following in which you assisted or played a direct role in
providing services will be accepted:
• exercise assessment
• exercise prescription
• supervision
• counseling
• education
Before a student takes the ACSM Clinical Exercise SpecialistSM certifying exam, consult the
following website to confirm the information is still up-to-date. http://certification.acsm.org/cesclinical-hours
Some clinical hours may be accumulated during the undergraduate NEP coursework – e.g.
NEP 427: Nutritional Assessment and Lifestyle Counseling
NEP 478: EKG, Medications, and Procedure,
NEP 479: Nutrition and Exercise Practicum I and II
NEP 480: Cardiac and Pulmonary Rehabilitation
It is the NEP instructor’s responsibility to make sure that the clinical hours meet ACSM’s
requirement and to inform each student of the number of hours accumulated during his/her course.
However, in some courses the student is required to document hours weekly. The NEP instructor is
not held responsible for signing the form if a student did not document the hours per the course
requirements or did not obtain the signature at the end of each semester in which the hours were
accrued. Each student is strongly encouraged to keep the form current and not wait until the end of
the internship to request signatures from NEP faculty. The NEP Internship Coordinator strongly
encourages the student to acquire ACSM’s pre-approval of clinical hours obtained outside the
program, which may be used to fulfill the 500 hour requirement. NEP faculty will not be held
responsible for any hours accumulated outside of the program.
32
APPENDIX E
ACSM CERTIFIED CLINICAL EXERCISE
SPECIALISTSM CLINICAL HOUR
VERIFICATION FORM
33
34
APPENDIX F
NEP ASSESSMENT FORMS
35
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
PRECEPTOR’S MIDTERM ASSESSMENT OF THE INTERN
The following are broad areas of knowledge, skills and abilities the student is expected to have to successfully
complete during the internship experience. For a detailed competency list of the content areas, refer to the NEP
Clinical Exercise Internship Manual, Appendix G, on the E-Value Homepage. Please select the appropriate
number in the Rating Scale that best describes your impression of the student’s competency. The rating for each
assessment must fall between the range 1 and 5; a 0.5 decimal increment will be available between each whole
number.
If the Intern receives ≤ 2 on this Midterm Assessment in any section, the Internship Preceptor and the Intern
should establish goals for improvement in areas that the Intern needs to strengthen. A specific improvement
goal for each category should be established and typed in the designated space at the end of each section.
PRACTICE AREAS: PLEASE CHECK ALL PRACTICE AREAS THE STUDENT PARTICIPATED IN DURING
THE INTERNSHIP
Cardiovascular
Neuromuscular
Immunologic
Pulmonary
Neoplastic
Hematologic
General population (e.g., fitness, wellness)
Sports Performance
Other:
Metabolic (e.g., obesity, DM 1, DM 2, metabolic syndrome)
Orthopedic, muscular, and skeletal (e.g., arthritis, back pain, osteoporosis)
RATING SCALE: PLEASE REFER TO THIS SCALE IN MAKING YOUR ASSESSMENT OF THE STUDENT’S
KNOWLEDGE, SKILLS, AND ABILITIES
5 = 100% Performs above the expectations of an Intern.
4 = 90%
Performs within and frequently beyond the expectations of an Intern.
Performs within and sometimes beyond the expectations of an Intern in most areas. Some areas
3 = 80%
are still in need of growth.
Performs within the expectations of an Intern in only some areas. Several areas are still in need of
2 = 70%
growth; a passing grade cannot be given at this time.
The Intern has too many areas needing significant growth and development; a passing grade
1 = <70%
cannot be given at this time.
Not applicable to this internship.
N/A
PROFESSIONAL SKILLS: THE INTERN DEMONSTRATED
Organization, Planning, and Implementation: Manages time efficiently; plans
ahead and follows through on assignments and projects; provides accurate
information about work/services completed.
Decision Making: Recognizes problems/potential problems; makes sound
decisions under pressure; seeks guidance when uncertain.
Dependability: Is punctual in arriving at work and maintaining designated work
hours; if circumstances require absence from work notifies preceptor or staff
promptly and provides a legitimate reason for the absence; meets professional
commitments and obligations; implements and adheres to directions.
Written Communication: Organized, clear, concise, professional; consistent with
the documentation policies/procedures of the facility.
5
4
3
2
1
N/A
36
Verbal/Non-Verbal Communication: Listens carefully to staff and clients;
communicates professionally and effectively with clients; communicates
professionally and effectively with other staff members (and administrators);
actively participates in discussions and meetings.
Resourcefulness: Readily determines alternative course of action in event of
change; seeks additional learning experiences to improve areas of knowledge;
thinks “outside the box”; uses any extra time effectively by taking on additional
work.
