Minnesota State University Mankato Department of Health Science

Community Health Education Internship Handbook

Copyright Amy S. Hedman

Minnesota State University, Mankato Department of Health Science

Course: Hlth 496/696: Internship in Community Health Education (1-9 semester hours)

Internship Director: Amy S. Hedman, PhD, CHES Office: HN 180 Voicemail: 507-389-5382 Email: amy.hedman@mnsu.edu

COURSE DESCRIPTION: A concentrated pre-professional work experience for those students preparing for a career in Community Health Education. Students must schedule placement one semester in advance. A Community Health Education Internship Site Resource List is available for review through the Department of Health Science. PREREQUISITES Successful completion of all Community Health Education core courses. FIELD EXPERIENCE CLOCK HOURS A 9-credit internship is equivalent to full-time employment for the semester (minimum of 450 clock hours). A 4-credit internship is equivalent to 225 clock hours. Additional clock hours may be required when Community Health Education Internship is combined with an internship from another major/minor or licensure program. INTERN OBJECTIVES Through the use of site screening procedures and site approval, it is the intent that the Internship Experience will provide abundant opportunities for students to gain further knowledge and skills in all of the CHES areas of responsibility and competencies. After completion of the internship, students will assess their competencies in the areas listed below. Assessment will be described in the course assignment Student Internship Experience Report.

1) Assess individual and community needs for health education 2) Plan health education strategies, interventions, and programs 3) Implement health education strategies, interventions, and programs 4) Conduct evaluation and research related to health education 5) Administer health education strategies, interventions, and programs 6) Serve as a health education resource person 7) Communicate and advocate for health and health education

(National Commission for Health Education Credentialing Inc.) INTERNSHIP EXPERIENCE The student will complete all responsibilities and duties of a community health educator at his or her assigned site. Internship sites are to be selected by a mutual agreement between student intern and the Community Health Education Internship Director during the semester prior to the actual experience. Deadlines for submitting internship materials to the Internship Coordinator are as follows: Semester Deadline

Fall semester internship May 15 Spring semester internship October 15 Summer semester internship March 15

Selection of the final internship site is to be discussed with and approved by the Community Health Education Internship Director. Permission to register for the internship credit hours (HLTH 496/696) will not be granted unless prior site approval has been granted. The student intern will submit completed Evaluation Feedback from his or her respective site supervisor to the Community Health Education Internship Director at the assigned times (mid-point and final) throughout the internship experience. The site supervisor will periodically inform the student intern and Community Health Education Internship Director regarding the student intern’s progress throughout the Internship. The internship experience is considered a practicum. Current employment positions are NOT accepted as internship experiences. STUDENT ASSIGNMENTS For the following assignments, specific directions as well as the necessary forms can be found in the Student Internship Handbook.

1. Internship Site Approval Form 2. Internship Goal Statement and Objectives 3. Updated Resume 4. Student Internship Experience Report 5. Intern Inventory of Health Education Competencies & Sub-competencies 6. Tracking Hours Handout

METHODS OF STUDENT EVALUATION 1. Goal Statement and Objectives 2. Resume 3. Student Internship Experience Report 4. Intern Inventory of Health Education Competencies & Sub-competencies 5. Midpoint and Final Evaluation of Student Internship Performance by the Site Supervisor 6. Completed Tracking Hours Handout

A grade of P will be assigned upon successful completion of the above activities. A grade of N will be assigned for students that do not successfully complete all of the above activities and fail to meet the expectations, responsibilities, and professional standards of their internship site and/or those of the Department of Health Science.

Final Student Internship Experience Report Requirements Upon completion of the internship, the student’s final report should include the following sections: 1) Completed Tracking Hours Handout (provided) 2) Site Description Report 3) Student Experience Report 4) Response to Initial Intern Goals and Objectives 5) Intern Inventory of Health Education Competencies & Sub-competencies

Student Internship Experience Report

1) Student Internship Experience Report a. Site Description Report. Answer each item using “2a-1.”,” 2a-2.”, “2a-3.”, etc. to distinguish

your responses. 1) Identify the extent of available health education services offered through the internship

organization/agency (1E-1). 2) Identify the populations that receive health education programs offered through the internship

organization/agency (2A-1). 3) Provide recommendations for collaborative efforts among health agencies and organizations with

mutual interests of those of the internship organization/agency (1C-1, 2A-4 2B-4). 4) Provide a list of suggestions for integrating health education and services into existing health

programs offered at the internship organization/site (2B-3, 2F-2). 5) Identify the information and resources needed to implement the health education interventions

offered through the internship organization/agency (2G-1) as well as their availability (2G-1). 6) Describe three ways the Code of Ethics in professional practice are demonstrated at the internship

site (3C-1). 7) Describe the needs assessment process employed by the internship organization/agency. Describe

the research methods and designs used (4D-1). Provide your analytical response to the needs assessment employed (1F-1).

8) Describe the evaluation process plan of the internship organization/agency. Provide recommendations for improving the evaluation plan (4E-1).

