Hca Internship Guide

Western Kentucky University
Department of Public Health

Healthcare Administration Program
Internship Guidelines
Academic e!uirements and Procedures for
Undergraduate and Graduate Internships
H"A ##$ and H"A %#&
Academic Year 2012-2013
Western Kentucky University Program in Health Care Administration
This document contains the guidelines for students conducting their internship in the
Health Care Administration program, Department of Public Health at Western Kentucky
Uniersity, !o"ling #reen, Kentucky$ %nternship students, preceptors &responsible for
superising the student on site', and faculty adisors should refer to these guidelines for
information relatie to the types and scope of tasks(actiities in "hich the student should
be engaged in order to demonstrate competence and the ability to apply academic
kno"ledge in an operational enironment$
%n addition, the guidelines proide Western Kentucky Uniersity re)uirements, program
re)uirements, internship purpose, and ob*ecties, in addition to other pertinent
information relatie to the internship e+perience$
,tudent interns and preceptors haing )uestions concerning the internship program or
desiring additional information, guidance, or clarification regarding any items contained
"ithin this guide should contact the program directors-
Dr' Gregory (llis)Griffith, Director HCA Program, oom A" *+,
Phone- ./01/23140/5
6a+- ./01/231224/
7mail- gregory$ellis$griffith8"ku$edu
Dr' William -kanta. Director 9HA(79HA Programs, oom A" */,"
Phone- ./01/2313.50
6a+- ./01/231224/
(mail0 "illiam$mkanta8"ku$edu
2
11111 Helpful 2ips to Prospective Interns 11111
:$ ,tudents must read carefully and completely these guidelines to understand the re)uirements for
HCA and 9HA internships$
2. %nitially, students should consult "ith program directors- Dr$ 9kanta &9HA' or Dr$ 7llis1#riffith
&HCA' or their academic adisors at least one semester prior to their internships to discuss about
and find internships sites$ ,tudents are allo"ed to suggest the sites of their choice that might be
used if they meet program re)uirements 1 Appendi3 A4 Pages *+)*%' ;ther"ise the program
can allocate students to sites preiously used by the program$ Dr$ 7llis1#riffith can be contacted
by phone at &./0'1/23140/5 or e1mail- gregory$ellis1griffith8"ku$edu$ Dr$ 9kanta can be
contacted by phone at &./0'1/2313.50 or e1mail- "illiam$mkanta8"ku$edu$
4$ 7ery student has to ensure that their internship agency has a alid and current affiliation "ith
both the program and uniersity- Print and take the Affiliation Agreement Form -
Appendi3 A4 Pages *+)*% to the agency for filling$ !ring the filled and signed form to the
program director for further processing$
2$ Prior to the start of the internship, students are mandated to submit signed Internship
Responsibilities Form to their respectie program directors$ The forms can be printed from
this document 1 Appendices 5 and "4 Pages *&)*,

3$ 7ery "eek, for all :. "eeks of internship, students are re)uired to submit "eekly internship
reports$ Use the Internship Weekly Report rompt !"estions 1 Appendi3 D4 Page *6
and Internship Acti#ity $og - Appendi3 (4 Page *$ to help you in report preparation$ The
report should be one to t"o pages in length, typed and saed in a Word format$ %t should be sent
eery "eek "ithout fail on 9onday to the program director for records$ <ou can email or fa+ &./01
/231224/' the report$ All reports must be reie"ed and signed by the preceptor$
5$ After completing the first t"o or three "eeks of the internship, the student has to schedule a
meeting "ith their preceptor to decide upon a pro*ect that has to be completed by the intern$
The ro%ect Agreement Form 1 Appendi3 74 Page /8 has to filled, signed and returned
to the program director indicating the identification and initiation of the pro*ect$
/$ The pro*ect report should be /1:0 pages &HCA', :01:3 pages &9HA' in length, typed and saed
in Word format$ The filled and signed ro%ect &ompletion Form - Appendi3 G4 Page /*
has to be submitted "ith the pro*ect report$
=$ At the conclusion of the internship, the follo"ing ealuations hae to be completed$
3
%$ The preceptor "ill ealuate the intern based on the responses to the Intern '#al"ation
Form 1 Appendi3) H4 Pages //)/#$ This ealuation has to be submitted anonymously
to the program director$
II. The student "ill ealuate the program using the (t"dent Assessment of the
Academic rogram Form - Appendi3)I4 Pages /%)/,' The completed ealuation
form has to be submitted to the program director$
A"AD(-I" (9UI(-(:2;
7ach student in the health care administration &HCA' program is re)uired to successfully
complete a t"ele "eek or 2=0 hour internship e+perience in an approed health care
organi>ation, health related organi>ation, or a goernmental agency that is associated
"ith health care organi>ation licensing, certification, or regulation$ This can include, but
is not limited to hospitals, long term care facilities, rehabilitation agencies, home health
and hospice organi>ations, physician office practices, managed care organi>ations,
reimbursement or financial intermediaries, medical suppliers, goernmental agencies,
