GUIDEBOOK to Clinical Optometry Internship 2016

8/18/2019 GUIDEBOOK to Clinical Optometry Internship 2016

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2016

An Internship Protocol

Davao Doctors College Inc.

Community & Hospital

Optometry


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DAVAO DOCTORS COLLEGE INC.

Institutional Mission Statement 5

Vision, Mission & Goals 5

Motto 5

DOCTOR OF OPTOMETRY

Philosophy 6

Departmental Objectives 6

Motto 5

Republic Act 8050 7

COMMUNITY AND HOSPITAL OPTOMETRY 8

An Introduction 9

Objectives 10General Objectives 10

Educational Objectives10 10

Learning Objectives 11

COMMUNITY AND HOSPITAL OPTOMETRY I (INTERNSHIP PROGRAM) 12

Course Code & Credit, Contact Hours, Pre-requisites, Placement 12

Course Description 12

COMMUNITY AND HOSPITAL OPTOMETRY II (EXTERNSHIP PROGRAM) 13

Course Code & Credit, Contact Hours, Pre-requisites, Placement 13

Course Description 13

TABLE OF CONTENTS


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TABLE OF CONTENTS

POLICIES & IMPLEMENTING GUIDELINES: THE INTERNSHIP PROTOCOL 14

I. Eligibility 15

II. Pre-internship Requirements 15

III. Grooming and Appearance 17

IV. Duties and Responsibilities 18

V. Proper Decorum 19

VI. Attendance and Punctuality 21VII. Make-up or Extension Duties 24

VIII. Internship Offenses 25

IX. Incident Reports and Discipline 27

X. Sanctions 28

XI. Merits and Demerits 29

XII. Monthly Revalida 31

XIII. Performance and Evaluation 32

XIV. Portfolio of Learning Experiences 33

XV. Post-Internship Recognition and Pinning Ceremony 34

XVI. Awards and Recognition 35

XVII. Commencement Ceremony 37

CLINICAL INTERNSHIP FORMS and TEMPLATES 38

Conforme Sheet and Waiver 39

Internship Clinical Evaluation Form 40

Internship Clerical Evaluation Form 42

Record of Demerits Form 44

Case Presentation Form 46

PROFILE OF AFFILIATION CENTERS 47


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- Lorem Ipsum

TABLE OF CONTENTS

CLINICAL INTERNSHIP JOURNALS 66

ROTATION NO. 1 67

ROTATION NO. 2 67

ROTATION NO. 3 67

ROTATION NO. 4 68

ROTATION NO. 5 68

ROTATION NO. 6 68

CLINICAL EXTERNSHIP JOURNALS 70

ROTATION NO. 1 71

ROTATION NO. 2 71

ROTATION NO. 3 71

ROTATION NO. 4 72

ROTATION NO. 5 72

ROTATION NO. 6 72

EVALUATION OF STUDENT-INTERN EXPERIENCES 73

EVALUATION TOOL for STUDENTS 74

EVALUATION TOOL for PRECEPTORS 75

REFERENCES 76


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VISION

Davao Doctors College is a premier non-sectarian academic institution

that provides quality health and wellness education in Mindanao and the East

ASEAN Growth Area.

MISSION

Davao Doctor’s College is committed to produce highly competent

graduates imbued with the core values of excellence, service, integrity,

empowerment and commitment.

GOALS

To achieve its vision and mission, Davao Doctor’s College aims to:

1. provide innovative, balanced and relevant education for lifelong learning

of the global Filipino;

2. provide community outreach services through comprehensive general well-

being projects;

3. promote passion for continuous improvement by upgrading facilities,

strengthening research culture, intensifying partnerships and linkages;

4. promote environmental concern and community awareness by maintaining

a sustainable and environment-friendly institution and implementing

activities that help nurture the environment, and

5. achieve organizational efficiency and financial stability through competent

management and governance.

MOTTO

“Through Excellence We Shall Lead ”

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PHILOSOPHY

The study of Doctor of Optometry affirms the motto of Davao Doctors

College “Through Excellence We Shall Lead ” and the recognition of the

Commission on Higher Education as a regulating body.

Individuals have the right to quality eye care through highly educated

and well-trained primary eye care providers. The Department of Optometry

readily prepares a learning environment that support and advance an individual

to this professional discipline. This ideal is translated into a student’s

experience to ethically deliver service by addressing each person’s specific

needs.

The faculty commits to provide the best foundation necessary for

students to fully assume the role of a professional which encompasses practice,

pursuit of clinical expertise, commitment to academic and clinical teaching andfacilitation of research.

