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					                          KINE 484


       Applied Exercise Physiology
                Internship
              Policy Manual

                 Department of
              Health & Kinesiology

            Texas A & M University
Faculty:

Dr. John S. Green, Clinical Professor
Applied Exercise Physiology Intern Coordinator
Chair, Clinical & Applied Exercise Physiology Programs
University Intern Supervisor

Dr. Steve Crouse, Professor
University Intern Supervisor

Dr. Steve Martin, Assistant Clinical Professor
University Intern Supervisor

Dr. Steve Riechman, Assistant Professor
University intern Supervisor
                                                      Table of Contents


Purpose of the Internship ................................................................................................................. 3
Importance of the Internship Manual ............................................................................................... 3
Definitions ........................................................................................................................................ 4
Internship Entrance Requirements .................................................................................................. 5
Selecting and Applying for an Intern site ......................................................................................... 6
Internship Completion Requirements ............................................................................................... 9
The University Supervisor's Role ................................................................................................... 10
The Agency Supervisor's Role ....................................................................................................... 11
Written Requirements .................................................................................................................... 11
The Intern's Responsibilities .......................................................................................................... 14
Evaluation Criteria for KINE 484 Grade Assignment ..................................................................... 14
University Rules for Undergraduate and Graduate Internships ..................................................... 15
After Graduation ............................................................................................................................. 16
Appendices .................................................................................................................................... 17
            List of Internsites
            Internship Checklist (Form 100)
            Site Selection Form (Form 101)
            Permit to Intern (Form 102)
            Intern Report (Form 104)
            Six Week Evaluation of Intern
            Final Student Evaluation


Note: Placing MS word files on the internet often messes up the pagination of the
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should correctly paginate the forms and materials you need to turn in so they fit on the
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                                                                         2
                              Purpose of the Internship
        1.      To provide you with experiences in "real life" situations that arise in actual
                work settings. To expose you to the “dynamics” of the workplace, the
                dangers and pitfalls of “office politics”, and the development of client /
                patient relationships.

        2.      To provide you with opportunities to learn additional relevant concepts and
                skills that, due to time and curriculum constraints, are not able to be taught
                in the classroom or laboratory here at Texas A&M. To expand your current
                knowledge and experience base to make you competitive in the job market.

        3.      To provide you with an opportunity to meet and interact with current
                professionals in the field; thereby developing relationships which will
                enhance:
                  1. Your opportunities for employment after graduation (by getting a good
                         recommendation letter from your supervisor)
                  2. Your chances of getting into professional school (by enhancing the
                        “experience” section of your resume and getting a good
                        recommendation letter from a known professional in the field)

        4.      To facilitate your making career path decisions....to decide if this area of
                work is right for you.


                  The Importance of the Internship Manual
This manual is designed to guide you through the process of attaining an intern site and
completing your internship answer questions you may have about the internship program.
READ THIS MANUAL CAREFULLY, AS YOU ARE TOTALLY RESPONSIBLE FOR
CARRYING OUT, TO THE LETTER, THE INSTRUCTIONS HEREIN.
In addition to reading the manual now, you must keep the manual to use as a procedural guide
throughout your internship. The manual contains step by step directions on how to secure
an intern site as well as the various forms and information you will need for:
        1. The internship application process
        2. The satisfactory completion of the actual internship
        3. Application for graduation
Put this manual in a LARGE three-ring binder in order to preserve the information and forms,
all of which must be in usable condition for you and your agency supervisor. The steps listed and
discussed on the following pages and abbreviated on the Internship Checklist (Form 100 in
Appendix) should be followed throughout the internship selection process and the actual
internship semester so as to insure the completion of all requirements of the internship.




                                                 3
                                          Definitions


Field Experience/Internship: Those activities in which the student is involved while working
cooperatively with an approved agency or institution.


Chairman of Field Experiences: The departmental person responsible for approving all student
field experiences in Health and Kinesiology.
(Dr. Dave Wright – Division Chair)


University Coordinator: The departmental person directly responsible for coordinating and
setting up student internships in the Clinical and Applied Exercise Physiology fields. This person
is responsible to the Chairman of Field Experiences.
(Dr. John Green – Program Chair / Coordinator)


University Supervisor: The departmental person directly responsible for the supervision of the
student intern while he/she is in the field. This person is responsible to the Chairman of Field
Experiences. (Dr. John Green, Dr. Steve Martin, Dr. Steve Crouse, Dr. Steve Riechman)


Intern: A student of senior or graduate classification who is seeking a degree in Kinesiology from
Texas A&M with a specialization in Clinical or Applied Exercise Physiology. This person must
have all the requirements and have been approved by the cooperating agency/institution and the
Chairman of Field Experiences.


Agency Supervisor: The individual employed by the participating agency / institution to whom
the intern will be directly responsible. This person also plays a significant role in the student
intern’s evaluation.




                                                  4
                      Internship Entrance Requirements
In order to begin an internship, the student must be in the professional phase
of the program and meet the following requirements:

Note: All students should check with your academic advisor to be sure that you will have
fulfilled all requirements prior to your application to intern and your enrollment in KINE
483. In summary you must……


1.   Be of senior classification & have completed all courses prior to interning.

2.   Be enrolled in KINE 483 the semester just prior to interning.

3.   Have a cumulative 2.25 GPA at the END of the 483 semester just prior to interning

4. You must have made a grade of “C” or better in all of the science and professional
     courses that you have taken, which may include the following (depending on the
     catalog you began under and the course selections you made).
        BIOL 111        BIOL 112        CHEM 101        CHEM 102        CHEM 227
        CHEM 237        NUTR 202        PHYS 201        PHYS 202        KINE 213
        ZOOL 319        ZOOL 320        VAPH 305        VTTP 423        KINE 318
        MICR 206        MICRO 351       KINE 121        KINE 199
        KINE 402        KINE 406        KINE 425        KINE 426
        KINE 427        KINE 433        KINE 439        KINE 483
        ENGL 104        ENGL 210        COMM 205        ENGL 301
        ENGL LIT        SCOM 203        PHYS 201        PHYS 202
        HTLH 216        MATH 131        MATH 141        HLTH 335
5.   Meet the requirements outlined in the applicable university catalog and degree plan
6.   Acquire LIABILITY insurance

        The liability insurance form must be downloaded from Dr, Green’s web site
        under the “Internships & Jobs” link. Once you know where you are going
        to intern, turn in the completed form to the applied exercise science office
        assistant, Jana Crouse, between 8:05-12:00 Monday-Thursday in Steed 112.
        All requests from your intern site for verification of liability insurance should also
        be made through Ms. Crouse Phone: 979-845-3997 email: j-crouse@hlkn.tamu.edu
NOTE: Some Internships may require that you have personal health insurance for
which you are totally responsible. Other sites may require specific documents not
specified in this manual. If that is the case, talk with Dr. Green.