Adaptability: Flexible; demonstrates a positive attitude to change, unexpected
situations, and adversity; does not express or exhibit frustration or annoyance with
changes or unexpected situations.
Interpersonal Skills: Tactful; demonstrates professional and positive conduct;
accepts criticism; cooperative and respectful of patients/clients and staff; listens
carefully and does not interrupt clients or staff.
Professional/Ethical Conduct: Adheres to policies and procedures of the
institution; conducts self with honesty, integrity, and fairness; maintains the
confidentiality of patients and personnel.
Please list the intern’s improvement goals (if applicable):
Additional comments on professional skills:
CONTENT AREAS: The intern’s knowledge of
Exercise physiology and related exercise science
Risk factors and pathophysiology of disease
Health appraisal, fitness and clinical exercise testing
Electrocardiography and diagnostic techniques
Patient management and medications
Medical and surgical management
Exercise prescription and programming
Nutrition and weight management
Patient education and counseling
Safety, injury prevention and emergency procedures
Program administration, quality assurance and outcome assessment
Please list the intern’s improvement goals (if applicable):
5
4
3
2
1
N/A
5
4
3
2
1
N/A
Additional comments on the intern’s knowledge:
INTERN’S SKILLS AND ABILITIES: The intern’s demonstration of
Patient initial intake: review of medical history, medications, etc.
Physical assessments: height, weight, BP, HR, heart/lungs sounds, edema, etc.
Exercise testing: exercise stress testing, 6 min WT, CPET, sit to stand, etc.
Development of ITP or care plan: create chart, etc.
Patient documentation: daily and / or monthly reports
Exercise programming: warm-up, cool down, aerobic, resistance, balance, etc.
Exercise equipment: appropriate use of aerobic machines, strength equipment
Exercise prescription: FITT principles and use of intensity parameters
37
ECG monitoring and rhythm interpretation
Emergency preparation: follows P/P, participates in mock codes
Patient safety: monitors patients appropriately and follows P/P
Patient education / counseling: appropriate and uses motivational interviewing
Please list the intern’s improvement goals (if applicable):
Additional comments on the intern’s skills and abilities:
GENERAL COMMENTS:
Please comment on the intern’s areas of strength:
Please comment on areas needing improvement:
Did you review and discuss this assessment with the Intern? Please circle Yes or No.
Do you feel the Intern is on track to pass the internship at this time? Please circle Yes or No.
If No, the Internship Coordinator will be contacting you as soon as possible to discuss the Intern’s progress and
appropriate plan of action.
Midterm Percentage
38
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
PRECEPTOR’S FINAL ASSESSMENT OF THE INTERN
Please select the appropriate number that best describes your impression of the student’s competency. For a
detailed competency list of the content areas, refer to the Appendix G in the NEP Clinical Exercise Internship
Manual, on the E-Value Homepage. The rating for each assessment must fall between the range 1 and 5; a 0.5
decimal increment will be available between each whole number. To successfully pass the internship the
student must receive > 2 in all categories. If a final score of 2 or below is selected, E-Value will request that the
Preceptor give additional comments on why the student is receiving this score and will request that the
Preceptor validate the final score prior to submitting the assessment.
We greatly appreciate your time and want to thank you for mentoring our students.
PRACTICE AREAS: PLEASE CHECK ALL PRACTICE AREAS THE STUDENT PARTICIPATED IN DURING
THE INTERNSHIP
Cardiovascular
Neuromuscular
Immunologic
Pulmonary
Neoplastic
Hematologic
General population (e.g., fitness, wellness)
Sports Performance
Other:
Metabolic (e.g., obesity, DM 1, DM 2, metabolic syndrome)
Orthopedic, muscular, and skeletal (e.g., arthritis, back pain, osteoporosis)
RATING SCALE: PLEASE REFER TO THIS SCALE IN MAKING YOUR ASSESSMENT OF THE STUDENT’S
KNOWLEDGE, SKILLS, AND ABILITIES
5 = 100% Performs above the expectations of an Intern.
4 = 90%
Performs within and frequently beyond the expectations of an Intern.
Performs within and sometimes beyond the expectations of an Intern in most areas. Some areas
3 = 80%
are still in need of growth.
Performs within the expectations of an Intern in only some areas. Improvement goals established
2 = 70%
at mid-term evaluation have not been met. A passing grade cannot be assigned.
The Intern needs significant growth and development in most areas. Improvement goals
1 = <70%
established at mid-term evaluation have not been met. A passing grade cannot be assigned.
Not applicable to this internship.
N/A
PROFESSIONAL SKILLS: THE INTERN DEMONSTRATED
Organization, Planning, and Implementation: Manages time efficiently; plans
ahead and follows through on assignments and projects; provides accurate
information about work/services completed.