The Department believes that any individual who aspires to be Doctor of

Optometry is endowed with a foundation for lifelong learning, committed to

give eye care, ethically bound in the realm of practice and recognizes the value

of service in a dynamic quality health care environment.

DEPARTMENTAL OBJECTIVES

The Optometry Department aims to produce an Optometrist who has:

1. acquired and developed the knowledge and skills essential to the practice of

Optometry.

2. developed a high level of competence needed to deliver the full spectrum of

Optometric services: which consist of prevention, examination, evaluation,

diagnosis, management, and rehabilitation of disorders, dysfunctions and

diseases of the visual system, the eye and its associate structures.

3. developed the qualities, attitudes and values essential to the delivery and

promotion of eye care services to the Filipino people.

4. developed the desire to improve Optometry by advancing knowledge, skills

and values of the profession.

5. developed professional attitudes conducive to inter-professional under-

standing and cooperation.

MOTTO:


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R

EPUBLIC

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CT 8 5

“Optometry is the science and art of examining the

human eye, analyzing ocular functions, prescribing and

dispensing ophthalmic lenses, prisms, contact lenses andtheir accessories and solutions, low vision aids, and

similar appliances and devices, conducting ocular

exercises, vision training, Orthoptics, installing

prosthetics, using authorized diagnostic pharmaceutical

agents (DPA), and other preventive and corrective

measures or procedures for the aid, correction,

rehabilitation or relief of the human eye or to attain

maximum vision and comfort.”

(RA 8050, sec. 3)

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Community & Hospital

Optometry


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Introduction

The COMMUNITY AND HOSPITAL INTERNSHIP / EXTERNSHIP PROGRAM is a 10-

months clinical rotation scheme in which is offered in the fourth year proper of the Doctor

of Optometry degree. It provides an intensive, challenging, educational training for

students in a unique and individualized experience in Optometric care in the context of

the total health and eye care.

The internship program enhances the intern’s clinical knowledge and skills through

intensive clinical experience. It provides quality exposure in diverse clinical settings

including government and private hospitals with optometry or ophthalmology centers,

referral centers, military bases, HMO’s, urban family clinics, hospital clinics and Health

Center Service facilities.

Student interns will have the opportunity to work with different patients and

doctors and will be able to formulate their own individual style of practicing Optometry as

a result of these experiences.


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G

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BJECTIVES:

The intent of the Internship Program is to provide the Optometry student with an

opportunity to be trained by outstanding practitioners in the science of primary and/or

secondary care Optometry. It is an integral part of the curriculum designed to transform the

optometry student into a complete health care professional who can apply scientific

knowledge tempered by clinical insight and overall concern for the patient.

EDUCATIONAL OBJECTIVES:

1. To develop the student's ability to apply knowledge of vision and basic sciences to

prevent and/or solve problems of the vision system.

2. To develop the student's ability to utilize knowledge in the behavioral, social and

other health sciences to alleviate human problems.

3. To develop a high level of competence in the use of modern optometric techniques,

instruments and problem solving roles.

4. To engender high standards of professional competence and responsibility.

5. To develop the students ability to work and communicate effectively with other

health professionals and ancillary personnel in meeting patient needs.

jec t ives


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L

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BJECTIVES:

1. To demonstrate to the student the art of the practice of optometry as evidenced by the

attending doctor/practitioner.

2. To widen the student's understanding of the spectrum of optometry by showing the

student the clinical conditions (mental, physical and social, both acute and chronic) and

their interaction with each other that make up the wide variety of health conditions in the

community.

3. To demonstrate where legal, the use of common diagnostic and therapeutic procedures

involved in the problem solving stages of the delivery of eye care.

4. To demonstrate the conscious and purposeful use and development of the doctor-patient

relationship.

5. To demonstrate the comprehensive care of the family from infancy to the aged

particularly in highly susceptible groups.

6. To demonstrate the effect of an individual vision problem on the entire family.

7. To demonstrate the role of the "health team" in patient management and continuity of

care including relationships with other health professionals and agencies.

8. To demonstrate preventive optometry and the importance of early diagnosis of ocula

and vision anomalies, including ocular-related disorders.

9. To demonstrate the practical approach of the primary care optometrist to health

maintenance.

10. To demonstrate the role of the optometrist in patient education.

11. To demonstrate the changing patterns of optometric care and familiarize the student with

emerging patterns of eye care delivery.

12. To provide practical experience in the office management and business aspects o

optometric practice.