                                               5
                  Selecting and Applying for an Intern site
The responsibility for approving contact with the agency or institution regarding an
internship rests with the University Supervisor. You may have informal discussions with
personnel at a particular intern site and may even visit the site, but you can not and must not
make arrangements for or agree to an internship until you have cleared your application with the
Intern Coordinator (Dr. Green) during the semester in which you are enrolled in KINE 483.
All internships must take place at sites with which the University has a
current agreement (see appendices). NO NEW INTERNSHIPS WILL BE
CONTRACTED !

1.      Complete the Application for Internship form online then visit with your academic
advisor (Russell Ramirez) and submit a 1 page copy of your resume to him. Further, you
must now open (or have) a Texas A&M e-mail account that you will keep (same e-mail
address) throughout your KINE 483 semester and your internship. Make sure your
address is “professional sounding” and that you can be identified by your address
(IE. JOHNGREEN@NEO.TAMU.EDU).
2.      Next, you should enroll in KINE 483, the practicum class for Applied Exercise Physiology.
Early in the practicum semester, review the interns site information files located in the room 112
in the Applied Exercise Science Laboratory (secretary’s office) and select 3 agencies or
institutions with which you would like to do your internship. Remember, you must do your
internship the semester following your KINE 483 class. Make sure this is financially
feasible before enrolling in KINE 483. Approved internships have been established locally and
throughout the state. After you have decided which 3 agencies or institutions are right for
you, complete the Site Selection Form #101 and turn it in to Dr. Green at the designated
time. FORM #101 MUST BE TYPED ACCURATELY IN LARGE (14 point) FONT. Dr. Green
will then determine the site where you are to intern and create a spreadsheet of where
everyone is to apply. Also be aware that more and more sites require such things as a
tuberculosis test, Hepatitis C vaccinations, and possibly even a background check, a drug
test, and personal health insurance. You are responsible for these requirements. Simply
put, you are responsible for ensuring that you meet all of the necessary contractual
requirements of your intern site and providing proof to your site that you have met those
requirements.




                                                 6
3.      After the intern site application approvals have been handed out by Dr. Green, you
must submit a formal application to your specific site by sending a letter of application,
resume, and any other application information (forms, transcripts, letters of reference, TB
test results, etc.) required by the intern site. Occasionally, two or more students will want
the same intern site. When this happens, Dr. Green will call and ask the site to entertain 2
applications. If this is not approved, that site will be awarded based on the students’ prior
KINE 439 academic record.


         Within 48 hours of notification of acceptance from the agency supervisor, you must write
        a formal acceptance letter to the agency supervisor. If the site to which you applied
        rejects your application, notify Dr. Green immediately.


4.      Complete liability insurance forms – download and complete liability insurance form
from Dr. Green’s website. It is the second link under “Internships and Jobs”. Turn it in to Jana.


5.      You should visit the intern site and agency supervisor at least once prior to officially
beginning your internship experience. This visit may take the form of a formal interview that is
required by the interns site. If possible, you should do the following during that visit:
                 1. Discuss specific requirements & objectives of that particular internship
                 2. Discuss and negotiate dates and times of your internship assignment
                         a. 13 weeks 520 hours scheduled in the best way for you both
                 3. Begin making residence and / or travel arrangements for your internship


6.      Make sure you have passed KINE 483, made a “C” or better in all required courses,
and have an overall 2.25 GPA (see page 5). FAILURE TO DO SO WILL MEAN THAT YOU
WILL NOT BE ABLE TO INTERN THE FOLLOWING SEMESTER. THIS COULD PUT YOUR
GRADUATION OFF FOR UP TO A YEAR……SO TAKE YOUR STUDIES VERY SERIOUSLY
THIS SEMESTER. If you fail to make a “C” or better in all required courses see Dr. Green
as soon as possible so you can register for that course again the following semester.
REMEMBER, YOU MUST HAVE A 2.25 GPA TO INTERN AND AN OVERALL 2.0 GPA AT
THE END OF YOUR INTERN SEMESTER TO GRADUATE.




                                                   7
7.      AFTER VERIFYING THAT YOU HAVE PASSED KINE 483, MADE A “C” OR BETTER
IN ALL REQUIRED COURSES, DR. GREEN AND DR. MARTIN WILL SUBMIT YOUR NAME
AND YOU WILL BE AUTOMATICALLY ENROLLED IN THE APPROPRIATE NUMBER OF
KINE 484 HOURS AND YOUR LIABILITY INSURANCE WILL BE PAID.


8.      Make sure to APPLY FOR GRADUATION, complete all necessary paperwork, and
pay all appropriate fees during the allotted time period during your intern semester. We
suggest that students go to http://graduation.tamu.edu/ early in the semester and acquire
all the necessary forms and determine deadline dates. If in doubt, you should check with
your academic advisor to make sure that you know the allotted time and associated
procedures and deadlines.


9.      Form 102 must be completed and presented to your agency supervisor upon your
arrival at the intern site. After your intern supervisor signs it, it must be faxed back to
both the university coordinator (Dr. Green - fax- 979-862-2207) and your academic advisor
(Russell Ramirez- fax 979-847-8987). Make sure both faxes are addressed and faxed to the
appropriate person. Be sure to include your neo account e-mail address on the form.
Also, type the form in a very large font (14 point minimum) so a fax of that form can be
easily read.


AS MENTIONED PREVIOUSLY, YOU MUST HAVE AN ACTIVE NEO E-MAIL ACCOUNT so
that your university supervisor can communicate with you. You must remember to
CHECK THIS E-MAIL ACCOUNT AT LEAST EVERY OTHER DAY, even after your internship
is finished (between the time your internship is finished and graduation), for updates on
supervisor visits and other important information WHICH MAY INCLUDE JOB
OPPORTUNITIES.       Also, as mentioned previously, make sure you can be identified by
your NEO e-mail address, even if you have to change your current one (ie. “
johngreen@neo.tamu.edu ”). For help or information concerning e-mail accounts call
979-845-8300.


10.     Begin your internship. In most cases, your university intern supervisor will contact you by
e-mail or phone to set up a personal visit or a phone interview, depending on your location,
                    th   th   th            th
sometime after the 4 , 5 , 6 , or even the 8 week of your internship semester.




                                                 8
11.     The six-week and final evaluation forms must be completed by the agency supervisor at
the appropriate times. The six-week evaluation should be completed and faxed to your
university supervisor (Dr. Green) no later than the last day of the seventh week of the
semester. FAXING IS PREFERRED 979-862-2207. DO NOT CALL OR E-MAIL DR. GREEN
TO CHECK IF YOUR FAX MADE IT THROUGH. IF IT IS NOT RECEIVED ON TIME, DR.
GREEN WILL CONTACT YOU. The final evaluation and all written notebook requirements
for your internship should be completed and received by your university supervisor (Dr.
Green) no later than one week prior to the start of final exams for that particular semester.
To determine this date go to http://admissions.tamu.edu/Registrar/General/Calendar.aspx
A COPY OF BOTH YOUR 6 WEEK AND FINAL EVALUATION MUST BE TURNED IN WITH
YOUR INTERNSHIP NOTEBOOK. It is your responsibility to remind the agency supervisor
to complete these forms at the proper time.