Decision Making: Recognizes problems/potential problems; makes sound
decisions under pressure; seeks guidance when uncertain.
Dependability: Is punctual in arriving at work and maintaining designated work
hours; if circumstances require absence from work notifies preceptor or staff
promptly and provides a legitimate reason for the absence; meets professional
commitments and obligations; implements and adheres to directions.
Written Communication: Organized, clear, concise, professional; consistent with
the documentation policies/procedures of the facility.
5
4
3
2
1
N/A
39
Verbal/Non-Verbal Communication: Listens carefully to staff and clients;
communicates professionally and effectively with clients; communicates
professionally and effectively with other staff members (and administrators);
actively participates in discussions and meetings.
Resourcefulness: Readily determines alternative course of action in event of
change; seeks additional learning experiences to improve areas of knowledge;
thinks “outside the box”; uses any extra time effectively by taking on additional
work.
Adaptability: Flexible; demonstrates a positive attitude to change, unexpected
situations, and adversity; does not express or exhibit frustration or annoyance with
changes or unexpected situations.
Interpersonal Skills: Tactful; demonstrates professional and positive conduct;
accepts criticism; cooperative and respectful of patients/clients and staff; listens
carefully and does not interrupt clients or staff.
Professional/Ethical Conduct: Adheres to policies and procedures of the
institution; conducts self with honesty, integrity, and fairness; maintains the
confidentiality of patients and personnel.
Please list the intern’s improvement goals (if applicable):
Additional comments on professional skills:
CONTENT AREAS: The intern’s knowledge of
Exercise physiology and related exercise science
Risk factors and pathophysiology of disease
Health appraisal, fitness and clinical exercise testing
Electrocardiography and diagnostic techniques
Patient management and medications
Medical and surgical management
Exercise prescription and programming
Nutrition and weight management
Patient education and counseling
Safety, injury prevention and emergency procedures
Program administration, quality assurance and outcome assessment
Please list the intern’s improvement goals (if applicable):
5
4
3
2
1
N/A
5
4
3
2
1
N/A
Additional comments on the intern’s knowledge:
INTERN’S SKILLS AND ABILITIES: The intern’s demonstration of
Patient initial intake: review of medical history, medications, etc.
Physical assessments: height, weight, BP, HR, heart/lungs sounds, edema, etc.
Exercise testing: exercise stress testing, 6 min WT, CPET, sit to stand, etc.
Development of ITP or care plan: create chart, etc.
Patient documentation: daily and / or monthly reports
Exercise programming: warm-up, cool down, aerobic, resistance, balance, etc.
Exercise equipment: appropriate use of aerobic machines, strength equipment
Exercise prescription: FITT principles and use of intensity parameters
40
ECG monitoring and rhythm interpretation
Emergency preparation: follows P/P, participates in mock codes
Patient safety: monitors patients appropriately and follows P/P
Patient education / counseling: appropriate and uses motivational interviewing
Please list the intern’s improvement goals (if applicable):
Additional comments on the intern’s skills and abilities:
FINAL COMMENTS
Please comment on the intern’s areas of strength:
Please comment on areas needing improvement:
Did you review and discuss the Final Assessment with the Intern?
Please circle Yes or No.
41
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
STUDENT’S ASSESSMENT OF NEP CURRICULUM AND INTERNSHIP
The College of Pharmacy at Washington State University strives to ensure that you are academically prepared for the
internship. This information will assist us in identifying the strengths and limitations as well as enhance our educational
program and curriculum.
Please rate each statement below that best describes your actual perception/belief regarding the academic preparation and
internship experiences. This assessment must be completed no later than 7 days after the conclusion of your internship;
otherwise an “I” (incomplete) grade will be given until the evaluations are completed (refer to the Clinical Internship
Manual for more details).
The first section is a list of knowledge and skills that the College expects you to learn during the two years prior to your
internship. Please indicate how well prepared you were to apply knowledge and/or perform each skill at your Internship
Site If a rating of N/A is selected, please explain why the knowledge/skill was not applied and/or performed. If a rating
of 1 or 2 is selected, please explain why you were not well prepared to apply knowledge and/or perform each skill.
Under the second section you will be able to assess the internship experience. If a rating of 1 or 2 is selected, please
explain why you disagree with the statement.
