KIN 344: Pre-Therapy/Allied Health Practicum Checklist Obtain application packet and read all enclosed information Complete the Application Form Complete the Immunization Form Attach copies of medical record documenting your immunizations. Complete the Code of Conduct Form Attach unofficial transcripts Turn in application to the advising office for signature. If your overall GPA is < 3.20 you should schedule an appointment with your academic advisor. Applications with overall GPA < 3.2 without an advisor signature indicating you have had a meeting will not be considered. Submit your KIN 343 and KIN 344 applications. Applications should be submitted to in the mailbox for. If your application is submitted after the due date, it should be date stamped by the department office in Milam 101. Register for KIN 343 and KIN 344 once cleared by instructor/department After registration, complete the Blood Borne Pathogens Forms available on blackboard Once you receive information regarding placement, contact your clinical site Attend the first day of classes - MANDATORY DUE DATE FOR Term:
KIN 344/345 Pre-Therapy/Allied Health Practicum Information Sheet The Pre-Therapy/Allied Health Practicum is designed to provide the student with an opportunity to work with a member of the allied health community in the student s desired area of interest. Below is a list of the student expectations. The specific requirements for the grading of this practicum will be provided to you on the first day of class. Eligibility and authorization for registration for KIN 344 is made by the instructor of the course. Junior and Senior level students are eligible under the following criteria: o You have completed the anatomy and physiology series successfully ( C or greater) o You have completed the anatomy and physiology series with a composite GPA of 2.70 or greater o You have maintained at least a 2.5 in all EXSS/KIN coursework o You have maintained at least a 2.25 in all option coursework and supporting coursework (not bac core) o You have maintained an overall GPA of 3.0 o You have completed an application and have provided all of your immunization information including copies of medical record documenting all immunizations o You have been tested for Tuberculosis (Tb) within the last calendar year. It must remain current throughout your affiliation time. KIN 343 and EXSS 344 are to be taken concurrently. KIN 343 is your seminar course and KIN 344 is the practicum course. You will be expected to obtain 50 hours with your clinical supervisor during the term you register for the course which works out to be approximately 5 hours per week. It is up to you and the allied health professional to determine a schedule that is acceptable. You are expected to dress and behave in a professional manner at all times; this includes (1) closed toe shoes, (2) business, professional dress including khaki or dark colored pants, a collared shirt that can be tucked into your pants, (3) no perfume or cologne, (4) no facial jewelry, and (5) men should maintain facial hair nicely groomed. Do not bring personal items with you to your clinical rotation. All you will need is a pen and some paper for notes to be taken during your observation. Please contact your clinical supervisor if you are sick to make up hours. Patients in the acute care or skilled nursing settings may have compromised immune systems and are at risk for infection. Follow-all rules of the facility. Maintain patient confidentiality at all times. If additional students are located at your facility, limit chit-chat to outside of your affiliation. MANDATORY ATTENDANCE ON THE FIRST DAY OF CLASSES.
Pre-Therapy/Allied Health Practicum Practicum Guidelines The following guidelines will be expected during your clinical affiliation. Any violation of the below listed guidelines are reason for dismissal from your clinical experience and issuing of a failing grade. 1. Confidentiality. Patient treatment and records are currently under confidentiality laws. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates patient confidentiality. Patients, their treatment, their medical history, and personal information CANNOT be discussed outside of the clinic setting and only with clinic personnel. Patients should be asked for their permission prior to your observation by the supervising clinician. Some patients may refuse to have students observe and therefore, you may be asked to leave the room. Do not feel offended. 2. Dress Code. Whether you are in close, daily contact with patients or in a behind the scenes job, you represent the company to which you are observing as well as Oregon State University. The way you look, dress and act is just as vitally important. For this reason, grooming and apparel appropriate for a professional atmosphere is expected and any deviation from this will not be tolerated. Apparel is acceptable if it can be: (1) easily considered in good taste and could not be offensive to a reasonable person, (2) functional to allow the intern to perform various activities including laundry, cleaning and demonstration of activities. It is expected that students fulfilling internship requirements dress in: casual business attire which generally implies khaki or black slacks appropriate button down or polo shirt which can easily be tucked in for a more professional look. The shirt should be of sufficient length to be tucked in and remained tucked in when engaging in routine duties. closed toe shoes Inappropriate dress includes such things as: apparel such as tight pants or extremely saggy pants bare midriffs casual attire such as jeans, T-shirts and open toed shoes Facial hair and jewelry should be in good taste. Facial hair should be well-groomed and facial jewelry should be removed. Some older patients find facial jewelry very offensive. If you have any doubts about your personal dress, please err on the side of caution and choose a different attire. Inappropriate dress is reason for a student intern to be dismissed from their duties for the day and multiple episodes of inappropriate dress is reason for a failing grade. 3. Name Tag. Each student completing a clinical practicum experience will be expected to obtain a name badge from the ID center prior to starting their clinical placement. 4. Punctuality. Please be on time. Because most clinicians see a new patient every ½ hour, it is important that you are there to see the initiation of the treatment, assessment, evaluation. 5. Questions. As a student intern, your supervisor is expecting that you will have some questions. It is a vital component to your learning process. However, use good judgment when asking questions in front of a patient. It is usually better to wait until you are in the staff office or away from patients before asking certain questions. 6. Duties. In exchange for the learning environment and the opportunity to observe patients, you may be asked to perform some light housekeeping duties. These duties are a timesaver for the staff. However, try not to let it be done in exchange for possible learning situations. If you see a table that needs to be cleaned or a pile of towels that need to be folded and you are not currently engaged in a learning situation, then please take the initiative and help out as needed. However, if you feel that you are performing too many housekeeping duties and not enough observation, then communicate with your supervisor that you would like to sit in with them while they treat, evaluate, assess their next patient. 7. Contact. You should be assigned to 1-2 clinical supervisors. If you have any questions, please feel free to speak with them. If you are having difficulty with your affiliation, please contact the course instructor BEFORE there is a problem.