9) Identify the program goals of the organization. 10) Analyze the organization’s culture in relationship to program goals (5A-2). 11) Identify four principles of community organization employed by the internship

organization/agency and/or yourself (3A-1, 2B-2). 12) Analyze parameters of effective consultative relationships (6D-1). 13) Analyze the role of the health educator as a liaison between program staff and outside groups and

organizations (6D-2). 14) Describe the ways in which the internship organization/agency facilitated collaborative training

efforts among health agencies and organizations (2B-4, 6D-5) 15) Report the effectiveness of the internship site’s programs in achieving their proposed objectives

(4E-4). 16) Describe the implementation methods used by the site to evaluate factors that influence shifts in

health status (4D-4). What barriers to implementation did you observe (2G-2)?

b)Student Experience Report. Answer each item using “2b-1.”,” 2b-2.”, “2b-3.”, etc. to distinguish your responses.

1) Describe the role you played in delivering educational programs to diverse populations at the internship organization/agency (1B-4, 3A-3, 3B-2).

2) Describe the implementation strategies you performed during the internship experience (1C-1, 3B-2).

3) Describe the techniques you employed that incorporated demographically and culturally sensitive strategies when implementing programs offered through your internship organization/agency (3B-2, 3C-4).

4) Describe the implementation intervention strategies to facilitate health-related change that you developed/utilized during your internship (1C-1, 3B-2, 3C-5). Describe the theoretical influence of the strategies selected (3C-2)

5) Describe your involvement in developing data gathering instruments or surveys (1B-1, 4C-2).

6) Describe your role in promoting cooperation and feedback among personnel associated with your internship organization/agency (5A-3) as well as facilitating groups (3A-4).

7) Describe the health information resources you accessed during your internship (1A-2, 1A-4, 2D-2, 6A-4).

8) Describe your role in acquiring resource materials at your internship site (1A-2, 1A-4, 2D-2, 6C-2). 9) Describe the educational materials of value to the health of individuals and community groups that

you assembled during your internship (1A-2, 1A-4, 2D-2, 3B-2, 6C-3). 10) Describe your role as a liaison among consumer groups, individuals and health care provider

organizations (3B-2, 6D-3). 11) Describe how you applied networking skills to develop and maintain consultative relationships

with completing your internship (3B-2, 6D-4). 12) Describe the ways in which you used culturally sensitive communication methods and techniques

(3B-2, 7B-4). 13) Describe the ways in which you used appropriate techniques when communicating health and

health education information (2F-1, 3B-2, 7B-5). 14) Describe the ways in which you used oral, electronic, and written techniques for communicating

health education information (3B-2, 7B-6). 15) How did you demonstrate proficiency in communicating health information and health education

needs during your internship (2F-1, 7B-7). 16) What is your two-year personal plan for professional growth (7C-1).

2) Response to Initial Intern Goals and Objectives In narrative format, address your success in achieving each of the goals and objectives you initially stated for the internship. In addition, identify unexpected outcomes and lessons learned that you had not considered prior to the internship experience. Provide an overall summary of your experience, describing how the internship has prepared you for a future career in Community Health Education. Lastly, indicate future goals that you have set for yourself.

3) Intern Inventory of Health Education Competencies and Sub-competencies (included in this

handout)

CONTACT INFORMATION Amy S. Hedman, PhD, CHES Assistant Professor, Community Health Education Program Coordinator and Internship Director Department of Health Science 213 Highland Center Minnesota State University, Mankato Mankato, MN 56001 Phone: (507) 389-5382 Email: amy.hedman@mnsu.edu

Standards of Professional, Department of Health Science The Department of Health Science at Minnesota State University, Mankato expects all students enrolled in Health Science courses to adhere to the following Standards of Professionalism.

Interact with students, college staff and faculty, and community in a positive, professional manner. Perceive and respect the physical, emotional, and social boundaries of others. Perceive and respect diversity among groups of people and individuals based on age, ethnicity, race,

gender, socioeconomic status, exceptionalities, language, religion, sexual orientation, and geographical area.

Listen and value others’ ideas. Adhere to the professional guidelines and ethics specific to their aspiring profession. Maintain confidentiality standards. Value and demonstrate honesty. Arrive on time and complete assigned tasks on schedule. Accept personal responsibility for one’s own actions. Arrive ready and able to support the intellectual, academic, social, and emotional growth of others. Use proper grammar and vocabulary in written and oral communication. Maintain personal hygiene. Dress appropriately.

MINNESOTA STATE UNIVERSITY, MANKATO COLLEGE OF ALLIED HEALTH AND NURSING

Department of Health Science • 213 Highland Center North Mankato, MN 56001

Telephone (507) 389-5832 • Fax (507) 389-2985

Community Health Education Internship (CHEI) Application Procedures

___ Discuss major/minor program requirements in consultation with Faculty Advisor

and Coordinator of the Community Health Education Program. Application for Graduation should be completed two full semesters before planned graduation date.