RATING SCALE FOR NEP CURRICULUM
Well Prepared
Not Prepared
4
2
Prepared
Not Well Prepared
3
1
EVALUATION OF THE
NEP CURRICULUM
NEP 300 – Professional Preparation
Knowledge of standards of practice in dietetics
and exercise physiology
NEP 320 – Strength Training
Ability to apply scientific principles of strength
training to exercise training
NEP 340 – Foods with Application to PA
Knowledge of food properties and applications
to physical activities (PA)
NEP 362 – Biomechanical Analysis
Knowledge of biomechanics
NEP 370 – Physiological Biochemistry
Knowledge of biochemical foundations
NEP 400 – Macronutrient Metabolism
Knowledge of macronutrients and their
utilization of energy
NEP 401 – Supervised Practice
Ability to provide the community with
nutritional education
4
3
2
N/A
1
N/A
Not applicable to this internship
Additional Comments
42
NEP 402 – Micronutrients Metabolism
Knowledge of nutritional requirements for
maintenance of health
NEP 427 – Assessment and Counseling
Ability to assess dietary intakes, provide menu
plan and perform lifestyle counseling with
communication skills
NEP 435 – Exercise, Diet and Disease
Knowledge of disease pathophysiology and
implications for dietary and exercise
interventions
NEP 450 – Management and Facilities
Knowledge of establishing and maintaining a
safe and proper facility
NEP 458 – Nutrition and Exercise
Ability to recognize nutritional needs and
dietary patterns throughout the life cycle
NEP 463 – Advanced Exercise Physiology
Knowledge of physiological responses to
exercise across the lifespan
NEP 465 – Assessments
Knowledge of field and laboratory techniques
and tools required to properly asses nutritional
and physiological parameters
NEP 470 – Sports Nutrition
Knowledge of energy and fluid requirements
during exercise, evaluation of dietary practices,
ergogenic aids, and weight maintenance
NEP 476 – Testing and Prescription
Ability to perform exercise tests and design
exercise prescriptions
NEP 478 – ECG, Meds & Procedures
Ability to interpret ECGs, identify the impact of
medications and understand common cardiac
procedures
NEP 479 – Supervised Practicum
Ability to perform exercise and nutrition
assessments and develop
recommendations/prescription for healthy and
disease subjects
NEP 480 – Cardiopulmonary Rehab
Knowledge of exercise assessment/prescription,
nutrition recommendations and program
management for cardiopulmonary and
rehabilitation situations and populations
Please provide additional feedback regarding how the NEP curriculum prepared you for your internship:
43
Please provide additional feedback regarding how the NEP curriculum could have prepared you better for your
internship:
RATING SCALE FOR THE INTERNSHIP
Strongly Agree
Disagree
4
2
Agree
Strongly Disagree
3
1
EVALUATION OF THE
4 3 2 1 N/A
INTERNSHIP
You felt well prepared for your internship.
The academic preparation in nutrition was
beneficial to you during your exercise
internship.
The internship manual was a thorough guide
that helped you prepare for the internship.
The weekly reports helped you to reflect on
your professional growth and kept you focused
on your goals.
The case study helped you review important
information for the CESSM exam.
The Internship Coordinator was available to
answer questions or provide guidance regarding
situations not addressed in the internship
manual.
The Internship Coordinator was available to
facilitate conflict resolution or difficulty that
arose during the internship.
How could you improve your personal preparation for this internship?
N/A
Not applicable to this internship
Additional Comments
44
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
STUDENT’S ASSESSMENT OF INTERNSHIP PRECEPTOR AND SITE
Please fill out this assessment form of your Internship Preceptor and site. We appreciate your input and the information
you provide will be used to aid in continual enhancement of our educational program. The information will be shared
with your preceptor after your internship so they too will receive feedback regarding your experience. This assessment
must be completed no later than 7 days after your internship. If you fail to complete on time you will receive an “I”
(incomplete) for a grade until the assessment is completed. (see the NEP Clinical Exercise Internship Manual for more
details).
Below are several statements and questions about your Internship Preceptor. Please use the rating scale for statements
and provide comments for the questions.
RATING SCALE FOR INTERNSHIP PRECEPTOR AND SITE
Strongly Agree
Disagree
4
2
Agree
Strongly Disagree
3
1
N/A
Not applicable to this internship
EVALUATION OF THE INTERNSHIP PRECEPTOR
4
3
2
1
N/A
The preceptor provided you with a helpful orientation prior to patient interaction.
What improvements could be made to the orientation process?
The preceptor provided you with a hard copy of the policy and procedures to review prior to
patient interaction.
The expectations of the internship were clearly defined and communicated by the preceptor.
Goals were reviewed with the preceptor throughout the internship.
The preceptor was accessible.
The preceptor was approachable.
The preceptor provided frequent feedback regarding your performance.
How did the preceptor successfully communicate constructive criticism and positive feedback?
What improvements could the preceptor make to enhance communication regarding your performance?
The preceptor provided guidance and encouragement throughout the internship.