13. To demonstrate the civic involvement a professional owes to his community.

jec t ives


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Community Hospital

Optometry

COURSE NO. : CS 111

COURSE CREDIT : 6 Units (1 unit Lec/ 5 units Clinic)

CONTACT HOURS : 270 Hours (1 Hour Lec /15 Hours Clinic/week)

PRE-REQUISITE : ALL Professional subjects prior to this

PLACEMENT : Fourth Year Proper; First Semester

COURSE DESCRIPTION

The COMMUNITY AND HOSPITAL OPTOMETRY INTERNSHIP PROGRAM is a 1-

semester rotating type of service training program scheduled for 5 months commencing from

June to October of the Davao Doctors College academic calendar. It provides fourth–year

Optometry Proper interns with the opportunity to rotate through different off-campus clinical

sites, each of which lasts for at least a minimum of 18 weeks.

It is intended to provide Optometry interns with opportunities to be trained by

outstanding practitioners in each of their specialty fields. Said interns will have a clinical

exposure to areas of general ophthalmology practice, pre and post refractive surgery,

cataract management, glaucoma screening, retinal diseases, low vision rehabilitation and

other ocular disease management.

In the said facility, students are assigned to various areas within the clinic where,

under direct clinical faculty supervision, they participate in the provision of primary care

optometric services to clinic patients. The experience at internship sites promotes the intern’s

skills as a primary care provider and develops his or her ability to deliver quality care in

accessible healthcare facilities.

The clinical preceptor participates not only at their respective facilities, but also shares

their expertise through mini lectures, presentations and continuing education programs. They

are responsible for the supervision, training and evaluation of interns studying at off-campus


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COURSE NO. : CS 112

COURSE CREDIT : 15 Units (1 unit Lec/ 14 units Clinic)

CONTACT HOURS : 756 Hours (1 Hour Lec /42 Hours Clinic/week)

PRE-REQUISITE : ALL Professional subjects prior to this

PLACEMENT : Fourth Year Proper; Second Semester

COURSE DESCRIPTION

The COMMUNITY AND HOSPITAL OPTOMETRY EXTERNSHIP PROGRAM is a 1-

semester rotating type of service training program scheduled for 5 months commencing from

November to March of the Davao Doctors College academic calendar. It provides fourth–year

Optometry Proper interns with the opportunity to rotate through different off-campus clinical

sites, each of which lasts for at least a minimum of 18 weeks.

This course provides Optometry externs an opportunity to work with a variety of

patients and doctor practitioners. They are assigned to various Optometry clinics where, under

direct Clinical Instructor supervision and Preceptor, they participate in the provision of

Optometric services to a variety of patients with ocular health problems and other optical

services.

Student externs will be able to formulate their own individual style of practicing

Optometry as a result of these experiences. They will have the opportunity to explore different

areas of specialty within the practice of contemporary Optometry such as:

1. Cornea and Contact Lens

2. Vision Training and Orthoptics

3. Pediatrics and Binocular Vision

4. Low Vision and Rehabilitation

5. Geriatric Optometry

6. Optometry Management

7. Ocular Prosthesis

Community Hospital

Optometry 2


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the

Internship

Protocol

Policies &Implementing

Guidelines:


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Eligibility

To be eligible for admission to the Community and Hospital

Optometry Internship/Externship Program, a student must be at least

least 18 years of age and must have:

1.1 Completed ALL professional and academic requirements for Doctor of Optometry

from first year to fifth year. (CMO No. 38, S.2007)

1.2 Completed ALL the patient requirements during the fifth year.

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Pre-Internship Requirements

Prior to internship duties, an Intern must comply with the following:

2.1 Health Clearance

2.1.1 Complete Physical/Laboratory Examinations including chest X-ray

2.1.2 Medical Clearance duly signed by a Physician in a healthcare facility duly

accredited by DOH (CHED Memo 26, series 2009)

2.1.3 Hepatitis B screening and vaccination as per school/ hospital policy

2.1.4 Mental Health Certificate issued by DDC Guidance center.

2.2 Pre-internship Orientation

2.2.1 Attendance to this orientation with a parent/guardian is a MUST. No intern

shall be allowed to go on duty without orientation.

2.2.2 In case an intern fails to attend this orientation, a fee of P250 should be

paid to the Accounting office and the official receipt must be presented to the department for a

Special Orientation to be arranged.

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Pre-Internship Requirements

2.3 Conforme Sheet and Waiver

2.3.1 Every intern should read, understand and abide by the existing Policies &

Guidelines of the Clinical Internship/Externship Program, series of 2016.