___ Obtain and review the Community Health Education Internship Student Handbook from the Department of Health Science. ___ Review CHEI Criteria and Student Intern Checklist of the Handbook to initiate procedures for identifying and securing internship site location. ___ Identify potential internship site settings. Contact potential sites to inquire about internship

opportunities, application procedures and deadlines, and address additional questions you may have. See enclosed handout Informational Interview for Internship Experience to help you initiate contact with prospective internship sites.

___ Schedule an appointment with the CHEI Director prior to final selection/decision of internship site. Consider Internship Agreement criteria for participating as an intern at a selected site. ___ Prepare and submit application materials to the CHEI Director: (1) Completed Site Approval

Form, (2) Goal Statement/Objectives, (3) Resume, and (4) a copy of student’s updated Degree Audit Report (DARS). Materials must be submitted in hard copy and submitted together.

___ Obtain online permission to register for HLTH 496/696. Once internship site has been

approved, students will receive online permission to register for the internship credits. It is the student’s responsibility to plan ahead and have the internship site approved, at minimum, one full-month before the start of the semester in which the internship will be completed. Permission to register for HLTH 496/696 will not be granted unless the site has been officially approved by the CHEI Director and the student has submitted the application materials described above.

Amy S. Hedman, PhD, CHES, Assistant Professor and Director

Community Health Education Internship • Department of Health Science 213 Highland Center North • Minnesota State University, Mankato • Mankato, MN 56001

Telephone: (507) 389-5382 • Fax: (507) 389-2985 • Email: amy.hedman@mnsu.edu

Identifying an Internship Site Identifying the appropriate and fitting internship site is a very important process for each student. The internship experience can provide students with substantial and promising opportunities for future career options. Therefore, it is strongly recommended that students reflect upon their professional goals before inquiring about internship positions. Students should consider their preferred career setting and responsibilities assigned. For example, if a student is interested in promoting nutrition and prevention for young mothers and infants, completing an internship with the Women Infant and Children (WIC) program at a local county health department would be a beneficial internship site selection. Selecting the “right” internship can help to gain significant work experience, develop helpful networking connections, and open the door for future opportunities. Students are encouraged to conduct their own research into site locations. A listing of potential sites is also available through the Department of Health Science. Once a student has identified a few sites that are of interest to him or her, he or she is advised to contact the site (via personal visit, phone or email) and inquire about internship opportunities for community health education or health promotion students. The Informational Interview for Internship Experience handout is provided to help students engage in a discussion about such opportunities.

Informational Interview for Internship Experience Students are responsible for researching, identifying, and securing an appropriate and acceptable internship site location to complete HLTH 496/696. A list of sample organizations and agencies is available through the Department of Health Science. In researching whether or not a given site would meet the Department of Health Science, as well as the student’s, requirements and needs, an informational interview is often necessary. Below is a sample script to be used during a phone consultation with prospective internship sites. Important information to gather during this time includes whether or not a given site sponsors a community health education internship experience, and, if so, what the application process entails. Once an appropriate site has been identified, and an agreement has been made between the student and the site, the Site Approval Form must be completed and submitted to the Community Health Education Internship Director (Dr. Hedman) for final approval. Students are not eligible to begin their internship experience until final approval has been granted by the Department of Health Science Community Health Education Internship Director, and permission to register for the course HLTH 496/696 has been provided. Sample Script for Informational Interview “Hello my name is ________________ and I am a student in the Community Health Education Program at Minnesota State University Mankato. I am contacting you to inquire about the possibility of an internship experience at your organization/agency.” “Do you have a moment or two to answer a few questions that I have?” “Do you offer a Community Health Education/Health Promotion internship at your site?” “What type of work experience does your internship experience provide to students? Can you provide me with a list of duties/responsibilities that an intern would be assigned?” “Can you describe for me what a typical day would be like for an intern at your site?” “Would I be involved in projects that address any of the following: needs assessment; planning, implementing, and evaluating health education programs; advocacy; or media development?” “What is the application process entail?” “Is there a deadline for applications for a (spring, fall, summer) internship?” “At would time, would applicants learn of your decision for an intern?” (If applicable) “I would greatly appreciate the opportunity to meet with you in person to discuss an internship placement at your site.” Or (If applicable) “Could you please send the application for the internship?” “Thank you for taking the time today to answer my questions.”

Site Selection and Approval

Once a student has identified and secured a site for the internship experience, the appropriate materials must be submitted to the Community Health Education Internship Director. Note: by “secured,” it is implied that the student has met with the anticipated internship site supervisor, discussed the internship experience, and agreed upon the internship location, responsibilities, and hours/schedule. Also, the student must complete the required application procedures of the internship site. Next, students complete the Site Approval Form with the anticipated internship site supervisor and submit this form to the Community Health Education Internship Director, Amy S. Hedman, PhD. With the completed Site Approval Form, the materials that also need to be submitted include the student’s current Degree Audit Report (DARS), resume and a list of the student’s unique goals and objectives for his or her internship experience. Upon submission of these materials to the Community Health Education Internship Director, students will receive official word whether or not their site has been approved. If approved, students will be granted online permission to register for the course HLTH 496/696: Internship: Health Education.