research groups, pharmaceutical companies, information systems companies or health
care consulting groups$
This is a mandatory prere)uisite in order for the student to be eligible for graduation and
a"arding of a !achelor of ,cience &!,' degree in Health Care Administration or 9aster of
,cience &9,' from Western Kentucky Uniersity$ The internship e+perience may be
completed in any academic semester proided the student meets all current re)uirements
for internship placement$ Program directors are responsible for reie"ing and approing
all applications for internship placement and for approing all internship sites$
PUP<;(
The purpose of the administratie internship e+perience is to proide the student "ith
opportunities in an operational enironment to-
:$ Ac)uire and demonstrate competencies e+pected in a professional managerial
enironment "ithin a health care organi>ation as outlined aboe$
.$ %ntegrate and apply the academic theory and kno"ledge ac)uired in the classroom to
the actual practice of health care management$
4$ Ac)uaint the student "ith arious consumer, customer or client populations,
organi>ational actiities, scope of serices, and re)uired personnel "ithin the
internship organi>ation$
2$ Deelop ob*ectie methods for ealuating responsibilities, decisions, and operations
relatie to effectie and efficient management and organi>ation of a health care
organi>ation$
4
3$ Assess the e+ternal enironmental factors "hich affect the strategic ability of the
health care organi>ation to operate such as- community organi>ations, adocacy
organi>ations, ciil rights organi>ations, federal and state regulatory agencies and
regulations, reimbursement mechanisms and constraints, certification and
accreditation procedures, public attitudes, consumers, competition, or unions$
5$ Ac)uaint the student "ith the interrelationships and interdependencies of the arious
components of the health care deliery system and the interfaces to the internship
organi>ation$
/$ ;bsere and study the interrelationships and interdependencies "ithin the health care
organi>ation$
=$ Allo" students to assess the suitability of his(her )ualifications for and commitment
to the profession of health care management$
G(:(A= I:7<-A2I<: 7< ;2UD(:2;
The internship e+perience consists of a series of tasks and actiities that the student must
successfully complete in order to demonstrate his(her competence in a particular area
and e+hibit the ability to apply academic kno"ledge$ The preceptor may erify the
student?s competence by reie"ing performance and completion of tasks and actiities, by
obseration, or by oral or "ritten tests$ The student?s success during the internship
depends on indiidual motiation, and application$ ,tudent success can be achieed by
each indiidual "ho is capable of applying the theories, concepts, principles, kno"ledge,
and techni)ues learned and ac)uired through formal academic preparation to practical
operational situations, and problems in the areas to "hich the indiidual student is
assigned$
During the internship, the student must conform to the general policies, procedures,
rules, and regulations of the organi>ation in the same "ay that all personnel of the
organi>ation must do$ ,tudents must pay particular attention to and conscientiously
obsere the ethical directies specific to the organi>ation$ ,tudents must not interfere
"ith the operations of the organi>ation$ 6urther, students must obsere strict
confidentiality of all information as "ould any health care professional be e+pected to
follo"$ ,tudents "ill speak in a professional manner at all times in the presence of
personnel, patients, customers, clients, families, isitors, community representaties or
other guests of the organi>ation$ ,tudents are absolutely forbidden to discuss any
information relatie to a patient?s condition unless specifically authori>ed to do so$
,tudents "ill follo" the directions of the preceptor or the preceptor@s designee at all times
in matters pertaining to the organi>ation$
The preceptor, program coordinator, or the organi>ation superisor may, singularly or
collectiely, re)uire the student to be assigned to different "ork areas and different shifts
5
on a rotational basis$ %n such instances, the student "ill be under the superision of the
indiidual assigned by the preceptor and the student "ill be re)uired to perform a ariety
of tasks and actiities$ ,tudents are encouraged to seek the adice, counseling, and
guidance of the preceptor and others assigned as the student?s superisor$ ,tudents
should perform all tasks and actiities assigned to them effectiely and efficiently and to
continually seek better "ays of applying themseles in the internship e+perience, perform
assigned tasks as directed, and e+hibit a cooperatie attitude at all times$
,tudents are reminded that the internship e+perience is an e+tension of the academic
preparation and an opportunity to ac)uire e+perience in an operational enironment$
,tudents are also reminded remuneration by the Uniersity or the organi>ation should
not be e+pected or re)uested$
G(:(A= I:7<-A2I<: 7< P("(P2<; >Preceptor esponsibilities?