2.3.2 Once understood, the Conforme Sheet and Waiver (attached herein) must

be duly signed by the student intern. parent/guardian, Clinical Coordinator, Program Chair

and a notarized copy must be submitted to this department.

2.4 Submit an evidence of enrollment for that particular internship/externship period.

2.5 Review of Fundamentals

A 5-day review of ALL Optometry procedures, skills & competencies wherein an

incoming intern shall have to perform and pass before an assigned CI.

2.6 Team Building Activity

This is a goal setting activity wherein incoming interns and clinical instructors

come together to build rapport, level expectations, foster camaraderie, develop respect and

cooperation. It is an avenue to bridge the gap and settle the differences between and

amongst them so that they are able to transcend and take this relationship to a more

professional level as a preparation for their rotation duties outside of the school.

2.7 Clinical Low Vision Training

This is a 2-days seminar-training/workshop on clinical low vision handled by

Resources for the Blind Inc. (RBI) as a requirement prior to internship duty in the said

facility. Its objective is to prepare and strengthen the competencies of interns in assessing

patients with learning disability and visual impairments.

2.8 Basic Life Support Training (BLS)

As an added competency, all incoming interns are required to undergo a Basic

Life Support Training. Its aim is to further equip members of the allied health profession to

save lives or provide first aid during emergency situations. BLS training fee is P2,500.


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Grooming and Appearance

Optometry clinical interns are required to be well groomed,

practice good hygiene and maintain a highly professional appearance at

all times.

For FEMALES

3.1 Hair should be neatly combed and clipped or tied up if long. Outlandish hair color

is prohibited.

3.2 Wearing of jewelries is NOT allowed, except for wristwatches and stud earrings of

NOT more than 5mm. NO dangling earrings are allowed.

3.3 Fingernails should be kept short, neatly trimmed and free of colored nail polish.

For MALES

3.4 Hair should be according to the prescribed length and style as stipulated in the

Student Handbook.

3.5 Only simple accessories such as a watch will be allowed.

3.6 Wearing of earrings of any sort are prohibited.

3.7 Face should be cleanly shaven and should be free of any unwanted hairs such as a

mustache or goatee.

3.8 They must wear the prescribed internship uniform when reporting for duty.

Official uniform includes:

3.8.1 White blazer on top of the prescribed duty uniform

3.8.2 Black closed shoes with at least one (1) inch heel3.8.3 Nameplate

3.9 Nameplates must be worn and visibly displayed at all times.

3.10 Non-compliance means being marked ABSENT for that day and the sanction for

absences shall apply.

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Duties and Responsibilities

As a future professional, it shall be the resolve of a senior intern

to abide by the rules and regulations of the school and his/her

respective affiliation center. Each center is unique and is governed by its

own individual company policies, and so it shall be the responsibility of an intern to:

4.1 Obey governing rules and regulations of the school and assigned affiliation

center

4.2 Report for duty on time:

15 hours/week (1st

Semester) – Mondays to Fridays

42 hours/week (2nd Semester)- Mondays to Saturdays

4.3 Complete the internship period of 270 hours for the first semester; and 756

hours for the second semester, including all the sanctions and extension duties incurred.

4.4 Maintain a professional relationship with the affiliation center staff at all times.

4.5 Review the patient’s history before starting any examinations.

4.6 Perform examinations applicable to patient’s condition under the supervision of

an Optometrist inside the clinic or center.

4.7 Report to the school once a week on a given schedule and comply with all

requirements to be checked weekly by the Clinical Coordinator.

4.8 Pass the monthly Written Revalida to be given in the school every 2nd Monday

of the month or during scheduled periodic examinations, whichever comes first.

4.9 Submit a Portfolio of Learning Experiences weekly by email and a hard copy

(with pictures taken inside the center as evidence) at the end of each semester.

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Proper Decorum

All student interns are expected to show respect towards authority

and practice courtesy when dealing with fellow interns, doctors, staff,

clinical instructors, coordinators, other personnel and patients. Professional ethics must be

observed at all times. Equally important in the practice of Optometry is not just knowledge

and skills, but attitudes as well. One must conduct oneself in a manner befitting of a future

Doctor of Optometry.

Hence, an intern should:

5.1 Strictly adhere to the Code of Ethics for Doctor of Optometry.

5.2 Observe the proper conduct & decorum when on duty.

5.3 Obey the protocol set by their corresponding Affiliation Center.

5.4 Respect authority and show courtesy when dealing with patients, fellow interns &

staff.

