MHCA Internship Handbook -...

This handbook contains the basic

information and forms pertaining to the

internship experience for the UAFS

Master’s in Healthcare Administration. It is

available to the potential preceptor and

healthcare organization as well as the

MHCA student.

MHCA Internship Handbook Guidelines and Forms for

Field Experience

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TABLE OF CONTENTS UAFS MHCA PROGRAM .............................................................................................. 3

MISSION ........................................................................................................................... 3 VISION .............................................................................................................................. 3 VALUES ............................................................................................................................. 3 PROGRAM LEARNING OUTCOMES .................................................................................. 4

MHCA INTERNSHIP GUIDELINES .................................................................................. 5

PRECEPTORS .................................................................................................................... 6 Role of Internship Site .................................................................................................. 6 Role as Preceptor .......................................................................................................... 6 Role as Mentor ............................................................................................................. 6

STUDENTS ........................................................................................................................ 7 Semester before internship .......................................................................................... 7 Semester of internship .................................................................................................. 7 During internship .......................................................................................................... 8

PRECEPTORS AND STUDENTS .......................................................................................... 8

INTERNSHIP POLICIES ................................................................................................. 9

ABSENCES ........................................................................................................................ 9 HOLIDAYS ......................................................................................................................... 9 TRAVEL, PARKING, AND OTHER FEES ............................................................................... 9

MHCA PROGRAM RESPONSIBLITIES ............................................................................ 9

PURPOSE OF THE LEARNING CONTRACT ................................................................... 10

WRITING THE LEARNING CONTRACT ............................................................................. 10 LEARNING GOALS/OBJECTIVES AND EXPECTED OUTCOMES ......................................... 10

Knowledge and Understanding Outcomes ................................................................. 11 Skills Objectives .......................................................................................................... 11 Attitudes and Values Objectives ................................................................................. 11

SPECIFIC TASKS .............................................................................................................. 11 EXAMPLE ........................................................................................................................ 11

OTHER CONSIDERATIONS ......................................................................................... 11

PRECEPTOR SUPERVISION ............................................................................................. 11 MHCA PROGRAM CONTACT WITH PRECEPTOR ............................................................. 12 EVALUATION/COURSE GRADE ....................................................................................... 12

FINAL PAPER GUIDELINES ......................................................................................... 13

THE PROFILE OF A UAFS MHCA GRADUATE ............................................................... 15

REQUIRED FORMS CHART and FORMS ...................................................................... 17

ACKNOWLEDGE AND COMPLY FORM ........................................................................................ 18

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INTERVIEW COMPLETED FORM ............................................................................................... 19 LETTER OF AGREEMENT FORM ................................................................................................ 20 ORGANIZATION DESCRIPTION FORM ........................................................................................ 22 LEARNING CONTRACT FORM .................................................................................................. 23 WEEKLY WORK SCHEDULE FORM ............................................................................................. 24 PRECEPTOR EVALUATION OF STUDENT FORM ............................................................................. 25 FINAL REPORT COMPLETE FORM ............................................................................................. 30 STUDENT EVALUATION OF SITE FORM....................................................................................... 31 PROGRAM/PRECEPTOR CONTACT FORM ................................................................................... 32

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UAFS Master of Science in Healthcare Administration (MHCA)

The Master of Science in Healthcare Administration (Online Program) at UAFS is designed to prepare

students for management and leadership in the healthcare industry. The MHCA program holds an

associate graduate membership with the Association of University Programs in Health Administration

(AUPHA), which is a global network of colleges, universities, faculty, individuals and organizations

dedicated to the improvement of health and healthcare delivery through excellence in healthcare

management and policy education. As a part of UAFS, we hold regional accreditation with the Higher

Learning Commission. The program will seek program-specific accreditation with the Commission on

Accreditation of Healthcare Management Education (CAHME), which establishes the standard of

measurement of graduate healthcare management education.

MISSION To provide the knowledge and skills needed to prepare competent, ethical, and innovative healthcare

leaders who can improve access, quality, efficiency, and equity of health services across a global health

industry.

VISION To be recognized as a program that promotes the development of graduates who are academically and

professionally prepared to be healthcare leaders who can successfully manage and lead their

organizations and communities, from the local to a global level.

VALUES The MHCA program in the College of Health Sciences at the University of Arkansas Fort Smith holds the

value of excellence in the following areas:

Graduate education that utilizes adult learning theory and innovative online learning

techniques.

Ethical and professional behavior, including respect and integrity.

Evidence-based research, practice, and results.

Service to our fellow citizens and community.

Cooperation and collaboration with others for the betterment of healthcare.

Personal and professional growth through life-long learning.

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PROGRAM LEARNING OUTCOMES

Upon completion of the Master of Science in Healthcare Administration (Online Program), graduates will

be able to:

Demonstrate knowledge of the healthcare system and the environment in which healthcare

managers and providers operate, strategic planning, and healthcare policy analysis.