6or students planning an internship "ith an organi>ation that is not currently affiliated
"ith the HCA internship program, a formal affiliation agreement must be established$ %t
is re)uested that the chief e+ecutie officer &or authori>ed designee' of the organi>ation
complete and return an application for internship site affiliation Appendi3 A4 Pages *+)*%,
agreement to the HCA program director$ %n addition, it is re)uested that the appointed
preceptor for"ard a curriculum itae to the program director$ The aforementioned are
re)uired by the Uniersity and arious accrediting agencies$
Preceptors "ill be responsible for erifying the student?s competence relatie to re)uired
tasks and actiities as outlined in these guidelines$ 2he preceptor. or designee. must
initial all student assignments and reports before they are sent to the faculty
supervisor' If reports are being sent electronically. the student should first
submit the report>s? to the preceptor @ho @ill then for@ard the report>s? to
the faculty supervisor' 2his method should ensure the preceptor sees and
authoriAes all reports prior to submitting to the faculty supervisor'
The preceptor should meet "ith the student on a regular specified schedule in order to
ealuate performance, apprise the student of strengths and "eaknesses, identify problem
areas, and modify, if necessary, the outlined program to reflect changes and altered needs
of the student and the organi>ation$ Preceptors may formulate and administer oral and(or
"ritten e+aminations to erify student competence in a sub*ect or particular area$
Preceptors may formulate their o"n indiidual student internship plan as long as the
Uniersity?s plan is incorporated$ Ho"eer, such plans should be submitted in outline
form to the HCA program director either prior to or during the first "eek of the
internship$
6
The preceptor "ill be re)uired to complete and submit to the faculty superisor an
ealuation of the student intern at the end of the internship period &Appendi3) H4 Pages
//)/#'$ The student "ill proide the preceptor "ith a copy of the ealuation form$
;2UD(:2 (9UI(-(:2;
%nternship students "ill be re)uired to submit reports to the Uniersity program
director(faculty superisor as follo"s-
:$ Complete and for"ard both the A%nternship Weekly BeportA ,ee &Appendi3 D4 Page *6'
and the A%nternship Actiity CogA &Appendi3 (4 Page *$' at the end of each "eek during
the internship$ Beports may be submitted ia fa+ &./01/231224/', mail, or
electronically$ %f reports are submitted by fa+ or mail, they should be signed &or
initialed' by the preceptor$ %f reports are sent electronically, they should be submitted
to the preceptor first, and the preceptor should then for"ard the reports to the faculty
superisor &this "ill indicate the preceptor@s authori>ation of the material'$
.$ Consult "ith and determine mutually "ith the preceptor, any pro*ect, research study,
etc$, "hich "ill be commenced and completed during the internship period$ ;nce the
assignment&s' is determined, the student intern "ill be re)uired to complete, and
submit, an A%nternship Pro*ect Agreement 6ormA &Appendi3 74 Page /8' in accordance
"ith instructions contained on the form$
4$ Upon completion of the pro*ect, a DPro*ect Completion 6ormE &Appendi3 G4 Page /*'
should be completed by the student and authori>ed by the preceptor for submission to
the program director(faculty superisor$
%n addition to the "eekly reports and the pro*ect agreement form, student interns must-
:$ Complete tasks and actiities as outlined in these guidelines, and submit related
reports, abstracts, etc$, immediately upon completion$
.$ All assignments and reports submitted by student interns shall be type"ritten on
)uality bond paper or sent electronically, proof read for errors in spelling and
grammatical construction, and initialed &or authori>ed' by the preceptor prior to
for"arding to the faculty superisor$ If reports are sent electronically. the
intern should submit the report to the preceptor first' 2he preceptor @ill
then for@ard the report to the faculty supervisor >this @ill ensure that the
preceptor has had access to the material prior to submitting it to the
faculty supervisor?' Assignments and reports not initialed by the preceptor "ill be
returned$ 7rasable bond paper and oersi>ed computer paper are unacceptable$
7
4$ 6aculty approal must be obtained for any deiation from the planned internship$
Additionally, students "ill notify the faculty superisor of any changes regarding "ork
schedules, times, etc$
7A"U=2B ;I2( CI;I2;
The faculty superisor "ill make one or more site isits during each internship period to
confer "ith the student and preceptor *ointly or "ith each on a priate basis$ The
conferences "ill address areas relatie to student?s oerall performances and ealuation
thereof, student@s abilities and capabilities, student?s personal educational strengths and
"eaknesses, ealuation of internship e+perience, student?s suitability for health care
management, suggestions for student improement, suggestions for program
improement, etc$ The faculty superisor "ill proide, in adance, each preceptor and
student, "ith a schedule indicating the time and date of site isits$ ;ther faculty isits may
occur at unscheduled times$
;2UD(:2 (CA=UA2I<:
The preceptor "ill be re)uired to complete and submit to the faculty superisor an
ealuation of the student intern at the completion of the internship &Appendi3)I4 Pages /%)