School of Biological & Population Health Sciences KIN 344/345: Pre-Therapy/Allied Health Practicum Practicum Site Request Form (Student must be Junior or Senior Standing) Applicant Information (PLEASE COMPLETE IN BLACK OR BLUE PEN PENCIL IS NOT ACCEPTABLE) (Term) (Circle One) Major: Anticipated Graduation : Student ID Number: City: State: Phone: ONID *Your ONID account is considered your official email address. If you do not have an ONID account, please register for one. Permanent Address: (Please complete if your home address is different than your local address) City: State: Practicum Information qq Occupational Therapy qq Physical Therapy qq Acute Care/In-patient qq Orthopedics/outpatient qq Pediatrics qq Rehabilitation/Skilled Nursing qq Other (please specify) qq 0800-1000 qq 1000-1200 qq 1200-1400 qq 1400-1600 qq 1600-1800 qq Monday qq Tuesday qq Wednesday qq Thursday qq Friday Student Signature
KIN 344: Pre-Therapy/Allied Health Practicum Immunization Record Student Information Name: Term: Sr (Circle One) Local Address Address: City: Phone: Zip: ONID Email*: Major: Anticipated Graduation : Immunization Information PLEASE ATTACH COPIES OF YOUR MEDICAL RECORD DOCUMENTING YOUR IMMUNIZATIONS AND YOUR CURRENT TB CLEARANCE. This is required for application to the Practicum Course. TB clearance must remain current during the term of your practicum experience. of Birth Measles, Mumps, Rubella (MMR). Exempt from MMR requirement if born prior to 1957. 1 st MMR: 2 nd MMR: _ () () Titer Results: Titer Results: ( Rubella/Rubeola) +/- ( Rubella/Rubeola) +/- Hepatitis B Vaccine 1 st Dose: Institution: 2 nd Dose: Titer: 3 rd Dose: () +/- rr I have not received the Hepatitis B Vaccine. Please read and initial below. I understand that due to potential exposure to blood or other infectious materials I may be at risk of acquiring Hepatitis B virus (HBV) infection. It is recommended that I receive the Hepatitis B vaccine prior to my clinical experience; however, I decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If, in the future, I continue to have occupational exposure to blood or other potentially infectious materials I can be vaccinated with Hepatitis B vaccine at that time. If unable to have vaccine due to medical reasons, please provide explanation on a separate sheet of paper. initial Ki
Name: Term: Chicken Pox Have you had Chicken Pox? rr YES rr NO If YES, of Disease If NO, s of Vaccine: Vaccine #1 Vaccine #2 Titer +/- Tuberculosis (TB) Have you had a TB Test within the last 12 months? rr YES rr NO MUST ATTACH PROOF TB Skin Test : mm/induration Have you ever had a positive TB test? rr YES* rr NO If yes, date of last chest x-ray and results *You will need to complete the TB Risk Factor Screening Form Have you ever completed preventative drug therapy (INH)? If yes, in what year? Tetanus Diphtheria and Pertussis (Tdap). This is a 1-time injection which updates all previous tetanus and Diphtheria (Td). Some affiliations recommend all health care workers with direct patient care be immunized against Pertussis. If you do not have the updated immunization, you will be requested to obtain this prior to starting your affiliation. : Institution: I attest the information provided is true, complete, and accurate to the best of my knowledge. Signature of Student Signature of Practicum Coordinator Please Return to: Coordinator, Pre-Therapy/Allied Health Practicum Oregon State University Langton 221 Corvallis, OR 97331 541-737-8198 Ki
Pre-Therapy/Allied Health Practicum Code of Conduct Agreement My signature below indicates that I accept the Policies and Procedures of the Pre-Therapy/Allied Health Practicum at Oregon State University. Initial each statement below. I will abide by all policies and procedures of the Pre-Therapy/Allied Health Practicum as explained to me including dress code and code of conduct. I understand that I will need to obtain clinical observation experience in the Pre-Therapy/Allied Health Field. (KIN 344/345 = 50 hours). I understand that I may be placed in any of the Pre-Therapy/Allied Health Practicum experiences associated with KIN 344/345 according to my area of interest. Even though I may be asked for input regarding my clinical assignments, the final decisions for these assignments is the responsibility of the program s administration (depending on clinical site availability). I understand that there is no financial support associated with travel to and from clinical assignments associated with the Pre-Therapy/Allied Health Practicum. I understand that if I am injured while in attendance at a clinical assignment, unless it is determined the clinical site was negligent, my medical bills may not be covered. Oregon State University views off-site practicum experiences in the same manner as on-campus lab settings. Specifically, it is my responsibility to maintain personal health coverage during my clinical experience. I understand that I will need to obtain TB clearance and proof of immunization prior to being placed for my clinical assignment. I understand that I will need to make-up my missed clinical hours within one week of my absence so as to not bombard the clinical staff at the end of the term. I understand that I will need to maintain patient confidentiality both during and after the completion of my clinical experience. I understand that it is my responsibility to communicate with my clinical supervisor prior to arrival to obtain information regarding policies and procedures of the clinical site. I understand that it is my responsibility to communicate with the practicum coordinator any difficulties associated with a practicum experience in a timely manner. Student Signature OSU Practicum Coordinator Signature Ki