Integrate and apply business principles, skills, and knowledge, including systems thinking, to the

healthcare environment.

Display clear and concise communication skills with internal and external stakeholders, establish

and maintain relationships, and facilitate constructive interactions with individuals and groups.

Demonstrate transformational leadership that supports innovation, critical thinking, and ethical

decision making while inspiring individual and organizational excellence.

Practice professionalism through personal and professional accountability, development, and

lifelong learning while contributing to the community and the profession.

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MHCA INTERNSHIP GUIDELINES

The purpose of the internship experience is to ensure that students graduating from the MHCA program

have practical first-hand experience in an administrative setting within a healthcare organization. The

internship experience is a 15-week supervised educational experience that should give students an

opportunity to focus on concepts related to human behavior, law and ethics, quality improvement,

financial management, information systems, and managed care in a healthcare setting. The internship

experience will help students develop management competencies, critical thinking, and problem solving

skills while exploring standards of excellence and the role of a healthcare administrator. The internship

will also assist in promoting the professional development of the students and facilitate their career

planning.

Preceptors are vital to student success. Preceptors and students should refer to these guidelines for

information relative to the internship experience, the responsibilities of the student, preceptor,

organization, and the necessary forms to be submitted to the student’s Internship Course Facilitator. It is

important to the success of the internship experience for the preceptor and student to understand the

types and scope of tasks/activities in which the student should be engaged in order to demonstrate

competence and to apply academic knowledge in an operational environment.

The internship experience must involve:

A meaningful administrative role. The student has responsibility for completion of

tasks, activities, and/or project(s) of importance to the organization that relates

academic knowledge to challenges and issues in the healthcare field.

Independent responsibility. The tasks, activities, and/or project(s) are completed

autonomously by the student while under the supervision of an experienced health

administrator, called the preceptor.

Participation. The student is actively involved in administrative planning and/or project

implementation meetings of the organization.

Involvement in teams. The student participates in teams in both supportive and

leadership roles.

Exposure to multiple administrative experiences. The student should become familiar

with administrative duties and responsibilities, including upper management levels.

A comprehensive written report. The student will submit a written report reflective of

the practical experience that is evaluated by the preceptor before evaluation by

program faculty.

Preceptors and students having questions concerning the internship program or desiring additional

information, guidance, or clarification regarding any items contained within this handbook should

contact the MHCA Executive Director.

Dr. Wittney Jones, Executive Director - MHCA

UAFS College of Health Sciences

Phone: 479-788-7399

Email: [email protected]

mailto:[email protected]

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PRECEPTORS

During the internship, the preceptor has several responsibilities to the student and to the MHCA

Program. They include but are not limited to the following:

As an internship site, your organization must:

1. Provide students with learning opportunities.

2. Provide the student with clear guidelines for performance assessment.

3. Provide students with an appropriate orientation of your organization’s policies and procedures,

introductions to other staff members, and clear guidelines for performance assessment.

4. Provide students with workspace and necessary equipment to meet work obligations and

responsibilities (e.g., access to the Internet/Wi-Fi, desk space, access to phone, etc.).

5. Designate the name(s) of the employee(s) who will serve as preceptor(s) and supervise and

coordinate the internship educational experience of students.

As a preceptor, you must:

1. Work with the student to develop a work schedule.

2. Assist the student with identifying tasks and activities, and/or a work project(s) of which the student can take ownership.

3. Ensure the tasks, activities, and/or the work project(s) are of sufficient complexity and have significance to your organization and/or healthcare in general. Tasks, activities, and/or the work project(s) should meet the needs and goals of both the organization and the student.

4. Provide appropriate and adequate supervision of tasks, activities, and/or the work project(s), which includes signing off of the Weekly Work Schedule form.

5. Evaluate the student on the development of healthcare leadership competencies (see page 15), his/her contributions to the organization, and the student’s final report/paper by using the

Preceptor Evaluation of Student and the Final Report Complete forms.

6. Discuss the assessment of the student’s contributions and final report/paper with the student at the end of the internship experience.

7. Finalize and submit any required forms.

8. Serve as a mentor to the student.

In your role as a mentor, you should:

1. Meet with the student on a regularly scheduled basis and as needed.

2. Introduce the student to organizational personnel.

3. Expose the student to various departments and opportunities within the organization, stressing

administrative functions of each.

4. Create a motivating and learning environment for the student.

5. Share your knowledge, skills, and experience.

6. Evaluate the student’s progress.

7. Offer guidance and constructive feedback.

8. Stay flexible in changing expectations and plans.

9. Assist the student with networking and professional growth opportunities.

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10. Act as a positive role model.

Consult with the MHCA Executive Director as needed, especially if problems should arise.

MHCA STUDENTS

During the internship, the student has several responsibilities to the MHCA Program, the healthcare

organization, and to the preceptor. They include but are not limited to the following:

Responsibilities

Semester before Internship Experience and Course:

1. Begin to think about possible internship organizations. Keep in mind career goals and

geographic preferences.