/,'$
P<GA- PAA-(2(;
The administratie internship period is t"ele &:.' "eeks$ The total number of clock
hours associated "ith this period is appro+imately 2=0 hoursF ho"eer, student interns
"ill be re)uired to complete additional hours as specified by the preceptor in order to
proide the student "ith optimum opportunities for learning and ac)uiring operational
e+perience$ During this period of time, the student intern should be afforded the
opportunity for e+posure in all aspects of the organi>ation operation including, but not
limited to, the follo"ing-
:$ Direct interaction "ith clients and families$
.$ Contact "ith personnel in all of the organi>ation?s departments$
4$ %nolement "ith the goerning body$
2$ %nteraction "ith e+ternal enironmental forces$
3$ 7+posure to organi>ational policies, procedures, planning, financing, etc$
5$ Community inolement including seminars, conferences, meetings,
professional association actiities, etc$
/$ Day and night shifts, "eekends, holidays, etc$
=$ ,pecial assignments, pro*ects, research, studies, etc$
8
<U2=I:( <7 P<GA-
There are many organi>ations in "hich a student may perform an internship$ The
follo"ing outline is proided as an e+ample of actiities that might be undertaken in an
acute care organi>ation$ %f the student "ere in such an organi>ation the follo"ing tasks
and actiities are representatie of the e+pectations of the internship period$ Hours are
appro+imate and may be modified to meet needs of the organi>ation or modified as
situations and conditions dictate$
:$ T"enty four &.2' hours deoted to orientation of the organi>ation, administratie
policies, personnel policies, patient care policies, organi>ation mission and
philosophy, serices aailable, patient composition, organi>ation, etc$
;b*ectie- To ac)uaint the student "ith the organi>ation, arious policies,
departmental personnel, organi>ational structure, etc$
Be)uirements- ,tudent "ill submit a summary of the orientation actiities
including organi>ational chart of organi>ation &no free hand dra"ings "ill be
accepted$'F budgeting process and proceduresF census procedures and reportsF and
the preparation of balance sheet and income statement$
.$ 6orty &20' hours deoted to reie" of federal, state, and organi>ation manuals,
policies, procedures, etc$
;b*ectie- To permit the student to ac)uire a "ide ariety of information
concerning rules and regulations relatie to organi>ation operation$
Be)uirement- ,tudent "ill submit an abstract of information contained in the
manuals$ 7+amples of releant manuals are-
9edicare and 9edicaid reimbursement manual
Patient care policies manual
Administratie manuals such as the corporate by1la"s or the 9edical
staff by1la"s
Accounting and financial manuals
,afety manuals such as a fire and disaster manuals and procedures
Utili>ation reie" manuals
Pharmacy manuals
;ccupational ,afety and Health Administration manuals
Personnel deelopment and in1serice training manuals
Dietary manuals containing regular, therapeutic, and special diets
Plant engineering and maintenance manuals
Personnel manuals
%nfection control and sanitation manuals
9
Third party payer manuals
The Goint Commission, state licensure, certification sureys
;ther manuals as deemed pertinent by the preceptor
4$ 6orty &20' hours deoted to surey of the organi>ation relatie to certification of
organi>ation to participate in 9edicare and 9edicaid programs$
;b*ectie- To ac)uaint the student "ith all aspects of the organi>ation?s serices,
responsibilities, re)uirements, standards, etc$
Be)uirements- ,tudent "ill reie" preious sureys and submit summary of
insights gained
2$ 6orty &20' hours deoted to surey of the organi>ation?s serice area to identify all
priate, goernmental, )uasi1goernmental programs and serices aailable to
)ualified patients "hich the organi>ation and patients may take adantage$
;b*ectie- To proide the student "ith an opportunity to research and
learn about the arious programs and serices that are
aailable in the organi>ation?s serice area$
3$ 6orty &20' hours deoted to assignment in business office$
;b*ectie- To proide the student "ith an opportunity to ac)uire kno"ledge
relatie to total accounting and financial procedures regarding operation of the
organi>ation$
Be)uirement- ;btain kno"ledge and proide summary of the follo"ing- accounts
receiable procedures, 9edicare, 9edicaid, third party, priate pay credit, billing,
and collection proceduresF general ledger and subsidiary accountsF chart of
accountsF patient admission and financial status proceduresF inoice reconciliation
and payment proceduresF cost report and cost report preparation procedures$
5$ T"enty1four &.2' hours deoted to assignment in dietary area$
;b*ectie- To ac)uaint the student "ith the procurement, preparation,
distribution, storage, etc$, of food in the organi>ation$ Also, "ith arious diets and
dietary re)uirements$
Be)uirement- ,tudent must obsere and submit a summary of- food preparation,
patient tray preparation, nutritional programmingF food procurement, receiing,
storage and distribution systemF cost control methods and proceduresF
consultation and contract serices$
10
/$ 6orty &20' hours deoted to assignment in nursing serice$
;b*ectie- To proide the student a comprehensie orientation to nursing serice
duties and responsibilities for patient care$
Be)uirement- ,tudent "ill be re)uired to summari>e- staffing and staffing ratiosF