Community Health Education Internship Policies: Student Responsibilities

STUDENT RESPONSIBILITIES In exchange for the opportunity to participate in the internship at the selected Internship Site, the Student agrees to:

During the intern experience, students will conduct themselves according to the Student Code of Conduct and the Standards of Professionalism, as described in the Minnesota State University-Mankato Community Health Education Program Internship Handbook provided to students.

Students participating in the intern experience will furnish the agency with evidence of current immunization and other related information as required by the Agency.

Students participating in the intern experience are encouraged to carry their own health insurance.

Students participating in the intern experience are responsible for carrying their own professional liability insurance if professional liability insurance is not purchased through the University.

Each student shall submit a Confidentiality Statement to Minnesota State University-Mankato Community Health Education’s Program Internship Director.

Students are required to complete all the necessary steps to successfully complete the intern experience (course HLTH 496/696), as indicated to them in the Minnesota State University-Mankato Community Health Education Program Internship Handbook.

Keep regular attendance and be on time, both at school and at the Facility’s training site. The Student will promptly notify the Facility’s training site if unable to report. The Student’s placement will automatically terminate if the Student terminates his/her enrollment in the Program or is no longer enrolled as a student at the University.

Demonstrate honesty, punctuality, courtesy, a cooperative attitude, desirable health and grooming habits, desirable/required dress and a willingness to learn.

Furnish the Community Health Education’s Program Internship Director with all necessary information and complete all necessary reports requested by the Director. Submitting falsified reports is cause for immediate expulsion from the Program.

Conform to all rules, regulations, and policies including health, safety, and work environment of the Facility, follow all instructions given by the Facility and always conduct oneself in a safe manner.

Consult with the University’s Community Health Education’s Program Internship Director about any difficulties arising at the Facility’s training site.

Be present at the Facility’s training site on the dates and for the number of hours agreed upon.

Not terminate his/her participation in the training experience at the Facility without first consulting with the University’s Community Health Education’s Program Internship Director.

The Student also understands and agrees that: a. placement and participation in this training experience is not employment with the University or

Facility; b. the Student is not covered by the University worker’s compensation coverage; and c. the Student will not receive any money or compensation or benefits of any kind from the University in

exchange for his/her participation in the training experience. The Student also understands that the Facility does not promise or guarantee any future employment for the student.

The Student understands that he/she is responsible for providing his or her own health insurance and for any and all medical expenses incurred by him/her related to any injury, loss or illness sustained by him/her while participating in the training experience at the Facility.

Agency Responsibilities

The Agency agrees to provide the intern with appropriate and fitting work-related experiences for

students of Minnesota State University, Mankato enrolled in the Community Health Education

program during the designated academic semester.

The Agency agrees to work with the student intern(s) in establishing a personalized listing of student

goals and objectives to be worked towards during the intern experience.

The Agency will provide the university with a copy of its policies and regulations which relate to the

internship program.

The Agency will ensure equal opportunities in its educational programs, activities, and all aspects of

employment for all individuals, regardless of race, color, creed, religion, gender, national origin, sexual

orientation, veteran’s status, marital status, disability, status with regard to public assistance, or

inclusion in any group or class against which discrimination is prohibited by federal, state, or local laws

and regulations. The Agency agrees to adhere to this policy in implementing this Agreement.

The Agency is an equal Employment Opportunity/Affirmative Action Company committed to providing

full employment opportunity without regard to race, religion, color, creed, national origin, sex, age,

marital status, status with regard to public assistance, veteran status, or status as a qualified individual

with a disability/qualified disabled person.

The Agency agrees to

o Accept the identified student(s) for the internship experience(s).

o To provide an orientation for the intern(s) which includes reviewing Agency’s policies and

procedures, as appropriate.

o To provide on-site supervision and direction by an Agency employee with background

education and work experience in the field of health education, health promotion, or related

field.

o To provide the student(s) opportunities to collect and review appropriate Agency background

information and materials (for example past needs assessment or evaluation reports) to fulfill

student learning objectives.

o To provide full opportunities for the intern(s) to experience active involvement in the following

areas: needs assessment; program planning, implementing and evaluating; health

communications and media relations; community organizing; collaboration and partnerships;

in addition to other opportunities.

o To track and report upon completed student internship hours, providing a final hour tally with

the final student evaluation report. Note: for full internship, 450 completed hours is required.

o To complete and submit student intern progress and final evaluation reports, provided by

Minnesota State University-Mankato Community Health Education Internship Director.

o To not allow the student to perform any functions that are not a part of the Minnesota State

University-Mankato Community Health Education’s Program. For example, providing direct

care or clinical services to patients/populations.

o To consistently provide feedback to the student regarding intern performance and suggest

professional areas of growth and improvement, as observed.

o To participate in the in-depth evaluations of the intern’s/interns’ performance with the

Internship Director of Minnesota State University-Mankato Community Health Education

Program, which may include on-site visits by the Internship Director.