                    Internship Completion Requirements
Some agencies require evening or weekend obligations. You will be expected to perform all
reasonable activities requested by the agency. The minimum time required for the internship is
13 weeks / 520 hours.         Starting and ending dates along with associated work
schedules should be negotiated in discussions with your agency supervisor. Students
starting in the fall must wait until Sept 1 to start their internship for insurance coverage
purposes. In general, an 8:00 am - 5:00 pm time schedule should be followed if possible.
Sometimes, the nature of the internship site will require you to be there at odd hours;
however, internships consisting solely of evening and weekend hours are not permitted.
A “vacation” during the internship semester is also not allowed. While interning, you
should consider yourself as part of the agency's staff and dress according to agency
policy and act professionally. With reference to holidays, the agency's holidays will be
observed and not those of Texas A&M University (sorry - this includes Spring Break). The
agency's policies concerning absenteeism and tardiness apply to you. If, for any reason,
an absence or tardiness is anticipated, a call to the agency supervisor, prior to the
absence or tardy, is absolutely necessary.




                                               9
THE FOLLOWING GUIDELINES MAY BE HELPFUL FOR A SUCCESSFUL INTERNSHIP.
        1.       Be professional, open minded, and take the experience seriously.
        2.       Do not be a “know-it-all” or one who says such things as “That’s not the way we
                 do it at Texas A&M”.
        3.       Be empathetic and patient with both your Agency Supervisor and the University
                 Field Supervisor, they have more to do than just take care of you.
        4.       Dress and act according to the agency's expectations for its employees.
        5.       Confidentiality in all agencies is a must!! Never discuss a client with friends,
                 family, or other workers. This is in your internship contract, and
                 if violated, you may be prosecuted or taken to court. (HIPPA law)
        6.       Be punctual & be prompt in doing what is asked! Do something to get noticed!!
        7.       Do not procrastinate – 13 weeks may sound like a long time, but you will be
                 surprised how quickly it passes. This is particularly true with respect to
                 your semester project and notebook assignment.
        9.       Talk to your Agency Supervisor, feel free to express those things about which
                 you are not knowledgeable, but are willing to learn. Ask to see such things
                 as surgical procedures or facility operating budgets.
        10.      If any serious problems arise that you and the Agency Supervisor cannot
                 resolve on your own, let Dr. Green know immediately.


                            The University Supervisor's Role
Your University Supervisor will be assigned two weeks into the semester in which you are
interning. Their offices are in the Department of Health and Kinesiology.
Dr. Green        (979)845-3991                      Dr. Martin               (979)862-7726
Dr. Crouse       (979)845-3997                      Dr. Riechman             (979)862-3213
The University Supervisor's task is to be a liaison between the student, the university, and the
agency or institution. The University Supervisor will sometimes personally observe your progress
during the internship. If a visit to the intern site is appropriate, contact with the intern will be made
                  th   th   th                     th
on or about the 4 , 5 , 6 , or maybe even the 8 week of the intern semester. Meetings or
                                                                        th       th
phone interviews will then be arranged for sometime between the 5 and 9 week of the
semester with the Agency Supervisor, the University Supervisor, and the student. During this
visit such things as internship objectives, semester project, six weeks evaluation and final
evaluation may be discussed. If at all possible, the six weeks evaluation should be
completed at this time with a copy made available to the university supervisor.




                                                  10
                          The Agency Supervisor's Role
The Agency Supervisor will be employed by the particular agency or institution at which you are
serving your internship and will probably not be available at all times. The Agency Supervisor's
task is to help you develop into a professional. A preliminary orientation (about 1 week) may be
planned to acquaint you with the agency. As your proficiency increases, so should your
responsibilities. The internship is meant to be a meaningful experience; however, you should be
aware that all internships require a certain amount of what seems to be busy work. That’s just a
part of the “pecking order”. If these kinds of chores appear to be excessive, you should discuss
this first with your agency supervisor and, if necessary, with the University Supervisor. Do not,
however, let the agency take advantage of you…..you are there to learn and get
experience, not to do copying and filing all the time. Talk with your agency supervisor
about such problems. If there is no resolution, contact Dr. Green immediately.


                                 Written Requirements
In addition to your practical requirement (13 Weeks or 520 Hours), you are to complete the
following written requirements. These items are to be completed and received by the
University Supervisor (Dr. Green, Dr. Crouse, or Dr. Steve Martin) no later than one week
prior to the start of final exams for that particular semester. NOTE: A final grade for KINE
484 or KINE 684 will not be issued until all of these requirements have been evaluated by the
University Supervisor. ALL DOCUMENTS INCLUDING NOTEBOOK TABS AND ALL OTHER
FORMS MUST BE TYPED:


1. Completed Intern Report, Form #104 (Reproduced exactly as it appears with appropriate
   answers and information inserted). Be sure to staple it to the Critique and Guidelines


2. Critique and Guidelines for Future Interns. In addition to Form 104, you are required to
   develop a critique of your internship experience. This should include information about tasks
   which were challenging, interesting, as well as those which you found mundane or boring.
   Near the end of the internship you should review your experiences and write down those items
   which you wished you would have known before entering the internship in that particular
   agency. This document should be detailed and comprehensive, as it serves as a tool which
   future students may use to decide if that particular site is right for them (minimum - two
   pages - typewritten - paragraph format). INDEX THIS CRITIQUE UNDER THE SAME TAB
   AS FORM 104 AND STAPLE THE TWO FORMS TOGETHER.




                                                11
3. A summary of daily activities (two pages - typewritten in list or brief discussion format).


4. A) a list of the objectives for your internship, B) the tasks and responsibilities you
   completed in order to meet these objectives, and C) whether or not YOU felt that the
   objectives were met.


5. Agency report. Find out all you can about the agency with which you are working. Detailed
   discussions of such topics as background and history, funding, budget, and mission
   statements should appear in this report. Make it as comprehensive as possible (2 double
   space pages minimum). It is not acceptable to replicate information from literature from the
   site.


6. A specific project to be left at the site. These projects are to be left with the agency and
   must be completed before the internship is terminated. A copy of the project proposal, a
   detailed description of the project must be included in the internship notebook described in
   section #8. Also, a CD containing the actual project is required when the project
   involves the construction of a PowerPoint presentation. The more appropriate, work
   intensive, and elaborate the project, the better your project grade.