method of care planning and chart documentationF incident and accident
procedures and reportsF re)uisition of re)uired suppliesF drug and biological
procurement, distribution, control, disposal, reports, etc$
=$ 6orty &20' hours deoted to assignment in engineering1maintenance area$
;b*ectie- To familiari>e student "ith the duties and responsibilities of the
engineering department and "ith the preentie maintenance procedures, "ork
re)uest procedures, etc$
Be)uirement- ,tudent must summari>e- routine maintenance and emergency
re)uest proceduresF preentie maintenance program and proceduresF life safety
codeF contract sericesF staffingF licensing re)uirementsF fire and disaster program
and proceduresF emergency generator procedures
H$ 9aterials 9anagement
;b*ectie- To familiari>e student "ith the procurement, receiing, issue, and
distribution system of the organi>ation relatie to supplies and e)uipment
necessary for operation$
Be)uirement- ,tudent must summari>e- Iendor selection, bidding and
procurement systems for durable and nondurable supplies, standard and non1
standard stock items, and ma*or and minor e)uipmentF receiing and stocking
systemF inentory reconciliationF re)uisition and distribution proceduresF
inentory systemF records maintained, endor appointments, and security
procedures
:0$ 6orty &20' hours deoted to assignment in personnel department$
;b*ectie- To proide the student "ith kno"ledge of the arious personnel
functions and the la"s and regulations "hich affect personnel administration$
Be)uirement- The student "ill be re)uired to report- *ob analysis proceduresF
formulation of *ob descriptionsF formulation of *ob specificationsF recruitment
procedures &internal and e+ternal'F interie" methodology and proceduresF
11
selection proceduresF placement proceduresF orientation proceduresF training
programs and proceduresF personnel policiesF "age and salary program and
proceduresF position control proceduresF labor1management relationsF grieance
proceduresF benefit programs and administrationF la"s affecting personnel
administrationF other pertinent information relatie to the personnel function of
the organi>ationF
::$ T"enty1four &.2' hours deoted to assignment in administratie office$
;b*ectie- To ac)uaint the student "ith the duties and responsibilities of the chief
e+ecutie(administratie officer and other top administratie personnel$
Be)uirement- The student "ill be assigned to obsere the daily duties and routine
of the chief e+ecutie(administratie officer and(or other top administratie
personnel$ ,tudents "ill be re)uired to submit a report on obserations after
reie" and consultation "ith the chief e+ecutie(administratie officer or other top
administratie personnel$
12
Appendi3 A0 Application for Internship ;ite Affiliation
Agency Jame- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
,treet
Address-KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
City, ,tate,
Lip-KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
MMM MMM MMM MMM MMM MMM MMM
President(C7; of Agency(or ,ignature Party- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
9ailing Address- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Phone- KKKKKKKKKKKKKK 6a+-KKKKKKKK e1mail-KKKKKKKKKKKKKKKKKKKKKKKKKKK
Type of ;rgani>ation-
Hospital %f hospital, number of beds- KKKKKKKKKKK
Jursing Home %f nursing home, number of beds- KKKKKKKKKK
Home health agency %f home health agency, isits per year- KKKKKKKKKK
Ambulatory care center %f ambulatory care facility, isits per year- KKKKK
Professional group practice %f group practice, number of proiderKKKKKKKKKK
%nsurance company
Health related product sales
Community agency
#oernment ;ffice
;ther ,pecify-KKKKKKKKKKKKKKKKKKKKKKKKKKK
Type of licensure held- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Type of Accreditations- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Preceptor name- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Preceptor title- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Preceptor department- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Phone-KKKKKKKKKKKKKK 6a+-KKKKKKKKKKKKK e1mail-KKKKKKKKKKKKKKKKKKKKKK
M M M M M M M
13
,ignature of person completing this form or if completed by student, name of agency
contact person proiding information-KKKKKKKKKKKKKKKKKKKKKKKKK
Title-KKKKKKKKKKKKKKKKKKKK
Print Jame-KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK Phone- KKKKKKKKKKKKKKK
Date- KKKKKKKKKKKKKKK
"riteria for Internship ;ite Affiliation
2he follo@ing criteria have been established for approval as an internship
site for the Health "are Administration program. Department of Public
Health. Western Kentucky University'
2he organiAation must be prepared to perform the follo@ing0
:$ Where appropriate, the organi>ation must be-
a$ Cicensed by the ,tate
b$ Accredited
c$ Certified for participation in 9edicare or 9edicaid
.$ !e committed to contributing to the educational preparation of health care
administration students$
4$ Proide the operational enironment necessary for the student to demonstrate
application of ac)uired kno"ledge, competence, and opportunity to ac)uire and
refine managerial skills$
2$ Assign an appropriate indiidual "ho is both educationally and e+perientially
)ualified to function as a preceptor for the student$
3$ 7aluate the student using the educational ob*ecties and performance criteria as
described in the %nternship #uidelines$