You feel the preceptor was respectful and concerned about your progress.
The preceptor modeled continuous professionalism throughout the internship.
45
How did the preceptor display/model professionalism?
How could the preceptor make improvements in modeling professionalism?
The preceptor continuously and effectively modeled proficient patient care skills.
The preceptor encouraged you to participate in independent problem solving and asked
questions that stimulated critical thought.
Your preceptor assigned activities that served to stimulate your professional growth and
development.
What additional activities could the preceptor include to better stimulate your professional growth and development?
What are the preceptor’s strengths and / or areas that could be improved?
Do you have any additional feedback for the preceptor?
EVALUATION OF THE INTERNSHIP SITE
4
3
2
1
N/A
The Internship Site allowed you to experience or observe all aspects of its operations.
The site was clearly set-up to accommodate interns.
The work environment was comfortable.
What were the strengths and / or weaknesses of the environment?
Ancillary personnel (other than the preceptor) were positive and willing to collaborate with you
to create a positive learning experience.
How did the ancillary personnel meet or exceed your expectations?
How could the collaboration between ancillary personnel and interns be enhanced?
As an intern you were able to collaborate with other health care professionals when/if
necessary.
What is an example of a positive collaborative encounter/experience you had during this internship with other health
care professionals?
46
How could collaboration between health care providers and interns be enhanced at this site?
The internship experience exposed you to diverse patient/client populations (i.e. age, gender,
ethnicity).
This site provided you with a wide variety of clinical situations and disease states.
You would consider accepting employment at this site.
You would recommend this Internship Site to other NEP students.
Do you have any additional feedback regarding this site?
The site explanation provided in E-Value was accurate.
What would future students need to know about either the site or internship description to better prepare them for this
site experience?
Please provide a brief description of this site that would provide next year’s interns with insight into the educational
experience that is possible at this location.
47
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
PRECEPTOR’S ASSESSMENT OF THE PROGRAM’S
ACADEMIC PREPARATION OF THE STUDENT
Please assess how well you feel the NEP Program prepared the student for the internship at your site. Answer
each of the following based on your expectations of the interns and how you feel the NEP student’s academic
preparation compares to other programs. We appreciate your input and the information you provide will be used
to aid in continual enhancement of our educational program.
PRACTICE AREAS: Please check all populations in which your site serves
Cardiovascular
Neuromuscular
Pulmonary
Neoplastic
General population (e.g., fitness, wellness)
Sports Performance
Metabolic (e.g., obesity, DM 1, DM 2, metabolic syndrome)
Orthopedic, muscular, and skeletal (e.g., arthritis, back pain, osteoporosis)
Immunologic
Hematologic
Other:
RATING SCALE: Please refer to this scale when completing the evaluation of the program’s academic
preparation of the student
Not Prepared
4 Well Prepared
2
N/A Not applicable to this internship
Not Well Prepared
3 Prepared
1
ACADEMIC PREPARATION OF THE INTERN’S
Knowledge
Skills and Abilities
Professionalism: i.e., dependable, organized, problem solver, interpersonal skills
4
3
2
1
N/A
PROGRAM’S TRAINING IN THE FOLLOWING KNOWLEDGE AREAS
Exercise physiology and related exercise science
Risk factors and pathophysiology of disease
Health appraisal, fitness and clinical exercise testing
Electrocardiography and diagnostic techniques
Patient management and medications
Medical and surgical management
Exercise prescription and programming
Nutrition and weight management
Patient education and counseling
Safety, injury prevention and emergency procedures
Program administration, quality assurance and outcome assessment
From the knowledge areas which do you feel need improvement:
4
3
2
1
N/A
48
Please pick the top 3 knowledge areas in which you feel the program’s training excels:
1.
2.
3.
PROGRAM’S TRAINING OF THE FOLLOWING SKILLS AND ABILITIES
Patient initial intake: review of medical history, medications, etc.
Physical assessments: height, weight, BP, HR, heart/lungs sounds, edema, etc.
Exercise testing: exercise stress testing, 6 min WT, CPET, sit to stand, etc.
Development of ITP or care plan: create chart, etc.
Patient documentation: daily and / or monthly reports
Exercise programming: warm-up, cool down, aerobic, resistance, balance, etc.