7. A copy of both your six week evaluation and final evaluation from your agency supervisor.


8. A LARGE 3-ring binder notebook with typed index tabs containing items 1 through 7
   (listed above). The notebook should be thoroughly indexed (with typed tab index markers)
   so that all individual components can be found retrieved immediately and with ease. No
   sheet protectors. This notebook should be received by the University Supervisor no
   later than one week prior to the start of final exams for the term in which you intern.
   Failure to have the notebook and all required material to the supervisor on time will
   results in a substantial amount of points deducted from the final point total. In all
   likelihood, this will make at least one letter grade difference for the 12 hours of KINE
   484. IF A FINAL GRADE CANNOT BE ASSIGNED, YOU DO NOT GRADUATE. If you
   mail your notebook, you MUST use UNITED PARCEL SERVICE (NOT FEDEX or the US
   POST OFFICE because neither of them will deliver to the lab.) You Must send your
   package via UPS Next Day Air. Although it will get to A&M the next day, it will not get to
   Dr. Green for 4 additional days. So….bottom line…..If       you send your notebook
   through the mail you must send it UPS Next Day Air 11 days prior to the
   start of finals date of the semester in which you intern.

                                                12
   DO NOT PACK YOUR NOTEBOOK IN STYROFOAM PELLETS. SIMPLY PUT IT IN A
   BOX, SECURE IT BY PACKING IT IN NEWSPAPER OR PLASTIC PELLET PAPER AND
   SHIP IT. DO NOT CALL OR E-MAIL DR. GREEN TO SEE IF YOUR NOTEBOOK ARRIVED
   ON TIME….IF THERE IS A PROBLEM IN THIS AREA, DR. GREEN WILL CONTACT YOU.


9. In addition to items 1 through 7 listed above, this notebook should contain information you
    have collected over the course of your internship which relates to your professional
    development. RECEIVING A GRADE OF “A” FOR YOUR 12 INTERNSHIP HOURS
    REQUIRES MORE THAN JUST THE MINIMUM NOTEBOOK REQUIREMENTS
    DISCUSSED ABOVE. Do not include items such as program brochures, facility forms,
    facility policies or procedures, recipe books, American Heart Association literature,
    etc. Notebooks are graded on quality, not quantity. Examples of acceptable material to
    include to get a grade of “A” for your internship hours are recent journal articles you have
    collected and reviewed; clinical or personal training case studies; personal training or
    patient exercise prescriptions that you have created; examples of ECG's or other
    medical tests that you have seen or done; quality medical or therapeutic images that
    you have viewed and downloaded to a CD. DO NOT WRITE ON THE ECG’S OR
    TEST RESULTS and be sure patient’s name is blacked out on all medical information.
    Make a copy of this material for yourself as your supervisor may want to keep some of
    what is included in your notebook. Be sure to place a typewritten description and
    interpretation on all ECG’s and medical tests. Do Not Overstuff A Small Notebook.
    Get A Large One To Make Sure There Is Plenty Of Room For Everything. A
    Significant Part Of Your Grade Will Be Determined By How Well You Followed
    Directions In Completing The Notebook And By Both The Appearance And
    Contents Of The Notebook. Also Remember, The Six Week And Final
    Evaluations Should Be Included In The NOTEBOOK. If your supervisor cannot
    complete the final evaluation before you have to turn in your notebook, notify your
    university supervisor (Dr. Green) via e-mail.

    If you mail your notebook, you MUST use UNITED PARCEL SERVICE. You MUST send
    your package via UPS Next Day Air. It must be sent at least 11 day prior to the start of
    the finals for the semester in which you intern. Send it to the following address:
                Dr. John Green
                Netum Steed Building Room 112
                Texas A&M University
                College Station, TX 77843


                                               13
                                                      The Intern's Responsibility
                Remember, you are expected to act in a professional manner and you will be held accountable
                for your actions.    There have been students who were dismissed from their
                internships for such things as insubordination and absenteeism.....and
                they didn’t graduate.
                Remember, in order to graduate - you must pay all outstanding fees, make application for
                graduation within the allotted time, and complete all other necessary paperwork. It is your
                responsibility to check the date and complete the necessary items. Be sure to take care of this
                and all other necessary logistics before you leave for your internship. If there is any doubt about
                the procedures, items to be completed, fees, etc. that are required for graduation, be sure to
                check with your Advisor.
                Remember, you must have all internship materials turned in to your University Supervisor
                (Dr. Green) no later than one week prior to the start of finals for the semester in which you
                intern. FAILURE TO HAVE THESE REQUIREMENTS IN ON TIME WILL, AT A MINIMUM,
                RESULT IN A SUBSTANTIAL REDUCTION IN YOUR GRADE. IT MAY MEAN THAT A FINAL
                GRADE COULD NOT BE ASSIGNED AND RESULT IN YOU NOT BEING ELIGIBLE FOR
                GRADUATION.


                         Evaluation Criteria For KINE 484 Grade Assignment
                                         KINE 484 Final Intern Grade
                6 Week        Final                                                                                     Instruction on
              Evaluation   Evaluation                                                                                   notebook and
    Tasks    (assigned by (assigned by  Daily                       Intern    Future                                         form
                agency       agency    Activities Internship Agency Report    Intern      Project   Semester              completion
              supervisor) supervisor) Summary Objectives Report (form 104)   Guidlines   Proposal    Project   Notebook    followed.     total

    Points      200         400        25        25        25       100        100         100        225        200          600        2000



A meeting in the Applied Exercise Science Lab will be held Thursday or Friday morning
before graduation at 10:00 am in the Netum Steed lab unless otherwise noted by your
intern supervisor. Your attendance at this meeting is mandatory. Here, you will pick up
your notebook and receive your grade. You will also give a 2-3 minute overview of your
internship experience. All notebooks not picked up at this meeting will be discarded.




                                                                          14
        University Rules for Undergraduate and Graduate Internships

1.    No internship site will be established without the approval of the University Coordinator and the Chairman of Field
      Experiences.

2.    Only sites with established, ongoing Adult Fitness, Cardiac Rehabilitation, Industrial/Corporate/Club Fitness
      or hospital-based wellness programs will be considered as potential internship facilities.

3.    The student must respond affirmatively within 48 hours of notification of acceptance to intern at a particular internsite.

4.    No student will be permitted to intern at a site of previous employment or affiliation unless the previous job
      responsibility is not related to their prospective internship responsibilities.

5.    The student must not be under contract for permanent employment at their particular intern site during the
      one semester internship experience; however, a stipend (a one time lump sum payment) may be paid to the
      intern.

6.    The student must be in good standing with the Department of Health and Kinesiology and all University entities before
      interning (all pre-internship requirements must be fulfilled, no parking tickets, etc).

9.    The student must be an official candidate for the B.S. Degree in Kinesiology with specialization in Applied Exercise
      Physiology (officially applied for and been accepted into the Program), or for the M.S. Degree in Kinesiology, and an
      approved and signed degree plan must be present in the student's folder.

10.   The student must spend the full semester at the intern site (usually, a minimum of 13 weeks and 520 hours -
      negotiable depending on intern agency and semester).

11.   The student must not approach the internship site personnel with a request to shorten the internship
      experience. Contact the University Supervisor if an emergency situation exists which might preclude the
      completion of your internship commitment.

12.   Once a student has applied to an intern site, he or she is obligated to accept and complete the internship there
      if the site offers the internship.