Minnesota State University-Mankato Community Health Education Internship Program Director agrees to:

To assist student interns in the following areas:

o Provide advisement in selecting an appropriate and fitting site for each student. Assist student

with site selection and application process.

o Approve student’s resume, goals, and objectives for the internship experience. Submit a copy

of student goals and objectives to Agency.

o Process the Site Approval Form. Provide copies to both agency and student intern.

o Be available for phone conference calls and consultations to the student intern and internship

site supervisor as needed.

o Review all completed internship requirements and award a grade as appropriate.

To assign only those students for the intern experience who have completed required preliminary

courses and are deemed ready to fulfill the practicum-internship sequence of the program.

To assure responsibility for the instruction and collaborative supervision with the site supervisor of

students throughout the entire internship.

To instruct students to be responsible for the provision of professional liability insurance coverage for

themselves.

To instruct students to hold as confidential any patient/population or Agency information acquired

while engaged in the intern experience.

To provide the Agency with directions and materials necessary to complete the student intern

evaluation procedures.

When conducting on on-site visit, Program faculty will show proper identification before entering the

Agency, as required.

To allow the Agency staff to require suspension or withdrawal from the internship experience any

student whose work, conduct, or health may have a detrimental effect on its personnel or populations

served.

To allow the Agency staff to require suspension or withdrawal from the internship experience any

student whose work, conduct, or health may have a detrimental effect on agency operations.

To inform student interns that they shall be subject to the Agency’s policies, inasmuch as such policies

are relevant to student interns.

Mutual Responsibilities, both parties agree to:

This agreement may be amended or extended at any time upon mutual agreement in writing of the

parties.

That if either party wishes to withdraw from this agreement, the party shall give due notice.

That students shall not be placed in positions of responsibility for which they are not ready to assume.

Both parties will communicate areas of need or concern with one another, and work together to

identify solutions.

Student Requirements

During the intern experience, students will conduct themselves according to the Student Code of

Conduct and the Standards of Professionalism, as described in the Minnesota State University-Mankato

Community Health Education Program Internship Handbook provided to students.

Students participating in the intern experience will furnish the agency with evidence of current

immunization and other related information as required by the Agency.

Students participating in the intern experience are encouraged to carry their own health insurance.

Students participating in the intern experience are responsible for carrying their own professional

liability insurance if professional liability insurance is not provided by the University.

Each student shall submit a Confidentiality Statement to Minnesota State University-Mankato

Community Health Education’s Program Internship Director.

Students are required to complete all the necessary steps to successfully complete the intern

experience (course HLTH 496/696), as indicated to them in the Minnesota State University-Mankato

Community Health Education Program Internship Handbook.

Prior to their internship experience, students are required to submit the following:

Proof of personal medical/hospitalization insurance Proof of Malpractice Liability Insurance MSU-Mankato Community Health Education Confidentiality Agreement MSU-Mankato Community Health Education Code of Conduct and Standards of Professionalism Pledge

Upon completion of their internship experience, the following materials must be submitted to the Internship Director:

1. Student Internship Experience Report and Intern Inventory of Health Education Competencies & Sub-competencies (Student Responsibility)

2. Tracking Hours Handout (Student Responsibility) 3. Site Midpoint/Progress Evaluation Report (Site Supervisor Responsibility) 4. Site Final Evaluation Report: Intern Inventory and Final Report (Site Supervisor Responsibility)

A grade of P will be assigned upon successful completion of the above activities. A grade of N will be assigned for students that do not successfully complete all of the above activities and fail to meet the expectations, responsibilities, and professional standards of their internship site and/or those of the Department of Health Science. CONTACT INFORMATION Amy S. Hedman, PhD, CHES Assistant Professor, Community Health Education Program Coordinator and Internship Director Department of Health Science 213 Highland Center Minnesota State University, Mankato Mankato, MN 56001 Phone: (507) 389-5382 Email: amy.hedman@mnsu.edu

MINNESOTA STATE UNIVERSITY, MANKATO COLLEGE OF ALLIED HEALTH AND NURSING

Department of Health Science • 213 Highland Center North Mankato, MN 56001

Telephone (507) 389-5832 • Fax (507) 389-2985

Community Health Education Internship (CHEI) Confidentiality Internship Agreement

During the internship experience, assigned tasks may require that a student intern work with records, files, paperwork or electronic files that contain private and confidential information. Unlawful disclosure of private data is illegal in the state of Minnesota (Minnesota Statutes, Section 13:08-13.09) and can lead to disciplinary action and criminal penalties. Directions: Please read the information below and indicate agreement to comply by signing this form. As an intern in the Community Health Education program at Minnesota State University, Mankato, I, ______________________, understand that there may be situations where I have access to, and work with, confidential and private materials. These materials may include patient/client files or records, organization background data, including personnel and budget to name a few, or other sensitive information. I acknowledge that I have access to this information only because of the internship I am completing. I acknowledge that this information is designated as private data under the Minnesota Government Data Practices Act, MN Stat. Sec. 13:43, Subd. 3. I agree to NOT disclose this information, during or at any point after my internship experience, to anyone that is not permitted access to this information and employed by the internship site. Specifically, I agree to the following:

1) I will not discuss patient/client data or other confidential materials with individuals that have not been given access to such information (this includes family and friends)

2) I will not discuss private information in public places where others may overhear 3) I will not remove, copy or transfer private data or records from the internship site unless permission

from the supervisor has been given 4) In situations where private data, records or materials are in my possession, I will do everything in my

power to assure that information is secured and protected at all times 5) I will notify my supervisor and the Internship Director if I have any concerns regarding this agreement

I, _____________________________, have read the above information and agree to comply with this Confidentiality Internship Agreement. I understand violating this agreement may lead to disciplinary consequences that will negatively affect my status at the University, which may include immediate dismissal from the internship and program, in addition to potential criminal penalty. Student Signature ______________________________________ Print Student Name ______________________________________ CHEI Director Signature ______________________________________ Print Name ______________________________________ Date ______________________________________

Student Internship Experience (CHES Competency) Report HLTH 496 Final Student Internship Experience Report Requirements

Upon completion of the internship, the student’s final report should include four sections: 1) Completed Tracking Hours Handout (provided) 2) Student Internship Experience Report

a) Site Description Report b) Student Experience Report

4) Response to Initial Intern Goals and Objectives 5) Intern Inventory of Health Education Competencies & Sub-competencies Student Reporting Requirements:

1) Completed Tracking Hours Handout 2) Student Internship Experience Report a) Site Description. Answer each item using “2a-1.”, “2a-2.”, “2a-3.”, etc to distinguish your responses.

1. Identify the extent of available health education services offered through the internship organization/agency (1E-1).

2. Identify the populations that receive health education programs offered through the internship organization/agency (2A-1).

3. Provide recommendations for collaborative efforts among health agencies and organizations with mutual interests of those of the internship organization/agency (1C-1, 2A-4 2B-4).

4. Provide a list of suggestions for integrating health education and services into existing health programs offered at the internship organization/site (2B-3, 2F-2).

5. Identify the information and resources needed to implement the health education interventions offered through the internship organization/agency (2G-1) as well as their availability (2G-1).

6. Describe three ways the Code of Ethics in professional practice are demonstrated at the internship site (3C-1).

7. Describe the needs assessment process employed by the internship organization/agency. Describe the research methods and designs used (4D-1). Provide your analytical response to the needs assessment employed (1F-1).

8. Describe the evaluation process plan of the internship organization/agency. Provide recommendations for improving the evaluation plan (4E-1).

9. Identify the program goals of the organization. 10. Analyze the organization’s culture in relationship to program goals (5A-2). 11. Identify four principles of community organization employed by the internship

organization/agency and/or yourself (3A-1, 2B-2). 12. Analyze parameters of effective consultative relationships (6D-1). 13. Analyze the role of the health educator as a liaison between program staff and outside groups

and organizations (6D-2). 14. Describe the ways in which the internship organization/agency facilitated collaborative training

efforts among health agencies and organizations (2B-4, 6D-5) 15. Report the effectiveness of the internship site’s programs in achieving their proposed

objectives (4E-4).

16. Describe the implementation methods used by the site to evaluate factors that influence shifts in health status (4D-4). What barriers to implementation did you observe (2G-2)?

b)Student Experience Report. Answer each item using “2b-1.”, “2b-2.”, “2b-3.”, etc. to distinguish your responses.

1. Describe the role you played in delivering educational programs to diverse populations at the internship organization/agency (1B-4, 3A-3, 3B-2).

2. Describe the implementation strategies you performed during the internship experience (1C-1, 3B-2).

3. Describe the techniques you employed that incorporated demographically and culturally sensitive strategies when implementing programs offered through your internship organization/agency (3B-2, 3C-4).

4. Describe the implementation intervention strategies to facilitate health-related change that you developed/utilized during your internship (1C-1, 3B-2, 3C-5). Describe the theoretical influence of the strategies selected (3C-2)

5. Describe your involvement in developing data gathering instruments or surveys (1B-1, 4C-2).

6. Describe your role in promoting cooperation and feedback among personnel associated with your internship organization/agency (5A-3) as well as facilitating groups (3A-4).

7. Describe the health information resources you accessed during your internship (1A-2, 1A-4, 2D-2, 6A-4).

8. Describe your role in acquiring resource materials at your internship site (1A-2, 1A-4, 2D-2, 6C-2).

9. Describe the educational materials of value to the health of individuals and community groups that you assembled during your internship (1A-2, 1A-4, 2D-2, 3B-2, 6C-3).

10. Describe your role as a liaison among consumer groups, individuals and health care provider organizations (3B-2, 6D-3).

11. Describe how you applied networking skills to develop and maintain consultative relationships with completing your internship (3B-2, 6D-4).

12. Describe the ways in which you used culturally sensitive communication methods and techniques (3B-2, 7B-4).

13. Describe the ways in which you used appropriate techniques when communicating health and health education information (2F-1, 3B-2, 7B-5).