Exercise equipment: appropriate use of aerobic machines, strength equipment
Exercise prescription: FITT principles and use of intensity parameters
ECG monitoring and rhythm interpretation
Emergency preparation: problem management, code response/CPR
Patient safety: monitors patients appropriately and follows P/P
Please comment on areas of strength:
4
3
2
1
N/A
Please comment on areas that need improvement:
Any additional feedback:
49
APPENDIX G
NEP 490 CLINICAL
COMPETENCY LIST
50
Washington State University College of Pharmacy
Program in Nutrition and Exercise Physiology
NEP 490 CLINICAL COMPETENCY LIST
PRACTICE AREAS: THE INTERN IS COMPETENT TO WORK WITH PATIENTS WITH THE FOLLOWING DISEASE
STATES. PLEASE CHECK ALL THAT APPLY TO THIS INTERNSHIP SITE
Cardiovascular
Pulmonary
Other:
Metabolic: includes obesity, DM 1, DM 2, metabolic syndrome
RATING SCALE
2 = Competent
0= Unsatisfactory
1 = Developing
N/A=Not applicable
This list is to guide you in evaluating the intern in the content areas listed on the intern’s assessment form.
You do not need to complete this form.
EXERCISE PHYSIOLOGY AND RELATED EXERCISE SCIENCE
2 1 0 N/A
Identify the determinants of myocardial oxygen consumption (i.e., heart rate X systolic
blood pressure = double product OR rate-pressure product) and the effects of exercise
training on those determinants.
Plot the normal resting and exercise values associated with increasing exercise intensity
(and how they may differ for cardiac, pulmonary, and metabolic diseased populations) for
the following: HR, SV, CO, RPP, A-V O2 difference, VO2 consumption, SBP and DBP,
VE, Vt, RR, Vd/Vt, VE/VO2, and VE/VCO2,SaO2, blood glucose, PFTs (FEV1.0, MVV,
FVC).
Demonstrates knowledge of acute and chronic adaptations to exercise for patients.
Identify the metabolic equivalent (MET) requirements of various occupational,
household, sport/exercise, and leisure time activities.
Describe the effects of variation in environmental factors (e.g. temperature, humidity,
altitude) for patients.
RISK FACTORS AND PATHOPHYSIOLOGY OF DISEASE
2 1 0 N/A
Recognize the pathologic process that various risk factors contribute for the development
of cardiac, pulmonary, and metabolic diseases (e.g., smoking, hypertension, abnormal
blood lipid values, obesity, inactivity, sex, genetics, and diabetes).
Describe the risk factor classifications and define their relationship to pathology of
disease.
Describe the influence of exercise on cardiovascular, pulmonary, and metabolic risk
factors.
Describe the pathophysiology of cardiovascular, pulmonary, metabolic diseases (includes
ischemia, angina, MI, CHF, COPD, IRD, DM 1 & 2, metabolic syndrome and renal
disease).
Examine the role of lifestyle on cardiovascular risk factors such as hypertension, blood
lipids, glucose tolerance, and body weight.
HEALTH APPRAISAL, FITNESS AND CLINICAL EXERCISE TESTING
2 1 0 N/A
51
Describe common procedures and apply knowledge of results from radionuclide imaging,
stress echocardiography, and pharmacologic testing.
Demonstrate knowledge of exercise testing procedures for various clinical populations in
terms of exercise modality, protocol, physiological measurements, and expected
outcomes.
Review clinic’s paperwork (i.e., informed consent, referral)
Review patient’s history (i.e., medical, family, personal, social)
Demonstrate ability to conduct a brief physical exam
• Height and weight
• Blood pressure, heart rate and rhythm, respiratory rate
• Heart and lung sounds
• Peripheral pulses and edema
• Oximetry
• Other assessments: (i.e., blood glucose)
• Other medical conditions: (i.e., incision, injury, limitation)
Instruct patient on use of scales (RPE, dyspnea, pain, claudication, angina).
Monitor patient at rest, during test and post- exercise test appropriately (HR, ECG, BP,
O2).
Identify absolute and relative contraindications to exercise testing and test termination.
Recognize normal and abnormal chronotropic and inotropic responses to exercise testing
and training.
Describe the differences in the physiologic responses to various modes of ergometry (e.g.,
treadmill, cycle and arm ergometers) as they relate to exercise testing and training.
Demonstrate the ability to perform a six-minute walk test and appropriately use the results
to assess prognosis, fitness, and/or improvement.
Interpret test results accurately & document test for chart or physician.
ELECTROCARDIOGRAPHY AND DIAGNOSTIC TECHNIQUES
Locate the appropriate sites for the limb and chest leads for resting, standard, and exercise
ECGs.
Interprets ECG rhythm accurately (atrial, junctional, ventricular, blocks, premature beats);
• Axis determination,
• Ischemia/infarction,
• Other: LVH, electrolyte, drug therapy.
Identify potentially hazardous arrhythmias or conduction defects observed on the ECG at
rest, during exercise, and recovery.
MEDICATIONS AND PATIENT MANAGEMENT
Demonstrate understanding of common medications: indications; mechanism; effects on
HR, BP, ECG, and exercise capacity; adverse effects; food interactions.