2. Contact the Internship Course Facilitator or the MHCA Executive Director to receive the MHCA

Internship Handbook. A copy of this handbook is located at

http://health.uafs.edu/health/student-handbooks.

3. Once you have read the MHCA Internship Handbook, submit the Acknowledge and Comply

form to the Internship Course Facilitator.

4. Contact possible organizations, set up interviews, and interview for internship position. For

every interview completed, have the person interviewing you complete the Interview

Completed form which is then submitted to the Internship Course Facilitator.

5. Make a final decision, secure an internship site, and establish who will be your preceptor.

Complete the Letter of Agreement form and submit to the MHCA Executive Director.

6. Complete the Organization Description form. Submit a copy of this to the Internship Course

Facilitator. This form will also be an appendix in the Final Paper.

7. Develop and finalize learning objectives, expected outcomes, and specific activities to

accomplish these objectives in collaboration with preceptor. Complete the Learning Contract

form and submit to the Internship Course Facilitator. This form will also be an appendix in the

Final Paper.

8. Register for the internship course.

Semester of Internship Experience and Course:

1. Complete all course assignments, including forms, discussions, and final report/paper.

2. Complete all tasks and activities at internship organization. Be on site at specified hours and

actively engage in assigned tasks and activities, meetings, and/or project(s).

3. Have Preceptor initial and date the Weekly Work Schedule form at the end of each week. This

form indicates that the student worked designated internship hours and completed assigned

tasks for that week. Any ‘No’ response will need further explanation on a separate sheet of

paper. This documentation will be required in the Final Report.

4. Failure to complete or unsatisfactory completion of required internship hours and/or specific

tasks or project(s) may result in the following action/s:

a. Decreased final course grade

b. Failure of the internship course

http://health.uafs.edu/health/student-handbooks

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c. Repeating the course/internship experience

5. Prepare your final report paper to be read, evaluated, and signed by your preceptor. Submit

Final Report Complete form to the Internship Course Facilitator when you submit your Final

Paper.

6. Give your preceptor the Preceptor Evaluation of Student form in week 15 of the internship.

Ensure that the preceptor completes the form and discusses it with you before you submit it to

the Internship Course Facilitator.

7. Submit your final report, evaluations, and any other required forms by designated due date of

your internship semester. All finalized documents must be submitted to the Internship Course

Facilitator.

8. Represent the University, the MHCA program, and yourself in a professional manner.

9. Follow the rules and regulations of the organization sponsoring your internship.

During Internship Experience at Healthcare Organization:

The student should view the internship experience as an opportunity to learn how to apply theory and

principles in the context of work situations and to develop skills essential to these tasks. The student is

expected to function as a staff member with responsibilities commensurate with their capabilities and

position.

The student is expected to adhere to the policies, procedures, and working hours that apply to

professional and administrative staff members of the healthcare organization. Students may be

required to meet additional specific requirements for employment in the health service organization

(e.g., pre-employment physical examinations, personal background checks, etc.), and it is the intern’s

responsibility to find this out during the interview.

PRECEPTORS AND STUDENTS The student will be assigned tasks, activities and/or a project(s) in the healthcare organization, as

discussed and approved by the preceptor, appropriate with the student’s competencies and the

healthcare organization’s needs. The following are examples of healthcare organization management

processes in which active participation would be appropriate for students:

• Assessing the healthcare needs of the population or sub-populations served by the organization;

• Supervising personnel in the implementation of a program/policy;

• Developing a business plan or marketing strategies for community programs and services;

• Assessing staffing needs for programs and services;

• Developing a budgeting plan for program/services;

• Planning project/programmatic events;

• Organizing/coordinating personnel and other resources for project/program implementation;

• Working with healthcare organization personnel to write funding proposals or identify funding sources

for community programs.

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The student is expected to establish a productive and respectful working relationship with their

preceptor, co-workers, volunteers and other members of the department/division with the healthcare

organization with whom they may come in contact in the course of performing duties/responsibilities.

The student is expected to respect the confidentiality and dignity of the client population and

employees of the healthcare organization at all times.

If the student experiences difficulties that may be related to an improper placement, the student must

discuss the issue with their preceptor at the healthcare organization FIRST. The student should apprise

the Internship Course Facilitator in a timely manner of the issue and the steps proposed to resolve the

problem.

INTERNSHIP POLICIES Absences

The student is expected to maintain a regular work schedule as agreed upon by the preceptor and the

student. The student must notify both the preceptor and the Internship Course Facilitator in a timely

manner in the event of an unexpected absence (e.g. sickness). If the student is absent for three

consecutive internship workdays or more, a doctor's note/report is required prior to returning to the

internship and must be submitted to both the preceptor and the Internship Course Facilitator. Absences

must be made up before the last day of the internship. Physician and dentist appointments should be

scheduled outside of internship hours.