5.5 Observe professional ethics at all times.

5.6 Handle patients’ information with utmost confidentiality

5.7 Work harmoniously with fellow interns/externs and other personnel.

5.8 Avoid undue familiarity and intimacy with patients, staff and co-workers.

5.9 Refrain from bringing expensive gadgets such as laptops, tablet or iPad inside the

affiliation centers.

5.10 Minimize use of cellular phones while on active duty.

5.11 Bring the necessary Opto paraphernalia during duty such as:

5.11.1 OR Set / Trial Lens Set (as needed)

5.11.2 Penlight

5.11.3 Occluder

5.11.4 Small Notebook/ Ballpens

5.11.5 Punch Cards or DTR

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An intern should NOT:

5.11 Engage in vandalism, fighting, smoking, gambling, stealing or any other form of

illegal activities such as possession of illegal drugs and/or its paraphernalia.

5.12 Report for duty under the influence of alcohol or prohibited drugs.

5.13 Carry deadly weapons.

5.14 Be involved in any sexual harassment case.

5.15 Eat when on duty unless allowed to do so.

5.16 Entertain visitors except during emergencies.

5.17 Conduct any form of business such as selling or networking during duty.

5.18 Show public display of affection, which is contrary to acceptable moral standards.

5.19 Use words in which may be offensive, vulgar, scandalous, indecent and

blasphemous.

5.20 Sleep during duty hours.

5.21 Display inappropriate behavior inside any affiliation center.

Violation of any of the above shall be ground for DISCIPLINARY ACTION as

may be recommended by the Optometry Department and/or School Disciplinary

Committee.


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Attendance and Punctuality

Schedule of rotations shall be furnished to the intern and

corresponding affiliation center. It shall also be posted at the Optometry

Clinic and/or the Department bulletin board. Completion of duty hours and

punctuality are important elements of clinical internship hence, an Optometry intern is

expected to report for duty on time.

6.1 Duty Hours

6.1.1 Interns should follow the scheduled duty hours of their respective

affiliation centers. Swapping of schedules will NOT be allowed.

10:00 am – 1:00 pm Mondays to Fridays (1st Semester)

10:00 am - 12:00 nn Mondays to Saturdays (2n Semester)

1:00 pm – 6:00 pm Mondays to Saturdays (2nd Semester)

6.1.2 Interns on duty are NOT allowed to leave the affiliation center without

permission from their Preceptor or the Optometrist –On- Duty.

6.1.3 Tardiness of 30 minutes and beyond is considered absence for that dayand sanctions for unexcused absence shall apply.

6.1.4 Duty hours during official holidays shall be specified by the affiliation

centers. However, if the clinical rotation is in the malls or any commercial centers, the intern

should render his/her corresponding duty hours.

6.2 Recording of Attendance

6.2.1 Tampering of punch cards is strictly prohibited.

6.2.2 Timing in or out for other interns is not allowed.

6.2.3 In the absence or failure of a bundy clock, Preceptor-in-charge shall be

the one to sign the student’s DTR.

6.2.4 DTR should be as clean or neat as possible, free from any unnecessarymarks, superimpositions, mutilations or tears.

6.2.5 An intern is accorded a one (1) hour break for lunch, and a 30-minutebreak for snacks.

6.3 Tardiness and absences shall be subject to the following extension /sanction:

TARDINESS 30 mins. or more = One (1) day extension

Less than 30 mins. = Demerit (Community Service)

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ABSENCES

First Semester (1 day = 3 hours) Second Semester (1 day = 7 hours)

(1:1) 1 excused absence = 3 hrs extension 7 hours extension

(1:3) 1 unexcused absence = 9 hrs extension 21 hours extension

6.4 Absences shall be considered excused if due to any of the following:

6.4.1 Severe illness, accidents and/or hospitalization

6.4.2 Critical illness or death of an immediate family member,

6.4.3 Fortuitous events (e.g. fires)

6.4.4 Force majeur (e.g. earthquakes, storms, floods, tsunami)

6.4.5 Transportation strikes

6.4.6 Threats of civil war

6.4.7 Attendance to any school-related or co-curricular activity

6.5 In case of illness, a Medical Certificate duly signed by the attending physician

with telephone numbers written on it and an excuse letter from the parents or guardian

must be submitted upon returning to duty.

6.6 Official Pull-out from Duty

In any event that the presence of interns may be needed, they may be officially

pulled out from duty as deemed necessary by the department or school. Affiliation center

will be duly notified through an official communication from the Optometry Department.