13.   Breaking an agreement to intern at a particular intern site after the student has accepted an internship
      assignment will result in forfeiture of internship eligibility for that academic semester. Re-application for an
      intern assignment must be made before the student can again participate in the internship selection process.

14.   All applications to intern in any particular semester must be completed by the prescribed deadline listed in the site
      approval notification given to the students by the internship coordinator.

15.   Internships must be completed immediately after the KINE 483 semester. No “gaps” between the 483
      semester and the internship semester are permitted. Students not able to intern immediately after the 483
      semester will have to repeat the 483 course before interning.

16.   No “vacations” or trips are permitted during your internship. Essentially, internship attendance and absentee
      policy is the same as if you were in a class on the A&M campus.

17.   A student must be financially able to meet internship requirements. Do not enroll IN KINE 483 unless you are
      100% SURE that you can afford to complete an internship the following semester.




                                                              15
                                                 After Graduation
                                   (Some Answers to Commonly Asked Questions)



1.   How do I secure a job upon graduation?

     Graduation from Texas A&M University with a degree in Kinesiology and a specialization in Applied Exercise
     Physiology does not assure you of employment. Most corporate and clinical programs hire based upon their specific
     needs. Among the factors generally considered by employers are:

             a)      Recommendations from supervisors (advisors, professors, internship supervisors)
             b)      Personal appearance (the way you dress)
             c)      Experience and specialized skills, e.g., aerobics instructor, certified personal trainer, etc.
             d)      Subjective evaluation of your ability to perform within their specific environment
             e)      Certifications and licenses
             f)      Employer’s perception of how easily you could learn a new skill or manage people.

     Also, remember that some medical professions have a great deal in common with your specific type of training;
     therefore, when looking for employment, do not limit yourself to looking only in clinical exercise field (cardiac rehab) or
     the corporate fitness field. Apply for such jobs as lab technician, ECG technician, pharmaceutical sales, etc. Be sure
     to talk to Dr. Green or whoever conducts the post-internship seminar for job opening announcement they have
     received.

2.   How can I be more employable?

     The importance of developing a high degree of expertise in exercise testing, exercise prescription, and exercise
     leadership cannot be overemphasized. Companies who hire college graduates in business-related fields often plan to
     train these employees on-the-job but are not capable or interested in doing on the job training for exercise specialists.

     Extra skills are always helpful. These might include some of the following:

             a)      First Aid and CPR Instructor certification
             b)      EMT and CPR certification
             c)      ACSM or other exercise and health certification
             d)      Management experience
             e)      Computer skills
             f)      Research experience and interest
             g)      Volunteer or part-time work experience in field

3.   Is graduate school for me?

     Graduate school is essential for those individuals who wish to move ahead in the field and develop expertise in the
     clinical/research areas of cardiac rehabilitation and exercise physiology. Only those students who have
     demonstrated good verbal and analytical skills should consider graduate school. Alternately, many former
     students have pursued degrees in nursing, physical therapy, medicine, and business.

     In most cases, it is generally advisable not to enter graduate school directly upon completion of an
     undergraduate program. Much is gained by obtaining 1 to 2 years of employment experience before going on
     to complete a graduate degree. Some students will be better advised to pursue an M.B.A., M.H.A., or other
     Masters degrees instead of an M.S. degree in exercise physiology.




                                                            16
                                                                APPENDICES
                                                                                                     Updated 5 / 23 / 2011
                                                  LIST OF ACTIVE INTERNSITES
* = Signed internsite agreement form on file

The superscripted number prior to the facility name indicates the type of experience found at that site:
1
  = Corporate Fitness/Wellness/Personal Training; 2 = Cardiac Rehab/Medical; 3 = Private Fitness Club;
4
   = Clinic or Hospital Based Fitness Program 5 = Possible Stipend (check with facility)
6
  = Research Program 7 = Diagnostic Facility 8 =Requires a background check
9
  =Special permission & prerequisites required 10 = Strength& Conditioning

SITE                                      SUPERVISOR                               ADDRESS                          PHONE

AUSTIN
2
    * St. David’s Medical Center          Lydia Miller                             900 E. 30th Suite 314            512-544-4263
      Cardiac Rehabilitation Center                                                Austin, TX 78705                 512-544-4178


BRYAN/COLLEGE STATION
679
      The Applied Exercise Science Lab    Dr. Steve Martin                         Mailstop 4243 TAMU               979-862-7726
                                          Lab Coordinator                          Texas A&M University
                                                                                   College Station, TX 77843
2
    * St. Joseph Hospital Rehab           Cindy Emola                              1600 Joseph Drive                979-821-7589
                                          Cardiac Rehab Supervisor                 Bryan, TX 77802                  979-776-4919
                                          cemola@st-joseph.org
3
    *Aerofit Health and Fitness Center    Dr. Kathy Langlots                       1900 West Villa Maria Road       979-823-0971
                                          Intern supervisor / club director        Bryan, TX 77801
47
     * Scott & White Cardiology           Becky Braden                             1600 University Drive East       979-691-3830
                                          Exercise physiologist                    College Station, TX 77840        rbraden@swmail.sw.org
45
     * BCS Heart Cardiology Clinic        Dirk Brown                               1721 Birmingham Drive            979-764-1474
                                          Intern Supervisor                        College Station, TX 77845        md0brown@yahoo.com
4
    * D.C. Health Center                  Dr. Rio DeLeon                           1605 Rock Prairie Rd., Ste 222 979-696-1995
                                          Director                                 College Station, TX 77845

4*
     College Station Medical Center       Teresa Cooper                            1602 Rock Prarie Road E.        979-680-5420
    (apply as a “volunteer”)              Intern Supervisor                        College Station, TX 77845 teresa.cooper@csmedcenter.com
29*
      Texas A&M Athletic Rehabilitation   Danny Kniffin                            P.O. Box 30017                 979-862-0001
      (Spring & Fall only)                Director                                 College Station, TX 77842-3017 dkniffin@athletics.tamu.edu
24*
      Central Texas Heart Center, P.A.    Teresa Corbin                            2700 E. 29th Street, Suite 220   979-774-3698 ext. 286
                                          Nuclear Technologist                     Bryan, TX 77802                tcorbin@centraltexasheart.com


DALLAS - FT. WORTH AREA
4
  * Baylor Health Care System             Dr. Bill Smith                           411 N. Washington # 3100         214-820-2758
   Tom Landry Center                      Director of Internships                  Dallas, TX 75246
2
    * Doctor’s Hospital at                Dennis Mink                              9440 Poppy Dr.                   214-324-6369
      Whiterock Lake                      Exercise Physiologist                    Dallas, TX 75218                 (FAX) 214-345-4676