Holidays

The student will follow the work schedule of the healthcare organization and not of the University. The

student will be off on the holidays recognized by the healthcare organization for their employees. The

student is entitled to observe personal religious holidays and should discuss religious holidays with their

preceptor when establishing internship work hours. Preceptors are asked to work with students

regarding meeting student needs for religious reasons.

Travel, Parking, and Other Fees

Students are expected to pay for their own travel expenses, parking fees, conference fees, professional

wardrobe etc. as incurred as a result of the internship. If there are questions about such fees, the

student may discuss them with their preceptor; however the student should not expect the healthcare

organization to pay these fees. These costs are considered to be a part of the student’s professional

responsibilities.

MHCA PROGRAM RESPONSIBILITIES During the Internship, the MHCA Program has several responsibilities to the student, the healthcare

organization, and to the preceptor. They include but are not limited to the following:

1. Serve as a resource for both the students and preceptors during the internship and help ensure

that the experience is beneficial to both parties.

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2. Maintain contact with preceptors throughout each student’s internship experience, through

phone calls and/or email, to ensure student is working and completing tasks.

3. Maintain a pool of quality internship placements for students to choose from and assist students

in securing a match appropriate for their skills and ambitions.

4. Provide professional leadership for the internship component of the MHCA Program.

PURPOSE OF THE LEARNING CONTRACT The primary purpose of the Learning Contract is to clarify the educational purpose and work-related

responsibilities of the student during the internship experience, ensuring in advance an understanding

of the total experience among those principally involved – the student and the preceptor. The student is

responsible for filling out the contract, which must be signed by both the preceptor and the student

before being submitted to the Internship Course Facilitator. The value of this contract lies in the

dialogue it fosters as an obligation is created and the meaning of a quality internship project is discussed

with the preceptor.

The Learning Contract creates a basis for the student’s own unique course of study during the internship

experience. It articulates what the student will do and learn, how goals/objectives will be accomplished,

and how the student’s progress and project will be evaluated.

Writing the Learning Contract

The Learning Contract serves several purposes:

1. It provides a framework/structure for the internship.

2. It provides a reference against which progress can be measured.

3. It serves as a reminder to the preceptor and student of the purpose and activities of the

internship.

4. It provides a basis of evaluation and validation of the learning experience.

The Learning Contract requires the student to articulate clearly in writing and to obtain agreement from

the preceptor on the learning goals/objectives and activities in advance. The Learning Contract serves as

a useful tool for planning and evaluating the learning experience gained by the student.

Learning Goals/Objectives and Expected Outcomes

The learning goals/objectives are statements of what the student hopes to accomplish and learn during

the internship experience. The learning goals/objectives should be given careful thought and discussed

with the preceptor. The expected outcomes of these learning goals/objectives should be written as

specific, measurable statements – how will the student and preceptor know the goals/objectives were

accomplished. It should be noted that unexpected changes in student responsibilities are sometimes

made after the contract is in place. If this should happen, add this information as additional

documentation to the original contract, which will be included in the student’s final report.

In formulating your learning goals/objectives and expected outcomes, express the knowledge and skills

you hope to gain as well as attitudes or values you want to clarify.

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Knowledge and Understanding Objectives

Objectives related to gaining knowledge involve the acquisition and retention of information, facts, concepts, theories, or ideas. Objectives related to gaining understanding involves using gained knowledge for problem-solving, evaluating, reasoning, judging, analyzing, and synthesizing.

Skills Objectives

Objectives related to skills development involve applying acquired knowledge and understanding. Skills improve with use and practice. Skills may be mental or physical and can pertain to activities carried out

with people (interviewing, public speaking), with things (computers, creating graphs, etc.), or with data

(analyzing or preparing reports, gathering research materials).

Attitudes and Values Objectives

Objectives related to attitudes and values usually involve the formulation and/or classification of

personal values or feelings, and can include emotional intelligence development. Think in terms of

personal convictions you believe will be affected by the internship project experience. What opinions,

attitudes, or feelings do you hope to clarify? What emotions do you want to recognize, understand, and

manage in yourself and/or recognize, understand, and influence in others?

Specific Tasks

Describe the specific tasks or activities that will be directly related to your learning goals/objectives.

These tasks and activities will enable you to work toward achieving your goals/objectives

Example

Goal/Objective 1: To take advantage of professional growth opportunities.

Expected Outcome: Attend one national professional meeting during the internship period.

Specific Tasks/Activities: 1. Determine which professional meetings/conferences are being held during

my internship period. 2. Complete the registration process, including paying fees, hotel and travel

needs. 3. Attend the meeting. 4. Write a summary of the sessions attended and give to preceptor. 5. Meet with preceptor to discuss summary.