Recognize common medications associated in the clinical setting, their indications for
care, and their effects at rest and during exercise.
Develop an ITP (care plan) for patients.
Practice disease/case management responsibilities, including daily follow-up concerning
patient needs, signs and symptoms, physician appointments, and medication changes for
patients.
Demonstrate ability to assess signs and symptoms, interpret the data, and respond
appropriate in a clinical setting.
Recognize patient clinical need for referral to other allied health professionals.
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1
0
N/A
•
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MEDICAL AND SURGICAL MANAGEMENT
Recognize limitations of patient with recent invasive procedures: CABG with sternotomy,
PCI, or other surgical procedure.
Identify risk, benefit, and unique management issues of patients with mechanical,
prosthetic valve replacement and valve repair.
Describe and recognize bariatric surgery as a therapy for obesity.
EXERCISE PRESCRIPTION AND PROGRAMMING
Demonstrate appropriate use of aerobic and strength equipment.
Instruct and supervises patients on correct use of equipment.
Design an individualized aerobic exercise program for patients using FITT principles.
Design an individualized strength exercise program for patients using FITT principles.
Demonstrate correct form during strength and flexibility exercises.
Prescribe appropriate strength and flexibility exercises to develop muscle balance.
Demonstrate the ability to prescribe/modify intensity of exercise per clinic’s P/P.
Demonstrate the ability to lead group exercise, supervise and modify patient’s form.
Demonstrate the ability to monitor patients during exercise session (i.e., HR, BP, ECG,
O2).
Demonstrate the ability to prescribe and modify exercise programming for patients with:
1. Metabolic diseases / disorders (DM, dyslipidemia, obesity, metabolic syndrome,
renal disease,
2. Cardiovascular diseases (MI, PCI, CHF, LVAD, heart transplant, PAD, stroke),
3. Pulmonary disease (obstructive, restrictive, vasculature).
NUTRITION AND WEIGHT MANAGEMENT
Describe and discuss dietary considerations for cardiovascular and pulmonary diseases,
chronic heart failure, and diabetes that are recommended to minimize disease progression
and optimize disease management.
Compare and contrast dietary practices used for weight reduction, and address the
benefits, risks, and scientific support for each practice.
Calculate the effect of caloric intake and energy expenditure on weight management.
PATIENT EDUCATION AND COUNSELING
Discuss medications, procedures, treatments, and disease process with patients.
Demonstrate the ability to conduct effective and informative group and individual
education sessions directed at primary and secondary prevention of chronic disease.
Describe how exercise and/or nutrition will modify risk factors or progression of disease.
Use Motivational Interviewing with a patient(s) needing to modify risk factors through
lifestyle changes.
Provide strategies for dealing with patient’s ambivalence and noncompliance.
Provide nutritional recommendations based on national organizations.
Provide recommendations on how to modify weight through nutrition and/or exercise.
Design an effective home program on exercise and/or nutrition for patient.
Design pamphlets or handouts on educational information.
Recognize observable signs and symptoms of anxiety or depressive symptoms and the
need for a psychiatric referral.
Recognize and implement methods of stress management for patients with chronic disease
and their family.
SAFETY, INJURY PREVENTION AND EMERGENCY PROCEDURES
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1
0
N/A
2
1
0
N/A
2
1
0
N/A
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Stratify patients using appropriate risk-stratification methods and understanding the
prognostic indicators for high-risk individuals.
Demonstrate ability to use and safely monitor patient’s exercise on telemetry system.
Recognize patient’s abnormal S/S and modifies or terminates exercise session
appropriately.
Notify staff and / or physician of abnormal responses to exercise or other signs/symptoms.
Describe the emergency equipment, medications and personnel that should be present in
an exercise testing laboratory and rehabilitative exercise training setting.
Complete daily code cart check.
Understand emergency response/management of various signs or symptoms per P/P:
1. Angina,
2. Dysrhythmia,
3. Hypertension/hypotension,
4. Hyperglycemia/hypoglycemia,
5. Low O2 sats; and
6. Signs/symptoms of decompensated heart failure.
Understand different codes and participate in mock codes.
Aware of the current CPR, AED, and ACLS standards to be able to assist with emergency
situations.
PROGRAM ADMINISTRATION, QUALITY ASSURANCE AND OUTCOME
ASSESSMENT
Demonstrate comprehension and compliance with the clinic’s P/P.
Demonstrate appropriate handling of patient’s confidential information.
Complete daily charting and monthly reports.
Discharge the charts per clinic’s P/P.
Participate in clinic’s quality assurance projects and outcome assessment.
Meet productivity standards of clinic.
Work within scope of practice.