6.7 These are the activities in which an official pull-out from duty are allowed:

6.7.1 Institutional activities (e.g. Foundation Celebration, Club Fairs, etc)

6.7.2 In-house seminars, trainings & workshops

6.7.3 Co-curricular activities

6.7.4 Research Forum (departmental, institutional, regional, national)

6.7.5 Community Outreaches

6.7.6 Basic Life Support (BLS) Training


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6.8 Activities Outside the School

For activities held outside of the school not mentioned above, a Letter of Approval

must be submitted to the Program Chair and a certificate /proof of attendance must be

presented as soon as the intern resumes duty. Failure to comply with the above

requirements shall make the absences unexcused and sanctions for unexcused absence

shall apply.

6.9 Cutting of Duty Hours

Any intern who, after reporting for duty, leaves his area of assignment without

permission, shall be considered out of post and shall be subjected to one (1) day extension

duty.

6.10 Termination of Duty

Only three (3) excused absences will be allowed during one (1) cycle of the rotation.

A clinician who has incurred more than five (5)-days unexcused absences in a specific

affiliation center will be deemed terminated from that center. No grade (or evaluation) shall

be given for that rotation and the clinician will be required to wait for the next assignment.

6.11 Dropping

A clinician who has accumulated absences (whether excused or unexcused) of 20%

or more of the total number of required duty hours will automatically be dropped from the

internship subject. Said intern will be advised to repeat or re-enroll the internship subject.


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Make-up or Extension Duties

All extensions and/or make-up duties will be served at any

affiliation center at the END of the regular internship/externship period.

7.1 Fees

Regardless of the number of hours or days, an intern with extension duties shall be

charged P300.00 per day payable to the school’s Accounting office. Receipt must be

presented to the Clinical Coordinator or Program Chair prior to the commencement of

make-up duty.

7.2 Inclusion of Fees

ONLY extension duties for unexcused absences, tardiness and demerits are

applicable. However, excused absences shall be exempted from the extension fees.

7.3 Limitation to the Number of Make-up Duties

Make-up and/or extension duties should not exceed more than 20% of the total

required duty hours. If this happens, the student intern shall be advised to re-enroll the

subject.

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Internship Offenses

Enumerated herein is a list offenses and its classification.

MINOR OFFENSES:

8.1 Habitual tardiness (3x or more)

8.2 Non-observance of prescribed uniform or dress code

8.3 Playing games using electronic gadgets while on duty

8.4 Extending more than their prescribed breaks-lunch or snack breaks.

8.5 Loitering or roaming around while on duty (out of post)

8.6 Sleeping while on duty.

8.7 Cutting of duty hours.

8.8 Leaving the affiliation center without permission.

8.9 Reading of materials not related to Optometry such as pocketbooks, comics,

magazines, kindle, etc.

8.10 Wearing of the internship uniform inside bars or movie houses.

8.11 Sporting an earring for males and multiple earrings for girls and other similar

body piercing.

8.12 Having a visible tattoo while on active duty.

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MAJOR OFFENSES:

8.13 Repetition of minor offenses (5x or more)

8.14 Public display of affection

8.15 Uttering offensive words and making dirty signs inside the affiliation center

8.16 Littering and/or spitting within the vicinity of the center

8.17 Modifying computer settings and security hacking of the affiliation center’s

computer system

8.18 Engaging in cybersex or viewing pornographic sites while on active duty.

8.19 Circulating or divulging sensitive information regarding the affiliation center, its

doctors, staff and respective clients

8.20 Acts of disrespect towards authorities whether in the school or affiliation center

8.21 Smoking and gambling within 200 meters of the assigned affiliation center.

8.22 Rendering of duty apart from the assigned affiliation center

8.23 Stealing or asking money from the staff inside the affiliation center

8.24 Engaging in a fight while on duty

8.25 Reporting for duty under the influence of alcohol or drugs

8.26 Vandalism or rendering intentional damage to the center.

8.27 All forms of cheating or plagiarism

8.28 Falsification of academic records, tampering of attendance cards and forging of

documents found in the affiliation center

8.29 Any form of bullying, whether physical, mental or cyber bullying.

8.30 Any form of remarks in which is discriminatory to one’s gender, nationality,

culture or race, mental or physical disability

8.31 Inappropriate behavior inside the affiliation center such as use of foul language

even in the form of jokes, shouting, playing, terrorism, and all acts deemed improper.


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Incident Reports and Discipline

The VP of Academic Affairs, the Dean of the College of Allied

Health Sciences, the Optometry Program Chair and the Clinical

Coordinator reserves the right to review and revise the existing policies of

the Optometry Clinical Internship Program.

9.1 Any incident that concerns the intern in the affiliation center should be

reported to the Clinical Coordinator both verbally and in writing within 24 hours after the

incident has occurred.