OTHER CONSIDERATIONS

Preceptor Supervision

In your conversation with your preceptor, ask him/her to describe the type of supervision you can

expect. Ask specific questions, such as “Will you work with me on a daily basis?” or “Do you plan to

meet with me weekly or more often to review my work, make suggestions, or assign new

responsibilities?” This ensures that both the student and preceptor understand what is expected in this

area. This information can be included in your Learning Contract.

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MHCA Program Contact with Preceptor

Throughout the 15 week internship experience, the Internship Course Facilitator will contact the

preceptor, ensuring that internship hours and activities are being met by the student, that the internship

is progressing, and that there are no issues that need to be addressed.

Evaluation/Course Grade

Each week during the internship experience the preceptor will sign off on the student’s Weekly Work

Schedule form, indicating progress the student is making weekly. At the end of the internship

experience, the preceptor will evaluate the student in the areas of knowledge of health care

environment, communication and relationship management, professionalism, leadership and teamwork,

emotional intelligence, and other various areas (complete the Preceptor Evaluation of Student form).

The preceptor will also read, review, and approve or not approve the student’s final report (complete

the Final Report Complete form).

The student’s course grade will be based on a rubric that incorporates course assignments, completion

of internship hours, preceptor evaluation of student, and the elements of the final written report (see

pages 13-14). Failure to complete course assignments, specific tasks or project(s) during field work, and/

or unsatisfactory completion of required internship hours may result in the following action/s:

a. Decreased final course grade

b. Failure of the internship course

c. Repeating the course/internship experience

Contact the Internship Course Facilitator if further clarification is needed.

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FINAL PAPER GUIDELINES

The complete and final document presented to preceptor and the Internship Course Facilitator for

review should be professionally bound (e.g., spiral bound) with a protective cover sheet.

The final paper must be APA formatted. The following elements are required in the final paper:

1. Title page

This should include the project title, your name, your student ID number, semester (e.g.,

Fall 2016), the university name, college name, and program name

2. Abstract

A brief one paragraph summary (approximately 250 words) of the paper’s contents. It

should provide someone unfamiliar with your project with a good overview of the project.

3. Acknowledgements

It is customary to thank those individuals who have provided assistance during your

project.

4. Table of Contents

This should list the main sections of your paper. Use double spacing, consistent formatting,

create dot leader tabs, and page numbers.

5. Describe your healthcare organization’s characteristics including the mission statement and organizational structure.

6. Introduction of your preceptor and their administrative role within the healthcare organization.

7. Introduction or background of yourself (the student), including your administrative role within the healthcare organization during your internship.

8. Detail the goals and objectives of the internship experience. Describe internship tasks, activities, and/or project(s) to achieve goals and objectives, and explain how the essential tasks were organized and monitored.

9. Describe which objectives were completed and/or not completed. If an objective(s) was not met, explain what contributed to this.

10. Describe any challenges encountered and solutions used or implemented.

11. Detail how the internship experience addressed or developed the MHCA core competencies

(see the Profile of a UAFS MHCA Graduate, see pages 15-16).

12. Provide an overall evaluation of the experience, conclusions, and recommendations.

13. References

For in-text citations, if used.

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14. Appendices

This should include a reference list of the basic printed resources of the most use to you

during the internship project and any products that resulted from the internship project

such as project reports, education materials, presentations, etc.

15. The following MHCA program forms should be included as the last appendices in this order:

a. Organization Description

b. Learning Contract

c. Weekly Work Schedule with any supporting documentation

d. Final Report Complete

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THE PROFILE OF A UAFS MHCA GRADUATE The UAFS Master’s in Healthcare Administration Program prepares graduates to achieve excellence in

their professional careers. The student’s academic studies in combination with the internship

experience should help develop the following competencies that are foundations for professional

success (based on the HLA competency model used by ACHE):

LEADERSHIP AND MANAGEMENT Ability to inspire individual, team, and organizational excellence, create a shared vision and effectively

manage change.

Leadership Skills and Behavior

Organizational Climate and Culture

Role of Vision

Change Management

Sensitivity to Diversity

Context of Governance in Operations

COMMUNICATION AND INTERPERSONAL EFFECTIVENESS Ability to communicate clearly and concisely with internal and external stakeholders, establish and

maintain relationships, and facilitate constructive interactions with individuals and groups.

Communication Skills, written and oral

Relationship Identification and Management

Facilitation and negotiation

PROFESSIONALISM AND ETHICS Ability to align personal conduct with ethical and professional standards that include a responsibility to

the patient and community, a service orientation, and a commitment to lifelong learning and

improvement.

Personal and Professional Accountability

Professional Development and Lifelong Learning

Contributions to Community and Profession

Ethical Behavior

Emotional Intelligence

KNOWLEDGE OF HEALTHCARE SYSTEMS AND HEALTHCARE MANAGEMENT Ability to discuss and apply knowledge of the healthcare system and the interdisciplinary environment in

which healthcare managers and providers function.