5$ Beie" and approe student assignments prior to the submission of assignments to
the faculty superisor$
14
/$ Assist Uniersity faculty in planning and ealuating operational learning
e+periences of the student$
=$ Beie" student progress and confirm outcomes of the student@s learning process$
H$ Participate in preceptor or ad*unct faculty meetings relatie to the internship
program$
:0$ Appoint an indiidual &can be preceptor' to function as a liaison bet"een the
internship site and Health Care Administration Program$
::$ Conform to the Uniersity statement of compliance in that no discrimination shall
take place on the basis of age, race, color, religion, se+, national origin, or disability$
15
Appendi3 50 H"A ##$ Healthcare Administration Internship D esponsibilities0
%, KKKKKKKKKKKKKKKKKKKKKKK hae read all the documentation concerning the
Healthcare Administration %nternship including the internship guide, sample rotation
plan, and sample "eekly report$ % understand that % must submit a .14 page "eekly
report detailing the "ork and obserations made during the "eek and to submit it to the
6aculty Adisor for the internship course along "ith the ,ite Affiliation %nformation
6orm, the Pro*ect %nitiation form, the Pro*ect Completion form, the actual "ritten
internship pro*ect paper &appro+imately /1:0 pages', the t"ele &:.' "eekly reports for
the internship period of :. "eeks N 2=0 hours of "ork &there may be more reports if an
intern needs to stretch the internship beyond :. "eeks at 20 hours per "eek', the
student@s ealuation of the program, the Preceptor@s ealuation of the student, and the
contact information sheet$ % understand that % receied a complete and detailed briefing
on the re)uirements of the internship$ % also understand that % must submit the "eekly
reports each "eek after completing the rotations and that % must submit the other
reports in a timely fashion in order for the materials to be reie"ed "ith reasonable
time$ % understand that % cannot submit the ma*ority of materials at the last "eek of the
semester$ %f this occurs, % understand that it is highly likely that % "ill not graduate at
the end of the internship semester and the internship period "ill carry oer to the ne+t
semester, ultimately delaying my graduation to the end of that ne+t semester$ 6or 6all
semester internships, all materials must be deliered to the 6aculty 9ember of Becord
no later than the 6riday of the first full "eek in December$ 6or spring semester
internships, all materials must be deliered to the 6aculty 9ember of Becord no later
than the 6riday of the first full "eek of 9ay$ 6or summer semester internships, all
materials must be deliered to the 6aculty 9ember of Becord no later than the 6riday of
the first full "eek of August$
% hae read all the aboe statements and understand that if % fail to comply "ith these
internship re)uirements, then % "ill probably not graduate during that semester and
"ould receie my degree and diploma at the end of the ne+t semester date$
KKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKKKKKKKKK
,tudent ,ignature Date
KKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKKKKKKKKK
Print ,tudent Jame 6aculty 9ember ,ignature
16
Appendi3 "0 H"A %#& Graduate Internship D esponsibilities0
%, KKKKKKKKKKKKKKKKKKKKKKK hae read all the documentation concerning the
Healthcare Administration #raduate %nternship including the internship guide, sample
rotation plan, and sample "eekly report$ % understand that % must submit a .14 page
"eekly report detailing the "ork and obserations made during the "eek and to submit
it to the 6aculty Adisor for the internship course along "ith the ,ite Affiliation
%nformation 6orm, the Pro*ect %nitiation form, the Pro*ect Completion form, the actual
"ritten internship pro*ect paper &appro+imately :01:3 pages', the t"ele &:.' "eekly
reports for the internship period of :. "eeks N 2=0 hours of "ork &there may be more
reports if an intern needs to stretch the internship beyond :. "eeks at 20 hours per
"eek', the student@s ealuation of the program, the Preceptor@s ealuation of the
student, and the contact information sheet$ % understand that % receied a complete and
detailed briefing on the re)uirements of the internship$ % also understand that % must
submit the "eekly reports each "eek after completing the rotations and that % must
submit the other reports in a timely fashion in order for the materials to be reie"ed
"ith reasonable time$ % understand that % cannot submit the ma*ority of materials at the
last "eek of the semester$ %f this occurs, % understand that it is highly likely that % "ill
not graduate at the end of the internship semester and the internship period "ill carry
oer to the ne+t semester, ultimately delaying my graduation to the end of that ne+t
semester$ 6or 6all semester internships, all materials must be deliered to the 6aculty
9ember of Becord no later than the 6riday of the first full "eek in December$ 6or
spring semester internships, all materials must be deliered to the 6aculty 9ember of
Becord no later than the 6riday of the first full "eek of 9ay$ 6or summer semester
internships, all materials must be deliered to the 6aculty 9ember of Becord no later
than the 6riday of the first full "eek of August$
% hae read all the aboe statements and understand that if % fail to comply "ith these
internship re)uirements, then % "ill probably not graduate during that semester and
"ould receie my degree and diploma at the end of the ne+t semester date$