9.2 The written report shall describe in details the incident that occurred, the

people involved and other pertinent data. The Clinical Coordinator countersigns this

report and submit it to the PC.

9.3 For minor offenses, the Clinical Coordinator may enact appropriate disciplinary

action and inform the Program Chair regarding the sanction.

9.4 For major offenses, a Disciplinary Committee shall be created, which may

consist of the Program Chair, Guidance Counselor, members/head of the StudentPersonnel Services, fellow intern, department organization officer and/or any

representative of the affiliation center to conduct investigation of a reported incident.

9.5 Any violation of the rules and regulations governing the Internship Program as

stipulated in the Internship/Externship Policies and Implementing Guidelines, DDC

Student Handbook and affiliation center policies shall be subject to disciplinary action.

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Sanctions

Enumerated herein are the Offenses and its corresponding

Sanctions.

For MINOR OFFENSES:

10.1 Submission of incident report to the Clinical Coordinator within 24 hours.

10.2 Written reprimand

10.3 Oral and written apology to the concerned parties

10.4 Payment of actual damages incurred

10.5 Extension of duty hours

10.6 Referral to the Guidance Center for counseling

For MAJOR OFFENSES:

10.7 Submission of incident report to the Clinical Coordinator within 24 hours.

10.8 Oral and written reprimand

10.9 Oral and written apology to the concerned parties

10.10 Payment of actual damages incurred

10.11 Extension of duty hours

10.12 Failing grade for that particular rotation

10.13 Referral to the Guidance Center for counseling

10.14 Suspension with compulsory services

10.15 Denial of graduation privileges

10.16 Dismissal from the internship program

10.17 For grave offenses, expulsion from the program

10.18 Other sanctions as deemed proper by the Clinical Coordinator, Program Chair,

College Dean, Prefect of Discipline and/or the VP of Academic Affairs

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Merits and Demerits

Merits and demerits shall be computed at the end of every

clinical rotation and shall be applicable to ALL internship programs.

11.1 Merits

Merits may be earned as a reward for a job well done. It shall be made as a

recommendation by the staff, personnel or preceptor of affiliation center. It shall be

validated by the Clinical Coordinator and approved by the Program Chair. It may be

earned in any of the following cases:

11.1.1 Volunteer work as officially requested by the affiliation center

beyond intern’s duty hours as approved by the department.

11.1.2 Volunteer work in the school during an institutional activity.

11.1.3 As a delegate or representative of the school in any competition or

events.

11.2 Demerits and Sanctions

A student intern while on duty may demonstrate inappropriate behavior ormisdemeanor. As such, demerits may be earned in any of those situations or cases and

shall serve its corresponding sanction /extension duty. A tabulation of demerits is found

on the succeeding page.

.

.

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Table 1. Demerits and Sanctions

NO DEMERITS

SANCTIONS

EXTENSION DU

1 Out of post 1 day

2 Not in proper prescribed uniform 1 day

3 Failure to submit portfolio at the end of the week 1 day

4 Using cellular phones, tablets & other gadgets inside affiliation center 2 days

5 Entertaining visitors inside the center during duty hours 2 days

6 Insubordination (disrespect / discourtesy towards superiors, CI) 2 days

7 Sleeping/eating/smoking during clinic hours 2 days

8 Conducting business, recruitment or any type of networking 2 days9 Vandalism, stealing, fighting inside the affiliation center Suspension

10 Taking home of patient’s charts Suspension

11 Gambling during duty & within the premises of the assigned center Suspension

12 Loss of patient’s chart Suspension

13 Being involved in a sexual harassment case Dismissal

14 Alteration /Tampering of doctor’s orders Dismissal

15 Breach of confidentiality Dismissal

16 Falsification of documents (clinic forms. etc.) Dismissal

17 Intoxication within the premises of the assigned center Dismissal

18 Reporting for duty under the influence of prohibited drugs. Dismissal

19 Carrying deadly weapons, drugs or drug paraphernalia Dismissal

20 Loss of center-owned property Replacement

21 Damage of center-owned propertyReplacement

Repair

For sanctions that merit suspension and dismissal, policy as stated on Articles IX and

X of this Guidebook shall apply.


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Monthly Revalida

As an enhancement program of the department for graduating interns,

a written Revalida will be given monthly. This program aims to help them in

preparation for the incoming Optometry Licensure Examination (OLE).