Clinical Disciplines and Support Systems

Patient and Family Perspectives

Community Health Needs and the Broad Healthcare Environment

Patient Safety

Benchmarking Techniques

(continued next page)

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CRITICAL THINKING, ANALYSIS, AND PROBLEM SOLVING Know, apply and integrate business principles, including systems thinking, to the healthcare

environment. Areas in which these skills and knowledge are applicable include:

General Management

Financial Management

Human Resource Management

Organizational Dynamics and Governance

Strategic Planning and Marketing

Information Systems and Management

Risk Management

Quality Improvement

Health Law and Regulations

Health Policy and Economics

REQUIRED FORMS Form To be Signed by Due

Student Acknowledge and Comply MHCA Student Once you have read the MHCA Internship Handbook.

Interview Complete Potential Preceptor

After any interview with potential organization is complete. Must be submitted to the Internship Course Facilitator before Internship Course begins.

Letter of Agreement Organization’s Representative, Preceptor, MHCA Executive Director

After securing internship and before Internship Course begins. **Return to the MHCA Executive Director.

Organization Description Student and/or Preceptor

After securing internship and before Internship Course begins. Must be submitted to the Internship Course Facilitator before Internship Course begins. *A copy will be required in theFinal Report

Learning Contract Preceptor and Student

After accepting position of intern and before Internship Course begins. Must be submitted to the Internship Course Facilitator before Internship Course begins. *A copy will be required in theFinal Report

Weekly Work Schedule Preceptor and Student *This form will be required in theFinal Report only.

Preceptor Evaluation of Student Preceptor Last week of semester. Must be submitted to the Internship Course Facilitator.

Final Report Complete Preceptor and Student Last week of semester *A copy will be required in theFinal Report

Student Evaluation of Internship Site Student Last week of semester

Program/Preceptor Contact Internship Course Facilitator

This form is the responsibility of the Internship Course Facilitator.

Forms can be submitted by email or faxed. Unless otherwise noted, all forms should be submitted to the

Internship Course Facilitator. Contact the MHCA Executive Director, Dr. Wittney Jones, for this

information ([email protected] or 479-788-7399).

*Please note the forms that are required as part of the Final Report.

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mailto:[email protected]

Healthcare Administration Internship

Acknowledge and Comply Form

I have read the MHCA Internship Handbook and examined all the documentation and forms concerning the Healthcare Administration Internship.

I understand that I am responsible for securing an internship site and preceptor.

I understand that I must follow the rules and regulations of the healthcare setting of my internship.

I understand that I am expected to act with professionalism and ethically while participating in the internship

experience.

I understand that I am to work productively and be actively involved at the internship site.

I understand I am responsible for ensuring that all forms are completed and returned to the Internship Course

Facilitator within the timeframe allotted.

I understand I must complete the requirements of the internship course, including discussions and a final paper, as

well as work 10 hours/week at my internship site for the first 15 weeks of the 16 week semester.

I understand that all course assignments are due by said dates.

I understand that and failure to complete or unsatisfactory completion of specific tasks and activities related to my

project, as well as late submission of assignments and forms may result in the following action(s):

A. Decreased final course grade

B. Failure of the internship course

C. Repeating the course/internship experience

I have read all the above statements and acknowledge that I understand the expectations and guidelines for the

MHCA Internship. I understand that if I fail to comply with the requirements of the internship course and the

internship experience, then I may not pass my internship course which will delay my completion of and graduation

from the MHCA program.

_______________________________________________________________________________________

Student Signature Date

_______________________________________________________________________________________

Print Student Name ID Number

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Interview Completed Form

___________________________________________has concluded an interview with me regarding

possible placement in my organization as a student intern for the _________________ semester.

This placement will be: _______Acceptable ________Unacceptable (If unacceptable, please explain on the back)

Agreement if placement is acceptable:

I understand that full-semester Students are expected to work a minimum of 10 hrs/week during the semester at the Healthcare

Organization. The initial plan is to have this student work the following schedule:

______________________________________________________________________________________________________

(hours/days, including likely evenings and/or weekend activities)

I agree to promptly notify the Internship Course Facilitator if these hours/days need to change.

_______________________________________________ ___________________________________________________

Preceptor Name (Print) Healthcare Organization (Print)

______________________________________________________________

Preceptor Signature Date

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Letter of Agreement Form

This agreement is entered into this _________ day of ______________________________, 20_______

between the University of Arkansas Fort Smith Master’s in Healthcare Administration Program, an agency

of the State of Arkansas (hereinafter referred to as the “University/Program"),

and___________________________________________________________________ (hereinafter referred

to as the "Organization").