,tudent ,ignature Date
Print ,tudent Jame 6aculty 9ember ,ignature
17
Appendi3 D0 Internship Weekly eport
Jame- KKKKKKKKKKKKKKKKKKKKKKKKKKKKK 6or the dates of- KKKKKKKKKKKKKKK
:$ What ne" kno"ledge or skill did you learn this "eekO
.$ What did you learn, either from readings or classroom discussions, that you applied
on the *ob this "eekO &Do not gie course numbers or classes$'
4$ Which courses(sub*ects helped you most this "eekO Please gie course numbers or
topicsO
2$ Which courses(sub*ects you feel could be e+panded or added that "ould hae helped
you perform your *ob better this "eekO
18
Western Kentucky University Program in Health Care Administration Internship Guidelines
Appendi3 (0 Internship Activity =og
,tudent- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK for the dates of- KKKKKKKKKKKKKKKKKKKKKKKKKKK
Day of Week Activities or assignments 2ime spent in
each activity
-onday
2uesday
Wednesday
2hursday
7riday
<ther
C;997JT,-
19
Appendi3 70 ProEect Agreement 7orm
,tudent Jame- KKKKKKKKKKKKKKKKKKKKKKKK %nternship ,ite- KKKKKKKKKKKKKKK
Preceptor- KKKKKKKKKKKKKKKKKKKKK Date- KKKKKKKKKKKKKKKKKKKKKKKKKKK
Title of Pro*ect-
Description and Purpose of Pro*ect-
;b*ecties &7+pected results, use measurable indicators or )uantify if possible'-
9ethods &Describe ho" you intend to accomplish(complete pro*ect'-
Preceptor Approal- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
7+pected Completion Date- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
20
Appendi3 G0 ProEect "ompletion 7orm
,tudent Jame-KKKKKKKKKKKKKKKKK %nternship ,ite-KKKKKKKKKKKKKKKKKKKKK
Preceptor-KKKKKKKKKKKKKKKKKKKKKK Date-KKKKKKKKKKKKKKKKKKKKKKKKKK
Title of Pro*ect-
Description and Purpose of Pro*ect-
;b*ecties Achieed-
Ac)uired !enefit &i$e$, "hat did you learnO'-
Preceptor Approal-KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
21
Appendi3 H0 Intern (valuation 7orm >5y Preceptor?
,tudent Jame- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
%nternship ,ite- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Preceptor- KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Dates of %nternship- KKKKKKKKKKKKKKKKKKKKKKKKKKK
The follo"ing ealuation is based on a fie point scale$ Please circle the number you beliee most accurately
portrays the student@s performance or behaior$ ,pace for additional obserations or comments is proided
at the end of the ealuation$
The student arries to the site "hen e+pected$
Almost Almost
Jeer Al"ays
: . 4 2 3
When changes in the student@s schedule occur, the student informs all affected by the change$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student can be e+pected to conduct his or her actiities "ithout constant superision$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student fosters comfortable and communicatie atmosphere "ith others$
Almost Almost
Jeer Al"ays
: . 4 2 3
,tudent prepares re)uired reports and "ritten assignments that are focused and free from errors$
Almost Almost
Jeer Al"ays
: . 4 2 3
,tudent prepares re)uired reports and "ritten assignments on time$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student conforms to the organi>ation dress code as appropriate for the actiities of the day$
Almost Almost
Jeer Al"ays
: . 4 2 3
22
Intern (valuation 7orm "ontFd GGGGGGGGGGGGGGGGGGGGGGGGGGGGG'
The student preseres the confidentiality and sho"s proper respect for personal priacy of others$
Almost Almost
Jeer Al"ays
: . 4 2 3
When dealing "ith others, the student is polite and considerate in speech and manner$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student maintains a clean and orderly "ork area$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student reads directions thoroughly or listens to directions carefully$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student concentrates on "ork assignments until their completion and disregards outside distractions$
Almost Almost
Jeer Al"ays
: . 4 2 3
,tudent utili>es aailable time "ith independent study$
Almost Almost
Jeer Al"ays
: . 4 2 3
,tudent asks )uestions "hich indicate an interest in deeper or broader aspects of administration$
Almost Almost
Jeer Al"ays
: . 4 2 3
When confronted "ith a comple+ problem &or pro*ect', the student is able to coordinate seeral actiities,
ideas, and thoughts$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student sho"s the ability to organi>e assignments effectiely and efficiently$
Almost Almost
Jeer Al"ays
: . 4 2 3
The student gies thought to and makes in)uiries about the feasibility of a ne" or different course of action$
Almost Almost
Jeer Al"ays
: . 4 2 3
23
Intern (valuation 7orm "ontFd GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG
The student tries, despite difficulties, to accomplish assignments or planned actiities$ 6or e+ample-
"illingness to stay beyond normal hours to complete "ork$
Almost Almost
Jeer Al"ays
: . 4 2 3
%n interacting "ith employees, isitors, customers, etc$, the student demonstrates an a"areness of the
organi>ational or departmental procedures$
Almost Almost
Jeer Al"ays
: . 4 2 3
;erall, ho" "ould you rate the student@s performance on the internship pro*ect re)uired of them during the
internship e+perienceO
%neffectie Iery 7ffectie
: . 4 2 3
Do you beliee the pro*ect "as a aluable learning e+perience for the studentO
,trongly ,trongly Agree
Disagree
: . 4 2 3
Ho" aluable do you think the pro*ect "as to your organi>ationO
