EXTERNSHIP PACKET MEDICAL ASSISTANT
MEDICAL ASSISTANT PROGRAM
EXTERNSHIP FORM
Please note that you signed an agreement to comply with the following items when you enrolled in the program.
• I understand that my externship will begin after the class is completed. It may take up to 6 weeks after the coursework is complete to start the externship.
• I understand that the externship site assignment will be based on availability, attendance, participation, grades on assignments and instructor recommendations.
• I understand that my instructor or program administrator will determine my externship site, which may be at any location throughout Santa Clara County.
• Typical work days are 8 hour daily shifts during the day, but can vary depending on the clinic.
• Evening students will need to complete the externship during normal business hours.
• I understand that I need to have transportation to any location in Santa Clara County for my externship.
• My records, including program, enrollment and immunization records may be requested by my externship site.
• I understand that some externship sites may require that I complete a background check and/or drug screening. This will be done at my own expense.
• I understand that the course certificate is not issued until the classroom and externship hours are completed.
CODE OF PROFESSIONAL AND ETHICAL CONDUCT FOR STUDENT EXTERNS
GENERAL STATEMENTS
Santa Clara Unified School District (SCUSD) has Memorandum of Agreement (MOA) with a limited number of clinical externship sites. You will be assigned to one of the sites and you may have to go through an interview process.
As an extern of Santa Clara Adult Education, you are representing not just yourself, but the school and your fellow students, both current and future. As a student extern you are expected to adhere to the externship site’s policies, practices, procedures, dress code, and/or standards of conduct. To avoid any misunderstanding, it is recommended that you obtain clarification regarding such matters from your externship site when you begin your assignment.
Your performance during the 160 hours of externship will be evaluated by your supervisor at the externship site. Upon completion of your assignment the evaluation form will either be directly mailed or faxed to the school or the externship site may choose to hand the evaluation form directly to you. The school must have the evaluation form on file before your certification can be released.
The student extern is required to maintain a time sheet provided by the school which lists the exact amount of hours worked per day. Each day must be signed off by the supervisor at the externship site. Upon completion of the 160 hours externship the student must provide the school with the original time sheet before the certificate can be released. The timesheet is included in this brochure.
The medical assistant instructors and the program administrator will assign the student to an externship site and be in contact with both the externship site supervisor and the student extern. Any changes, issues or grievances must be reported immediately to the instructor and/or the program administrator.
EXTERNSHIP DIRECTIONS
Please conduct yourself in a professional manner at all times. This includes, but is not limited to:
1. Reporting for the externship on time. Maintaining required timesheets.
2. Following all rules and policies as required by the externship site.
3. Maintaining strict confidentiality regarding information obtained on any clients, members, customers, patients, employees, and products or services associated with the externship site.
4. Using appropriate written and oral communication in all interactions with all supervisors, employees, and school staff.
5. Observing all established safety rules and avoiding unsafe work practices.
6. Demonstrating honesty, cooperation, integrity, courtesy, and a willingness to learn.
7. Engaging in positive, ethical, and legal behavior.
8. Accepting responsibility and accountability for decisions and actions taken while at the externship site.
9. Treating all customers, clients, supervisors, and fellow employees with dignity and respect.
10. Complying with all directives regarding professional dress including wearing appropropriate scrubs and covering any tattoos. Acrylic or gel nails are not permitted.
I understand and agree with the professional standards of the externship program as listed in the preceding general and specific statements. I understand that if I do not adhere to any facet of the code of conduct and/ or any of the statements listed above, I may be at risk of forfeiting the Medical Assistant Certificate.
I understand that should the externship site expel me due to non-compliance with their policies, practices, and procedures, I will not be placed in a new externship site.
Print Name Signature Date
EXTERNSHIP SITE
Directions: At the end of each week, completed timesheets are faxed or emailed from the externship site representative or student to the SCAE representative.
Student Name:
Student ID:
Externship Site:
School Contact email:
EXTERNSHIP EVALUATION AND COMPETENCY
Name (print):
Date:
Externship Site:
Please evaluate our student’s performance on the ongoing externship program.
3
EXCEEDS EXPECTATIONS
2 MEETS EXPECTATIONS
SCORE COMPETENCIES
Effective and professional communication
Ability to come on time as scheduled
1 NEEDS IMPROVEMENT
Satisfactory performs clinical skills including review and preparation of patient charts, rooming patients, taking and recording vital signs, performing EKG’s, injections, and collecting specimens
Ability to work with minimal supervision
Readiness and motivated to work in a health provider office for an entry level position
Respect for co-externs, employees, and authorities
Proficiency in front office skills including computerized practice management
Contributes to the overall patient experience and satisfaction
Overall competency
COMMENTS
Evaluator Name (print)
EXTERNSHIP
SITE EVALUATION FORM
Students are required to submit an evaluation form of their externship site. This helps us to assess the quality and effectiveness of the organization. Completion of this form is mandatory and must be submitted to the CTE Program Administrator, together with the timesheet and student evaluation form from the externship site. Certificates will only be issued upon receipt of all completed documents.
Name (print):
Date:
Name of Externship Site:
Name of Site Supervisor:
Dates of Externship: 3 EXCEEDS
ORGANIZATION
I was provided with an orientation to the organization
The organization was prepared to have an externship student
The organization treated me in a professional manner
The work assigned at the organization enabled me to meet my learning goals
I was assigned an appropriate amount of work
EXTERNSHIP SUPERVISOR (AT SITE)
My supervisor clearly discussed the work involved with me
My supervisor provided constructive feedback on my performance
My supervisor was available and accessible when I needed help or had concerns
My supervisor monitored my progress during the externship
My supervisor gave me adequate direction for my work
OVERALL SCORE
The externship gave me a realistic understanding of my field of study
I was able to assume additional duties/responsibilities throughout the externship
The work I did was challenging and stimulating
There was enough work to keep me busy
I would recommend this externship site to other students
EXTERNSHIP SITE EVALUATION FORM
1. Do you have any advice for improving this externship experience?
2. Do you have any additional comments?