14. Describe the ways in which you used oral, electronic, and written techniques for communicating health education information (3B-2, 7B-6).

15. How did you demonstrate proficiency in communicating health information and health education needs during your internship (2F-1, 7B-7).

16. What is your two-year personal plan for professional growth (7C-1).

3) Response to Initial Intern Goals and Objectives In narrative format, address your success in achieving each of the goals and objectives you initially stated for the internship. In addition, identify unexpected outcomes and lessons learned that you had not considered prior to the internship experience. Provide an overall summary of your experience, describing how the internship has prepared you for a future career in Community Health Education. Also, please describe what training or skills you would have liked to have received in our program that would have prepared you for the internship. Lastly, indicate future goals that you have set for yourself.

4) Intern Inventory of Health Education Competencies & Sub-competencies (see next page)

Intern Inventory of Health Education Competencies and Subcompetencies

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I-Assess Individual and Community Needs for Health Education 1 2 3 4 5

I-A. Access existing health-related data. 1 2 3 4 5

1. Identify diverse health-related databases. 1 2 3 4 5

2. Use computerized sources of health-related information. 1 2 3 4 5

3. Determine the compatibility of data from different data sources. 1 2 3 4 5

4. Select valid sources of information about health needs and interests. 1 2 3 4 5

I-B. Collect health-related data.

1. Use appropriate data-gathering instruments. 1 2 3 4 5

2. Apply survey techniques to acquire health data. 1 2 3 4 5

3. Conduct health-related needs assessments. 1 2 3 4 5

4. Implement appropriate measures to assess capacity for improving health status. 1 2 3 4 5

I-C. Distinguish between behaviors that foster or hinder well-being. 1 2 3 4 5

1. Identify diverse factors that influence health behaviors. 1 2 3 4 5

2. Identify behaviors that tend to promote or compromise health. 1 2 3 4 5

I-D. Identify factors that foster or hinder the process of health education. 1 2 3 4 5

1. Determine the extent of available health educations services. 1 2 3 4 5

2. Identify gaps and overlaps in the provision of collaborative health services. 1 2 3 4 5

I-F. Infer needs for health education from obtained data 1 2 3 4 5

1. Analyze needs assessment data. 1 2 3 4 5

II. Plan Health Education Strategies, Interventions, and Programs 1 2 3 4 5

II-A. Involve people and organizations in program planning. 1 2 3 4 5

1. Identify populations for health education programs. 1 2 3 4 5

2. Elicit input from those who will affect, or be affected by, the program. 1 2 3 4 5

3. Obtain commitments from individuals who will be involved in the program. 1 2 3 4 5

4. Develop plans for promoting collaborative efforts among health agencies and

organizations with mutual interests.

1 2 3 4 5

II-B. Incorporate data analysis and principles of community organizations. 1 2 3 4 5

1. Use research results when planning programs. 1 2 3 4 5

2. Apply principles of community organization when planning programs. 1 2 3 4 5

3. Suggest approaches for integrating health education within existing health

programs.

1 2 3 4 5

4. Communicate need for the program to those who will be involved. 1 2 3 4 5

II-C. Formulate appropriate and measurable program objectives. 1 2 3 4 5

1. Design developmentally appropriate interventions. 1 2 3 4 5

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II-D. Develop a logical scope and sequence plan for health education practice. 1 2 3 4 5

1. Determine the range of health information necessary for a given program of

instruction.

1 2 3 4 5

2. Select references relevant to health education issues or programs. 1 2 3 4 5

II-F. Select appropriate strategies to meet objectives. 1 2 3 4 5

1. Analyze technologies, methods, and media for their acceptability to diverse

groups

1 2 3 4 5

2. Match health education services to proposed program activities 1 2 3 4 5

II-G. Assess factors that affect implementation. 1 2 3 4 5

1. Determine the availability of information and resources needed to implement

health education programs for a given audience

1 2 3 4 5

2. Identify barriers to the implementation of health education programs 1 2 3 4 5

III. Implement Health Education, Strategies, Interventions, and Programs 1 2 3 4 5

III-A. Initiate a plan of action. 1 2 3 4 5

1. Use community organization principles to facilitate change conducive to

health.

1 2 3 4 5

2. Pretest learners to determine baseline data relative to proposed program

objectives.

1 2 3 4 5

3. Deliver educational programs to diverse populations. 1 2 3 4 5

4. Facilitate groups.

III-B. Demonstrate a variety of skills in delivering strategies, interventions, and

programs.

1 2 3 4 5

1. Use instructional technology effectively. 1 2 3 4 5

2. Apply implementation strategies. 1 2 3 4 5

III-C. Use a variety of methods to implement strategies, interventions, and

programs.

1 2 3 4 5

1. Use the Code of Ethics in professional practice. 1 2 3 4 5

2. Apply theoretical and conceptual models from health education and related

disciplines to improve program delivery.

1 2 3 4 5

3. Demonstrate skill needed to develop capacity for improving health status. 1 2 3 4 5

4. Incorporate demographically and culturally sensitive techniques when

promoting programs.