The Letter of Agreement shall govern the use of the Organization's facilities by the faculty and students

enrolled in the UAFS Master of Science in Healthcare Administration degree program. The Organization

identified above agrees to the following conditions in accepting and supervising the University/Program's

Healthcare Administration Students:

A description of the Organization must be submitted to the University for inclusion in the Internship Site

Directory;

Notification must be made in advance to the University/Program Executive Director when (a) a semester

becomes inappropriate for internship experiences, (b) when there is a change in Preceptor, and/or (c)

when the Preceptor(s) will be on leave of absence;

The Organization must, at all times, provide adequate supervision. The Student should not replace any

employee or assume unsupervised command of any project or role;

The Organization will inform the student at the time of the interview of any reimbursement policies for

on-the-job travel, liability coverage, parking, immunizations, criminal background check or other job re-

lated expenses;

The student should be provided oral and/or written information (e.g. annual reports, description of the

Organization’s goals, organizational charts, nature of the placement, anticipated tasks of the Student,

working conditions) about the Organization to assist the student in making an informed decision when

selecting an internship placement. This exchange must be done at the time of the interview.

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The Preceptor must:

have a minimum of one year in her/his current position;

be responsible for a health care management project, or component of a larger healthcare management function in the Organization;

have extensive experience in healthcare management and/or related fields as well assupervisory experience;

be committed to and have sufficient time to devote to the professional growth anddevelopment of the Student;

agree to interview potential students;

consent to complete the Interview Form and return it to the MHCA Executive Directorafter interviewing the prospective Student;

agree to complete all evaluation forms;

agree to provide daily supervision for the student.

This Letter of Agreement binds both the University/Program and the Organization to the requirements

specified in the UAFS Master of Science in Healthcare Administration Internship Handbook. Should either

party be desirous of terminating this Agreement, prior notice must be given sixty (60) calendar days in

advance of its termination. Such termination shall not take effect, however, until Students already engaged

at the Organization have completed their internship experience. If no termination by either side is sought,

the Agreement will remain in effect. During the performance of this agreement it is agreed that there will

be no discrimination against any student because of race, color, religion, gender, sexual orientation or

national origin.

_________________________________________________________________

Organization Representative Date

_________________________________________________________________

Preceptor Date

_________________________________________________________________

Wittney Jones, MHCA Executive Director Date

Return to:

Wittney Jones, Ph.D. University of Arkansas Fort Smith MHCA Executive Director 5210 Grand Avenue, P. O. Box 3649 Fort Smith, AR 72913-3649 [email protected] 479-788-7399

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Organization Description Form

Name of Organization: ________________________________________________________________________________

Address: ___________________________________________________________________________________________

Contact Person: _____________________________________________________________________________________

Job Title: ___________________________________________________________________________________________

Telephone: ___________________________________ Fax: ____________________________________________

Email: _____________________________________________________________________________________________

Please complete the following (use additional paper as needed):

Brief Description/Overview of Organization:

Preceptor’s Position, Level of Management and Brief Description of Responsibilities/Experience (attach current CV):

Representative Intern Projects / Duties:

Is this Health Care Organization an equal opportunity employer in compliance with all EEO guidelines and legislation? Y N

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Learning Contract

This Learning Contract will be between ________________________________________, student, and

________________________________________________________________________________________.

(Preceptor’s Name, Title, Organization)

The internship will be designed to lead the student in developing the competencies identified of a UAFS

MHCA graduate to a level equivalent to that expected of an entry-level management position. With these

competencies in mind (see Profile of a MHCA Graduate), during the course of the internship the following

goals are set (add additional sheets as needed):

Goal/Objective 1: ____________________________________________________________________

Expected Outcome: __________________________________________________________________

Specific Tasks/Activities: ______________________________________________________________

Goal/Objective 2: ____________________________________________________________________

Expected Outcome: __________________________________________________________________

Specific Tasks/Activities: ______________________________________________________________

_________________________________________________________________________________


__________________________________________________________________________________


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Weekly Work Schedule Form

To be signed by the preceptor each week indicating that the student worked designated

internship hours and accomplished assigned tasks for that week.

Preceptor: Initial and date under Yes or No. Any ‘No’ response needs further explanation on a separate sheet of paper.

This form and supporting documentation is to be included in the student’s Final Report.

WEEK OVERVIEW OF WEEK’S TASKS Yes No

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Preceptor Evaluation of Student Form

Student Name: ____________________________________________________________________________________________

Dates of Internship: _______________________________________________________________________________________

Name of Organization: _____________________________________________________________________________________

Preceptor Name and Title: __________________________________________________________________________________

The evaluation of your student provides important feedback to the student and the University/Program. Please rate the student’s

performance, review the evaluation with him/her and then return the form to the MHCA Executive Director.

For each competency area, please provide a rating of the student, using a typical 5-level Likert scale, evaluating the objective and

subjective statements below. Comments or a brief description of the Student’s strengths and weaknesses are welcomed for each

criterion. For a complete description of each competency group, please refer to the attached Profile of a MHCA Program Graduate.

CRITICAL THINKING, ANALYSIS, AND PROBLEM SOLVING

The student demonstrates knowledge, can apply and integrate business principles, including systems thinking to the healthcare

environment.