2
1
0
N/A
Comments:
DATE: ____________________
INTERN ‘S NAME: _______________________________________
INTERNSHIP PRECEPTOR’S NAME: __________________________
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APPENDIX H
CLINICAL INTERNSHIP
CASE STUDY
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NEP CLINCIAL INTERNSHIP CASE STUDY
You will be expected to add a case study to your weekly report beginning the fourth week.
PURPOSE OF THE CASE STUDY:
The case study is an opportunity for you to review your didactic knowledge and apply it to what you
are currently experiencing. Each week review your ACSM Resource Manual, ACSM GETP,
AACVPR Guidelines, AHA Scientific Statements, ADA recommendations, or look up new
medications on the Internet. Your case study should be in your own words unless you are reporting
on a guideline, table or chart. However, cite your references properly and list resources at the end of
each report. Each week I do expect to see some depth of understanding reflected in your case study
as you take the didactic information and link it to real people/real circumstances (note: weekly points
double after week 3). By doing this, you are studying for your ACSM Clinical Exercise Specialist
exam!
As the internship progresses and your daily schedule becomes more routine, your case study should
take up more of the weekly report. However, do not make the report more than two pages. If the
material is excessive, divide it into two weeks.
SELECTION OF PATIENT/CLIENT:
During week three discuss with your Internship Preceptor a patient who you can use for your case
study. Try to select a patient with several comorbidities, risk factors, procedures and/or multiple
medications. The patient’s name cannot be used or any reference which could be linked to his/her
confidential information. Upon guidance by your preceptor, request permission from the patient or
client, if needed.
ADDITION TO YOUR WEEKLY REPORT:
4th Week: Provide the patient’s demographics and relevant medical history- this may include the
person’s present/past health and medical hx, risk factors, comorbidities, age, weight, etc. You can
add further description/detail in the future weeks (see below).
5th - 10th Week: Each week continue to build your case study with additional information that you
have researched/reviewed about your patient. Below is a list of various topics that you can use in
your case study.
1.
2.
3.
4.
5.
6.
7.
8.
Signs and symptoms pre-procedure
Pathophysiology of disease
Hospitalization records/medical records
Diagnostic procedures
Lab values and/or ECG’s with interpretation
Revascularization procedures
Other treatments or procedures
Medications-mechanism of action, side effects, common dosage, contra/indications,
interaction with foods, effects on exercise (FITT, BP, ECG, etc.)
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9. Initial general interview, assessment and/or limited physical exam or prep for procedure
(clinical exercise testing)
10. Exercise testing: indications, termination criteria, protocols, modalities, etc.
11. Exercise prescription and programming: endurance, resistance and/or balance training,
modalities, durations, intensity, etc.
12. Expected acute responses and chronic adaptations to exercise
13. Special considerations for disease and comorbidities (this is probably the most important
piece to understand when working with patients)
14. Education and/or counseling of patient- primary or secondary prevention for the patient
15. Lifestyle modification for risks factors (nutrition, physical activity/exercise, stress, smoking,
weight, etc.)
16. Dietary modification or medical nutrition therapy ordered by MD and observed by a RD
17. Emergency response or problem management
18. Administration - daily documentation, monthly reports, discharge reports
EXAMPLE:
For example, as a student in a clinical rehabilitation setting you note that your patient’s hemoglobin
lab value is < 11.5 g/dL, her skin color is pale and she states that she is not taking her iron
supplement due to complaints of constipation. You review her medical history to determine a
possible cause of anemia and you note a significant loss of blood during the surgical procedure.
Through your research you find that being anemic can result in less oxygen being transported and,
therefore, will limit exercise capacity. After discussing this finding with your supervisor you search
on reliable websites or create an educational resource, which provides a list of food sources high in
iron and another handout that lists foods high in fiber. With permission from your Internship
Preceptor, you provide this information to the patient and document the educational session. The
next week you ask the patient follow-up questions to determine if she understood the information and
is finding the information beneficial. Of course, you have previously encouraged your patient to
consult with her PCP.
For students completing clinical exercise testing internships, select an interesting patient each week.
Provide a brief patient history and then select a topic (from above) that is appropriate for this patient.
For example, a patient with a disability is confined to a wheelchair. You and the Internship Preceptor
design a unique protocol/modality for this patient that you have not used previously. Another
example may be to report on a diagnostic procedure that you have not discussed previously for a
patient. Perhaps a patient was completing a Lexiscan stress test and developed a run of ventricular
tachycardia. In your case study you explain the diagnostic procedure and then the emergency
procedures. For a case study such as this, scan/copy appropriate ECGs (name and/or number must
not be readable) labeled on top for your case study (I will pick ECGs up at site visit, if allowed).
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