                                                                              17
                                           SUPERVISOR                       ADDRESS                      PHONE

DALLAS - FT. WORTH AREA…continued
12
       * Carter Rehab and Fitness Center   Carleen Stout                    1400 Eighth Ave.             817-922-1061
                                           Intern Supervisor                Fort Worth, TX 76104
12
       * Hugley Assessment Laboratory      Kathy Stiever                    11801 S. Freeway             817-551-2681
                                           Manager                          Ft. Worth, TX 76115
25
       * Dallas Heart Group                Julie Penney                     7777 Forest Lane             972-566-7733
                                           Manager                          Dallas, TX 75230             fax: 972-566-7753
247*
         Medical City Dallas Hospital      Eric Jones                       7777 Forest Lane             972-566-7080
                                           Intern Supervisor                Dallas, TX 75230
2-4
       * Harris Methodist Hospital         Pat Paprocki, R.N.               1616 Hospital Pkwy.          817-267-9191
         HEB/Harris Fitness Center         Prog. Coord.                     Bedford, TX 76022
         Cardiac Rehab
10 *
       Michael Johnson                     Steward Carlisle                 6051 Alma Drive              469-424-6572
       Performance Center                                                   McKinney, TX 75002


HOUSTON AREA
4,7
 St. Luke’s the Woodlands Hospital    Steve Wetzel                          602 Pruitt Road              281-907-4200
Tektonic Athletic Development & Rehab                                       Spring, TX 77380
2-4
       *Hermann Hospital-Heart Center      Rhonda S. Leaverton, R.N.        6414 Fannin, Suite G100      713-704-5802
                                           Clinical Coord.-Cardiac Rehab.   Houston, TX 77030
4, 6 7
         * Herman Memorial                 Michael Masters                  7731 Southwest Freeway       713-456-5953
           Wellness Center                 Intern Coordinator               Houston, TX 77074
2
    * Methodist Hospital                   Ala Pourmahram                   6565 Fannin, M-Station SM583 713-441-5575
                                           Intern Coordinator               Houston, TX 77030            713-790-6075
2-4
       * St. Luke's Episcopal Hospital     Pedro Recalde                    St Luke’s Medical Tower       832-355-8240
                                           Internship Coordinator           Non-invasive Cardiology
                                                                            11th Floor
                                                                            6624 Fannin M.C. 6-402
                                                                            Houston, TX 770
9
 *University of Houston                    Mr. Dale Jones                   3100 Cullen Blvd            832-418-1617
Strength & Conditioning                    Assistant Strength Coach         Houston, TX 77204-6742 coachdalejones@yahoo.com
(contract must be renewed annually)

7
    * RM Bayer Clinic for                  Sarah Wooderson                  1535 West Loop South         713-961-0423
      Preventive Medicine                  Intern Supervisor                Ste 300, Houston, TX 77027
                                           sarah.wooderson@gmail.com

10
     * Genesis Athletic Performance        David Claiborne                  8525 Jackrabbit Road         832-380-5436
                                           Director                         Suite F
                                           David@Genesis-AP.com             Houston, TX 77095

3,1,
  * 24 Hour Fitness                        Shawn Glowacki                   1800 Lake Woodlands Drive    281-298-2428
(must have PT certification)                                                The Woodlands, TX 77380

15
       * Houston Racquet Club              Blake Stovall                    10709 Memorial Drive          713-464-4811
                                                                            Houston, TX          bstovall@houstonracquetclub.com
LUBBOCK
24
   * Covenant LifeStyle Center         Lewis Walker                      3615 19th Street    806-725-4386
     Methodist Hospital                Intern Coordinator                Lubbock, TX 79408



TYLER
East Texas Medical Center              Clint Rivers                      701 Olympic Plaza   903-596-3234
                                       Senior Clinical Physiologist      Tyler, TX 75701     rh_rivc@etmc.org


WACO
2
  * Hillcrest Baptist Medical Center   Chris Rosser                      7300 Bosque Blvd    254-202-3800
    Getterman Wellness Center          Manager, Cardiac Rehabilitation   Waco, TX 76712
                                                                                                    (Form 100)
                                          Texas A&M University
                            Applied Exercise Physiology and Master of Science
                                           Internship Checklist

Instructions: This form is for your personal use and outlines the procedures to follow to obtain an
internship, complete the internship requirements, and graduate. The steps should be completed in numerical
order. To be eligible to intern you must be an official candidate for the Bachelor of Science Degree in Applied
Exercise Physiology and have been accepted to the professional phase of the program. For the Master of
Science Degree in Kinesiology, you must have completed all specified degree requirements and have a
degree plan filed. A final grade will not be issued for your internship experience until all the following
are completed.

Name                                               Intern Dates      start     finish



1.      Consult with your academic advisor to be sure that you will have fulfilled
        all academic requirements prior to your application to intern. Make sure
        you are clear to graduate after your internship. Complete application for
        internship form on HLKN Website. A copy of the approved form along with a
        copy of the division chair’s approval letter will be sent Dr. Green’s office.
        (This is usually done in the semester prior to KINE 483 enrollment)
        Acquire a NEO email address that sounds professional and can identify you
        ie. johngreen@neo.tamu.edu and begin to monitor the site every other day

2.      Peruse through the internship file folders in the secretary’s office and select
        3 prioritized active intern sites (you must select 3 and they must be prioritized).
         Intern sites without current signed agreements with Texas A&M University
        cannot be considered. Also, your first choice may not be available or it may be
        taken by another student with better credentials. If two or more students desire the
        same site and Dr. Green has determined that they will not take but one intern,
        the student with the best KINE 439 grade will be allowed to apply
        After you have selected your three sites, complete the Intern
        site Selection Form #101. It must be typed in large font. Be sure to have
        acquired a TAMU e-mail address where you can be reached at
        all times during your KINE 483 semester and your internship. If you
        don’t have one, get one. For help call TAMU computing help desk
        at 979-845-8300. You are responsible for monitoring this e-mail site
        every other day for information concerning supervisor visits, graduation, etc.

3.      Turn in your form 101 application to Dr. Green.
        (NOTE: No student is to contact an intern site directly with the intention of
        seeking placement or obtaining an interview until site approval is given by
        the University Coordinator (Dr. Green).

4.      After your interns site has been assigned by Dr. Green, make formal
        application to the site by sending letter of application, resume, and any
        other application information or forms required by the specific intern site.
        Be sure to check the site folder and follow any additional directions,
        complete any additional forms, and meet the medical requirements
        required by your specific site. The dates and times of your internship
        may be negotiated with your site supervisor, but they must adhere to
        the 13 week - 520 hour requirement. Fall internships should start no
        sooner than September 1.
                                                                                               Page 2 - Form 100

5.      Within 48 hours of notification of acceptance from the agency supervisor you
        must write a formal letter of acceptance to the agency supervisor .
        Report rejections to Dr. Green immediately.

6.      Download insurance form on Dr, Greens web site, fill it out, then take to Jana Crouse

7.      Make sure you have a C or better in KINE 483 and all other required courses and             _______
        you meet all other academic requirements.