Jo Iery Ialuable
Ialue
: . 4 2 3
Would you hire this person to "ork in your organi>ation if you had the opportunityH
<es Jo %f your ans"er is no, please state your reasons$
Bemarks- &additional comments about the student?s performance during the internship period'
Academic Preparation'
%n your opinion, and in the opinion of others "ith "hom the student has interacted, ho" "ould you rate the academic
preparation and kno"ledge base of this studentO
%nade)uate KKKKKK Ade)uate KKKKKK #ood KKKKKK 7+cellent KKKKKKK
Academic ;uggestions' %n "hat areas do you think our students need more kno"ledge or preparationO
24
Appendi3 I0 ;tudent Assessment of the H"AI-HA Program >5y Intern?
,A P ,trongly Agree
A P Agree
J P Jot ,ure or Jeutral
D P Disagree
,D P ,trongly Disagree
!ased on your course "ork in the Health Care Administration Program, ho" "ould you rate
your ability to understand and(or perform for the follo"ing circumstances using the aboe
definitions for your responsesO
'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ;A A :
''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' D ;D
1. Understanding of problem soling process$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
2. Appropriate behaior "ith others in a team1based setting$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
4$ Communication "ith others in a team1based setting
or in a similarly structured enironment $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
2$ Determine the links bet"een causal factors

and the resulting )uality problem$ $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
3$ Use the appropriate tools for organi>ing and analy>ing data,
and ealuating and presenting correctie actions in a CQ% process $$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
5$ Complete an in1depth research actiity related to a )uality issue
beginning "ith an appropriate research )uestion to the final report$ $$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
/$ Understand the historical background of the follo"ing -
The healthcare deliery system$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
The public health system$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
The financing of healthcare serices$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
25
;tudent Assessment "ontFd'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ;A A :
'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' D ;D
8. Understand the relationships among the healthcare sectors$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
H$ Understand the relationships among the healthcare
consumers, proiders and payersRRRR$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
:0$ !e able to describe data appropriately$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
11.................................................. !e able to
use graphs and tables to present data appropriately$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
12.................................................. !e able to
interpret basic statistics appropriately$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
13.................................................. !e able to
form simple hypotheses$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
14.................................................. !e able to
test simple hypotheses$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
15.................................................. !e able to
perform basic inferential statistics$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
26
16.................................................. !e able to
read professional *ournals more intelligently$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
:/$ !e able to apply economic theories and concepts to the healthcare
Deliery system in the U$,RRRRRRRRRRRRRRRRRR$$ $$$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
:=$ !e able to analy>e, synthesi>e, and ealuate economic policies
and concepts$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

:H$ !e able to incorporate the theories and concepts into your
decision1making processes concerning indiidual, institutional, and
system "ide conflicts or issues RRRRRRRRRRRRRRRR$$
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
;tudent Assessment "ontFd ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ;A A :
'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' D ;D
.0$ !e familiar "ith the general legal principles as they relate to
health care organi>ations$ RRRRRRRRRRRRRRRRRRR
.:$ Becogni>e illegal or unethical behaior "ithin an organi>ation
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRR
..$ Assist in strategic planning efforts "ithin my organi>ation and hae a
basic understanding of ho" information management "orks "ithin
healthcare organi>ations RRRRRRRRRRRRRRRRRRRR$
.4$ Able to compute the reimbursement from different reimbursement
models RRRRRRRRRRRRRRRRRRRRRRRRRRR$
.2$ Able to reie" and understand income statements and balance sheets
RRRRRRRRRRRRRRRRRRRRRR$RRRRRRRR
27
.3$ Able to understand management techni)ues to increase collections of
accounts receiables$ RRRRRRRRRRRRRRRRRRRRR$$
26. Ho" satisfied "ere you "ith the adising you receied at WKUO

28

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Western Kentucky University

Department of Public Health

2$ Determine the links bet"een causal factors

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