5-Strongly Agree 4-Agree 3-Neither agree nor disagree 2-Disagree 1-Strongly Disagree

Comment:

KNOWLEDGE OF HEALTH CARE SYSTEMS AND HEALTHCARE MANAGEMENT

The student demonstrates the ability to discuss and apply knowledge of the healthcare system and the interdisciplinary

environment in which healthcare managers/providers function.


Comment:

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COMMUNICATION AND INTERPERSONAL EFFECTIVNESS

The student demonstrates the ability to communicate clearly and concisely with internal and external stakeholders, establish and

maintain relationships, and facilitate constructive interactions with individuals and groups.


Comment:

PROFESSIONALISM AND ETHICS

The student demonstrates the ability to align personal conduct with ethical and professional standards that include a responsibility

to the patient and community, a service orientation, and a commitment to lifelong learning and improvement.


Comment:

LEADERSHIP AND MANAGEMENT

The student demonstrates the ability to inspire individual, team, and organizational excellence, create a shared vision and effective-

ly manage change.


Comment:

EMOTIONAL INTELLIGENCE

The student demonstrates proficiencies in intrapersonal and interpersonal skills in the areas of self-awareness, self-regulation, self-

motivation, social awareness and social skills.


Comment:

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Overall, how would you rate the student’s performance during the internship experience?

5-Very Effective 4-Effective 3-Neither effective nor ineffective 2-Ineffective 1-Strongly Ineffective

Comment:

Do you believe the internship was a valuable learning experience for the student?


Comment:

Do you believe the student was valuable to your organization?


Comment:

What were the student’s most positive attributes?

In what areas is the student in need of improvement?

Please characterize the growth of the student during the internship.

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How would you rate the student’s potential in healthcare administration at the end of the internship?

5-Very Capable 4-Capable 3-Neither capable nor incapable 2-Incapable 1-Very Incapable

In what areas do you think the student’s skills, abilities, and potential might best serve them and the profession?

_____ General Management or Administration

_____ Sales

_____ Marketing

_____ Finance

_____ PR or Community Relations

_____ Direct Provider

_____ Supply Chain Management

_____ Other (please comment): ___________________________________________________________________

Would you hire this person to work in your organization if you had the opportunity?

Yes _____ No _____

Please state your reasons:

In your opinion, and in the opinion of others with whom the intern has interacted, how would you rate the academic preparation

and knowledge base of this student?

Excellent _________ Good ________ Adequate _________ Inadequate _________

Academic Suggestions: In what areas do you think our students need more knowledge or preparation?

Please include any additional remarks about the student’s performance during the internship experience or the academic

preparation of this student.

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To be completed by the Preceptor:

_____ I have evaluated and discussed my evaluation with the intern named above.

_______________________________________________________________________________________________________


_______________________________________________________________________________________________________


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Final Report Complete Form

PLEASE PRINT

Report Title: ___________________________________________________________________________________________

Student Name: _________________________________________________________________________________________

Preceptor Name: ________________________________________________________________________________________

Organization Name: ______________________________________________________________________________________

To be completed by Preceptor:

_____ I have read and reviewed the final report/paper written by the student named above. ________________ Date

_____ I have discussed my evaluation of the report/ paper with the student named above. ________________ Date

CHECK ONE:

_____ I approve the final written report/paper as written.

_____ I approve the final written report/paper with noted changes as discussed with the student.

_____ I do not approve the final written report/paper ( describe your reasons below).

Preceptor Comments Regarding Student’s Final Written Report/Paper (use back or additional paper in necessary):

______________________________________________________________________________________________________


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Student Evaluation of Site Form

Student Name: __________________________________________________________________________________

Dates of Internship: _____________________________________________________________________________

Name of Organization: __________________________________________________________________________

Preceptor Name and Title: _______________________________________________________________________

The evaluation of your internship site provides important feedback to the MHCA Program. Your honest evaluation is

appreciated.

Using the following scale, circle the response that represents your perception of your internship experience. Com-

ments to clarify and support your response may be added to the back of the page.

MARKING INSTRUCTIONS:


1. The preceptor was well qualified and experienced. 5 4 3 2 1

2. The facilities for students were adequate. 5 4 3 2 1

3. Orientation to the organization was adequate. 5 4 3 2 1

4. Opportunities for interaction with the staff were adequate. 5 4 3 2 1

5. The assignments met my learning objectives. 5 4 3 2 1

6. Staff were supportive of students. 5 4 3 2 1

7. The organization provided the agreed upon resources for 5 4 3 2 1

meeting learning objectives.

8. I was given a manageable workload at this internship site. 5 4 3 2 1

9. I recommend that this internship site be considered for 5 4 3 2 1

internship placement in the future.

Additional Comments (use back or additional paper as necessary):

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Program/Preceptor Contact Form

Circle one: Field Experience Project-Based

Student: __________________________________________________ Semester: __________________________

Preceptor: _________________________________________ Phone: ___________________________________

WEEK Yes No Notes regarding contact with Preceptor

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