8.      Your name will be sent to Ms. Mary Beth Henthorne who will enroll you for the
        appropriate number of hours for the KINE 484 - Field Experience course.
        Make sure you take care of all graduation requirements (pay diploma fees,
        etc.). Application to graduate must be completed within a certain window
        of time just after the start of your intern semester. Graduate students
        will be registered for KINE 684 - Field Experience for 4-6 semester hours of credit.

9.    Using a typewriter or computer, complete Form #102. This form must be
         presented to your agency supervisor upon your arrival at the intern site,
         signed, dated, and faxed back to the 1) University Coordinator and
         2) Academic Advisor. Make sure to complete this form in a large font
        (14 point at least) so it t can be easily read when faxed.
10.     Begin your internship.                                                                      ______

11.     Fax the completed six week evaluation to the University Supervisor
        at the appropriate time or give it him/her when they come to visit.

12.     An internship project worthy of 10 weeks of work must be completed.

13.     After successfully completing your Internship experience, you must turn
        in all prescribed assignments to the University Supervisor before a final
        grade can be assigned. This includes a 3 ring binder notebook that, at
        minimum, contains the following: (REMEMBER YOU MUST HAVE MORE THAN
        JUST THE MINIMUM REQUIREMENTS IN YOUR NOTEBOOK TO RECEIVE AN
        “A” FOR YOUR INTERNSHIP):

        (1) Site Evaluation Form #104,
        (2) a brief summary of daily activities
        (3) objectives of your internship, along with if/how these objectives were met
        (4) an agency report
        (5) a two page critique and guideline for future interns (in addition to form #104)
        (6) an in-depth description of the semester project you left with the agency
        (7) final evaluation
        (8) a large typed tab indexed 3 ring binder notebook containing items 1 through 7

14.     The final evaluation form and 6 weeks evaluaion form, along with the
        written requirements listed above, must be completed an turned in with
        the notebook. These evaluations along with the notebook should be
        received by the University Supervisor no later than one week prior to the
        day final exams begin for your intern semester. If the notebook is mailed
        it MUST be sent next day air by UPS 11 days prior to the start of finals to:
                                                                              Dr. John Green
                                                                              112 Netum Steed Building
                                                                              Texas A&M University
                                                                              College Station, TX 77843

15.     Attend Post-Internship Seminar at TAMU
                                                                                                         (Form 101)
                                                Applied Exercise Physiology
                                                 Internsite Selection Form


From the list of possible internsites in the secretary’s office, please select three sites you would prefer to intern,
then prioritize them. You must choose a minimum of three. Decisions regarding multiple applications to the
same site will be made by Dr. Green on the basis of students’ prior academic records, quality and content of
resume, etc.

Complete this form and set up a meeting with Dr. John Green, the University Coordinator for Applied Exercise
Physiology interns. Before this meeting, make sure your application for internship has been approved and you
have a copy of your resume ready for inspection.

The selections will be reviewed and a master internship application assignment list constructed. This
assignment list will be given to students during the second week of Kine 483 class. Remember, Do Not Send
out Your Application until Approval by Dr. Green Has Been Secured and Posted on the Assignment
List


Applicant’s Name:                                                      Date:




Choice 1.
                  (agency / institution name)                       (name of agency supervisor)



                 (agency / institution address / zip)          (agency supervisor phone & fax numbers)




Choice 2.
                  (agency / institution name)                        (name of agency supervisor)



                 (agency / institution address / zip)          (agency supervisor phone & fax numbers)




Choice 3.
                  (agency / institution name)                        (name of agency supervisor)


                 (agency / institution address / zip)          (agency supervisor phone & fax numbers)




                 SIGNATURE                                           DATE


Permanent TEXAS A&M e-mail address (LARGE FONT PLEASE):



_____________________________________________________________________________
                                                                                                 (Form 102)

                                           PERMIT TO INTERN
                               KINE 484 - B.S., Applied Exercise Physiology
                               KINE 684 - M.S., Clinical Exercise Physiology
                                        TEXAS A&M UNIVERSITY

Instructions for the Intern: Using a typewriter or word processor, type in all the requested information below.
COMPLETE THIS FORM AS SOON AS YOU ARRIVE AT YOUR INTERN SITE, HAVE YOUR SUPERVISOR
SIGN AT THE BOTTOM AND THEN FAX IT TO DR. GREEN AND YOUR ADVISOR, MR. RUSSELL
RAMIREZ.
USE AT LEAST A 14 POINT FONT TO COMPLETE THE FOLLOWING INFORMATION SO IT WILL
COME THROUGH CLEARLY ON FAX .

Student Intern Name ________________________________________________________________

Agency Name______________________________________________________________________

Agency Address 1 __________________________________________________________________

Agency Address 2 __________________________________________________________________

Agency Phone and Fax numbers_______________________________________________________

TAMU E-mail Address (MONITORED EVERY OTHER DAY) ______________________________________

Intern Resident phone # where intern can be reached after hours _____________________________

Direct Supervisor’s name, office phone, and email _________________________________________

__________________________________________________________________________________

The starting and ending dates for this internship have been agreed upon by the student and the agency
supervisor and are as follows:

from                            to

Please feel free to contact Dr. Green at any point during your internship with questions or problems
that may arise. Fax this form to the both persons listed below the day you arrive at your intern site.

John S. Green, Ed.D., Ph.D., FACSM                             Mr. Russell Ramirez
Mailstop 4243                                                  Mailstop 4243
Dept. of Health & Kinesiology                                  Dept. of Health & Kinesiology
Texas A&M University                                           Texas A&M University
College Station, Texas 77843                                   College Station, Texas 77843
(979) 845-3991 FAX: (979)-862-2207                             979) 862-1486 FAX: (979)-847-8987
E-mail: jsgreen@tamu.edu                                       E-mail: rramirez@hlkn.tamu.edu



Student’s Signature                                              Supervisor’s Signature
                                                                                      (Form 104)

                                    KINESIOLOGY INTERN REPORT
                               Undergraduate Applied Exercise Physiology
                                      Graduate Master of Science

                 (THIS FORM MUST BE TYPED OR DOWNLOADED AND REPRODUCED)

Intern Name

Address

Phone

Supervisor Name

Superviosr’s E-mail address

Agency Name

Agency Address

Phone

DATE OF INTERN ASSIGNMENT              From                   To

1.      What have your duties been for the duration of your internship? Be specific. (Attach additional page,
        if necessary).




2.      What components of the program at your particular facility gave you the most worthwhile knowledge
        and/or experience? Which gave you the least?
                                                                                 Page 2 - Form 104

3.      Did you experience a relevant and challenging use of your knowledge and skills, or were you mostly
        involved in activities that did not require the knowledge base and skills you acquired at A&M? Were
        there any courses you took at A&M that you thought were not helpful or relevant? Please explain in
        detail.




4.      Did you working in close communication with your intern supervisor or was authority over you
        delegated to someone else? Explain in detail.