1 2 3 4 5

5. Implement interventions strategies to facilitate health-related change. 1 2 3 4 5

IV. Conduct Evaluation and Research Related to Health Education 1 2 3 4 5

IV-A. Develop plans for evaluation and research. 1 2 3 4 5

1. Synthesize information presented in the literature. 1 2 3 4 5

2. Evaluate research designs, methods, and findings presented in the literature. 1 2 3 4 5

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IV-B. Review research and evaluation procedures. 1 2 3 4 5

1. Evaluate data-gathering instruments and processes. 1 2 3 4 5

2. Develop methods to evaluate factors that influence shifts in health status. 1 2 3 4 5

IV-C. Design data collection instruments. 1 2 3 4 5

1. Develop valid and reliable evaluation instruments. 1 2 3 4 5

2. Develop appropriate data gathering instruments. 1 2 3 4 5

IV-D. Carry out evaluation and research plans. 1 2 3 4 5

1. Use appropriate research methods and designs in health education practice. 1 2 3 4 5

2. Use data collection methods appropriate for measuring state objectives. 1 2 3 4 5

3. Implement appropriate qualitative and quantitative evaluation techniques. 1 2 3 4 5

4. Implement methods to evaluate factors that influence shifts in health status. 1 1 3 4 5

IV-E. Interpret results from evaluation and research. 1 2 3 4 5

1. Analyze evaluation data. 1 2 3 4 5

2. Analyze research data. 1 2 3 4 5

3. Compare evaluation results to other findings. 1 2 3 4 5

4. Report effectiveness of programs in achieving proposed objectives. 1 2 3 4 5

V. Administer Health Education Strategies, Interventions, and Programs 1 2 3 4 5

V-A. Exercise organizational leadership. 1 2 3 4 5

1. Conduct strategic planning. 1 2 3 4 5

2. Analyze the organization’s culture in relationship to program goals. 1 2 3 4 5

3. Promote cooperation and feedback among personnel related to the program. 1 2 3 4 5

V-C. Manage human resources. 1 2 3 4 5

1. Develop volunteer opportunities. 1 2 3 4 5

VI. Serve as a Health Education Resource Person 1 2 3 4 5

VI-A. Use health-related information resources. 1 2 3 4 5

1. Match information needs with the appropriate retrieval systems. 1 2 3 4 5

2. Select a data system commensurate with program needs. 1 2 3 4 5

3. Determine the relevance of various computerized health information resources. 1 2 3 4 5

4. Access health information resources. 1 2 3 4 5

5. Employ electronic technology for retrieving references. 1 2 3 4 5

VI-B. Response to requests for health information. 1 2 3 4 5

1. Identify information sources needed to satisfy a request. 1 2 3 4 5

2. Refer requesters to valid sources of health information. 1 2 3 4 5

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VI-C. Select resource materials for dissemination. 1 2 3 4 5

1. Evaluate the applicability of resource materials for a given audience. 1 2 3 4 5

2. Apply various processes to acquire resource materials. 1 2 3 4 5

3. Assemble education material of value to the health of individual and

community groups.

1 2 3 4 5

VI-D. Establish consultative relationships. 1 2 3 4 5

1. Analyze parameters of effective consultative relationships. 1 2 3 4 5

2. Analyze the role of the health educator as a liaison between program staff and

outside groups and organizations.

1 2 3 4 5

3. Act as a liaison among consumer groups, individuals, and health care provider

organizations.

1 2 3 4 5

4. Apply networking skills to develop and maintain consultative relationships. 1 2 3 4 5

5. Facilitate collaborative training efforts among health agencies and

organizations.

1 2 3 4 5

VII. Communicate and Advocate for Health and Health Education 1 2 3 4 5

VII-A. Analyze and response to current and future needs in health education. 1 2 3 4 5

1. Analyze factors (e.g., social, cultural, demographic, and political) that

influence decision-makers.

1 2 3 4 5

VII-B. Apply a variety of communication methods and techniques. 1 2 3 4 5

1. Assess the appropriateness of language in health education messages. 1 2 3 4 5

2. Compare different methods of distributing educational materials. 1 2 3 4 5

3. Respond to public input regarding health education information. 1 2 3 4 5

4. Use culturally sensitive communication methods and techniques. 1 2 3 4 5

5. Use appropriate techniques when communicating health and health education

information.

1 2 3 4 5

6. Use oral, electronic, and written techniques for communicating health

education information.

1 2 3 4 5

7. Demonstrate proficiency in communicating health information and health

education needs.

1 2 3 4 5

VII-C. Promote the health education profession individually and collectively. 1 2 3 4 5

1. Develop a personal plan for professional growth. 1 2 3 4 5

VII-D. Influence health policy to promote health. 1 2 3 4 5

1. Identify the significance and implications of health care providers’ messages to

consumers.

1 2 3 4 5

The above Intern Inventory was developed by M. K. Tappe and is based upon the National Commission for Health Education Credentialing Inc.’s Areas of Responsibility for Health Educators.