Internship Work Plan | HPA Internship Information

Student Intern's First and Last Name *

PSU ID Number: *

HPA 395 Section for UPark students: Choose your instructor

Campus you are enrolled in HPA395: *

Student's Phone Number *

Student's PENN STATE Email Address: *

Email Address of ACADEMIC ADVISER *

Students ALTERNATE Email Address:

Projected graduating semester and year *

Internship Organization *

Preceptor's Name/Title *

Preceptor's Phone Number *

Preceptor's Email Address *

Department/Division *

Website/URL *

Internship Address *

Credits (1-12) Most students will take 3. *

Is this internship on site, virtual or hybrid?

Internship Start and End Date *

Will your internship be paid or unpaid?

If paid, how much per hour or stipend amount?

Student's Internship Goals and Objectives: (To be completed with your preceptor either by email or over the phone) *

We understand, and even expect, that an internship may evolve over time as the preceptor and intern get to know one another and the intern's skills are assessed. To ensure that the student and preceptor maximize the experience however, there should be some agreement about the type of administrative experiences the student will have. To assist with this process, the Health Policy & Administration Department (HPA) created four (4) primary objectives that may serve as a roadmap for both the student and preceptor to follow. Those objectives include: 1 - To gain practical experience in health services administration or planning. 2 - To develop and professional identity, including communication and time management skills. 3 - To apply knowledge learned in the classroom and to analyze organizational activities. 4 - To learn the key aspects of a health services delivery system, including allocation of resources. In the space provided above, please list observational opportunities (committees, board meetings, clinicz) and participatory activities (committees, surveys, projects, assessment and planning activities).

Student has read and will follow the manual. *

Yes

-The student will work 320 hours as required for the internship which is typically an average of 40 hours per week, generally maintaining the same work schedule as the preceptor. Hours may vary. Occasionally evening and weekend hours may be required. - As deemed capable, the student may assume additional responsibilities. They will not, however, perform clerical duties, except those related to the completion of their internship responsibilities. - It is understood that the student will be expected to complete a log of activities and write an internship paper. To ensure confidentiality, no patient or employee names will be used in the reports, unless the student has been given written permission to do so. It is also understood that the student will not copy or use any confidential business information. The student agrees to the preceptor's right to request and retain copies of any academic work completed during the internship. -If unusual circumstances or emergencies prevent the completion of any of the commitments stated above, the appropriate parties signing this document must be consulted and give approval prior to any other action. -If the student defaults on the internship agreement, all credits may be forfeited and the student may receive an unsatisfactory grade thereby requiring him/her to repeat the internship experience.

Preceptor agreement: *

Yes

No

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