5.      Did any problems exist that you felt made this intern site unsuitable for future interns?




6.      Would you recommend the intern site to others? Individuals with what interests?




7.      Was housing difficult to obtain?


Rent cost/month $                                 Type of housing

Lease length                                      Miles from work

Transportation cost to and from work

Furniture (rented, cost, etc,)

No. of roommates

This Form Must Be Completed Before a Degree Can Be Conferred
                               Six Week Evaluation of Intern (a copy must be included in student notebook)

Intern Name

Agency Supervisor

Agency Name

*** INTERN SUPERVISORS*** – CIRCLE ONE OF THE POINT TOTALS BELOW THAT BEST
INDICATES HOW THE INTERN IS PERFORMING AT THE MIDPOINT OF THEIR
INTERNSHIP. Afterwards, feel free to complete the rest of the form (optional)
Outstanding          Very Good             Average             Marginal          Unsatisfactory
200 points           185 points           150 points          125 points           50 points
  If you so desire you may explain your evaluation further by completing the following and / or making
comments toward the end of this page, BUT PLEASE BE SURE TO CIRCLE A POINT TOTAL ABOVE.

 RELATIONS WITH OTHERS                              ATTITUDE - APPLICATION TO WORK
       Exceptionally well accepted                        Outstanding in enthusiasm
       Works well with others                             Very interested and industrious
       Gets along satisfactorily                          Average in diligence and interest
       Has some difficulty working with others            Somewhat indifferent
       Works very poorly with others                      Definitely not interested


 JUDGEMENT                                          DEPENDABILITY
      Exceptionally mature                               Completely dependable
      Above average in making decisions                  Above average in dependability
      Usually makes the right decision                   Usually dependable
      Often uses poor judgement                          Sometimes neglectful or careless
      Consistently uses bad judgement                    Unreliable
 ABILITY TO LEARN                                   QUALITY OF WORK
        Learns very quickly                               Excellent
        Learns readily                                    Very good
        Average in learning                               Average
        Rather slow to learn                              Below average
        Very slow to learn                                Very poor
 ATTENDANCE                                         PUNCTUALITY
      Regular                                            Regular
      Irregular                                          Irregular

Additional Supervisor Comments__________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________


Intern Signature                                                      Date_____________

Agency Supervisor Signature                                           Date______________
                               Texas A&M University
      Final Student Internship Evaluation - To be Included in Student Notebook
        Undergraduate Applied Exercise Physiology or Graduate Master of Science

STUDENT                                                                         TERM

AGENCY SUPERVISOR

INTERNSITE

PURPOSES OF EVALUATION:

1.     To provide the agency supervisor with a basis for counseling and guiding the student, thereby providing an
       opportunity for the student to learn and to improve performance in a constructive, academic context.
2.     To furnish feedback to the academic supervisor regarding student performance thus allowing a basis for
       assisting in the career guidance of the student.
3.     To provide the student with an assessment of his/her apparent strengths and limitations as a prospective
       professional.

FOR THE EVALUATOR: The final evaluation is based on a 400 points possible scale. Please do the following:

1.     Familiarize yourself with the rating form and the scale described below.
2.     Compare the student with persons of comparable training and experience.
3.     Circle the number corresponding to the best rating of the intern
                (please do not write in a point total that is not listed on the form)
4.     Go over the evaluation with the intern and have them sign the form
5.     Return the form to the appropriate university supervisor


               KEY TO RATING SCALE

               40 - Consistently above average

               35 - Usually above average

               30 - Satisfactory but shows limitations

               25 - Somewhat less than satisfactory

               20 - Completely unsatisfactory

FOR THE INTERN: You and your agency supervisor should complete this form sometime during the final weeks of
the internship and submit it along with the internship notebook to the following address.

       If notebook is mailed it MUST be
       sent 11 days prior to the start                 Dr. John Green
       of finals by UPS next day air to:               112 Netum Steed Building
                                                       Texas A&M University
                                                       College Station, TX 77843




                                                       27
                                                                   Page 2 - Internship Final Evaluation

                                            EVALUATION ITEMS

1.   DEPENDABILITY / PUNCTUALITY: Dependable in completing assignments, using judgment appropriate
     to this level of experience, etc. Accepts responsibility. Is thorough in completing tasks. Conscientious and
     shows attention to detail. Is punctual in arriving for work, performing assigned duties, and completing
     assigned projects.

                             20      25       30      35    40

     Comments:




2.   INTERPERSONAL RELATIONSHIPS: Able to relate appropriately to professional staff and other
     personnel. Excellent behavior in situations involving professional staff and other personnel. Exhibits
     empathy for clients. Good in handling delicate or stressful interactions with clients / patients.

                             20      25       30      35    40

     Comments:




3.   SELF MOTIVATION AND SELF RELIANCE: Is a “self starter” who demonstrates the ability to take the
     initiative. Does not have to be repeatedly told or reminded to complete assignments. Exhibits self-
     confidence and self-assuredness without narcissism.

                             20      25       30      35    40

     Comments:




                                                     28
                                                                 Page 3 - Internship Final Evaluation

4.   RESPONSES TO CRITICISM: Accepts guidance and constructive criticism with excellent attitude.
     Recognizes strengths and limitations and takes steps to correct weaknesses that have been pointed out.

                            20      25      30      35    40

     Comments:




5.   PERSONAL APPEARANCE AND DRESS: Personal appearance indicates cleanliness and neatness.
     Consistently neat and well groomed. Appropriately and professionally dressed.

                            20      25      30      35    40

     Comments:




6.   PROFESSIONALISM AND DISCREETNESS: Aware of what to do or say and what not to do or say in a
     professional setting. Approaches assignments and responsibilities in such a manor as to convey a sense of
     high personal standard and high self-expectation. Very discrete about such things as patient confidences
     and sensitive conversations.

                            20      25      30      35    40

     Comments:




                                                    29
                                                                    Page 4 - Internship Final Evaluation

7.   CLIENT / PATIENT INTERACTION AND RELATIONSHIPS: Able to modify behavior and personality to
     meet individual client / patient needs. Exhibits a sense of empathy for clients / patients. Does not exploit
     position for personal or social gain. Conveys a sense of enthusiasm for the job to clients / patients.
                                        20     25       30      35     40
     Comments:




8.   TIME MANAGEMENT: Ability to budget and organize time so as to complete assigned tasks on schedule.

                                      20      25       30      35       40
     Comments:




9.   WORK HABITS: Ability to work in a focused and determined manner without becoming distracted.
     Organizes work in logical sequence.

                                      20      25       30      35       40

     Comments:




                                                      30
                                                                            Page 5 - Internship Final Evaluation

10.     VERBAL AND WRITTEN COMMUNICATION: Ability to speak effectively with the clients / patients and co-
        workers (professional and supportive personnel). Easily understood by clients / patients. Communicates
        well with supervisors and co-workers. Writes in a clear and concise manner.

                                      20      25      30       35    40

        Comments:




(Signed)                                              (Date)
        (Intern)

(Signed)                                              (Date)
        (Agency Supervisor)




                                                     31

				
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