12.1 Proficiency ExaminationThe proficiency examination shall consist of 100-items in Multiple Choice Question

(MCQ) format to be administered within a two-hour period. Schedule of subjects will be a

follows:

First Semester

12.1.1 Ocular /Visual Biology

12.1.2 Physiological Optics / Binocular Vision and Perception

12.1.3 Ocular Diseases and Ocular Emergencies

12.1.4 Ocular Pharmacology

Second Semester

12.1.5 Theoretical /Practical Optics, Ophthalmic Dispensing/ Contact Lens Optics

12.1.6 Primary Care and Refraction

12.1.7 Clinical Optometry: Low Vision, Contact Lens, Ocular Prosthesis, Pediatri

Opto, Geriatric Opto, Neuro-Opto, Occupational/Industrial Opto, Public Health Opto, Sports

Vision

12.1.8 Ethics and Jurisprudence, Practice Management

12.2 Any intern who arrives 15 minutes late for the Revalida will NOT be allowed to

take the examination and will receive a failing grade for that specific exam.

12.3 Said Revalida will be given for interns with excused absences. Policy on absences

stated earlier will apply.

12.4 Passing Grade

A passing grade of at least 75% is required. An intern who receives a grade below the

passing mark of 75% will be pulled-out from duty to retake the proficiency examination. Pull

out from duty will be considered as an excused absence equivalent only to one (1) day

extension duty.

12.5 Failing Grade

A maximum of 3 takes shall be accorded to an intern. In case of failure on the third take, tha

intern will receive a grade of 5.0 for that particular subject. The intern has to take and pass the

said exam again by the end of the internship rotation. Passing ALL of the exams is a

requirement for internship clearance.

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Performance and Evaluation

Every student intern shall be graded by the Clinical Preceptor in

accordance with a set of criterion based on his/her performance

inside an assigned affiliation center.

13.1 Evaluation Forms

An internship evaluation form is provided for every rotation. It contains a set of

criterion based on knowledge, skills acquired and personal attributes.

13.1.1 Internship Clinical Evaluation Form

This is used for hospital, eye centers and optical rotations.

13.1.2 Internship Clerical Evaluation FormThis is used for rotations in the school wherein each intern is assigned to areas

where management and office skills are learned.

13.2 Performance and evaluation shall be computed as follows:

INTERNSHIP ROTATION: 60%

Preceptor Evaluation 60%

Portfolio of Learning Experiences 40%

100%

WRITTEN REVALIDA: 40%

Weekly Quizzes/Monthly Revalida 80%

Decorum 10%

Attendance 10%

100% ____

PERIODIC GRADE 100%

13.3 Final Clinical Internship Grade

The final clinical internship grade is computed as the grade average of the four

Grading periods:

PRELIM + MIDTERM + PREFINAL + TENT. FINAL

4

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Portfolio of Learning Experiences

This portfolio is a narrative report in which contains rich

experiences, activities and personal insights by an intern inside the

affiliation center. Experiences, activity and observations inside the

affiliation centers should be done objectively and with tact.

14.1 Requirement

An electronic copy shall be submitted to the Clinical Coordinator weekly.

14.2 Content

The portfolio must contain the following:

14.2.1 Learning experiences

14.2.2 Profile of the affiliation center

14.2.3 Background of patients/clients served

14.2.4 Description of the clinical practice

14.2.5 Interests from the internship experience

14.3 Final Activity Portfolio

A final copy in hardbound (for the entire class) must be submitted at the end

of each semester. It shall contain photos taken inside the affiliation centers as evidence and

shall be used for documentation by the department in future inspection and monitoring

visits by CHED, PACUCOA and PRC.

14.4 Format

14.4.1 Font - Arial 11

14.4.2 Margins - Top, bottom, left & right margins is 1 inch

14.4.3 Spacing - 1.5

14.5 The activity portfolio is included in the intern’s computation of grades and also a

requirement for clearance.

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Post-Internship Recognition &

Pinning Ceremony

At the end of the clinical internship/externship period, a

culminating activity is held wherein student interns shall receive their Certificates ofCompletion and qualified interns shall be awarded for their exemplary performance in each

of their assigned affiliation centers.

15.1 Attendance

ALL student interns shall be required to attend the Post-Internship

Recognition & Pinning Ceremony together with their respective parents or guardians.

15.2 A Certificate of Completion and Optometry Pin shall be given to an intern who

has completed his/her clinical rotation within the prescribed period.

15.3 An intern who is still serving make-up or extension duties shall be given the

Optometry Pin, while the Certificate of Completion shall be given only AFTER completion of

the said make-up or extension duties.

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Awards & Recognition

Optometry interns who demonstrated exemplary performance

during their rotation inside their respective affiliation centers are

rewarded for a job well done. The following awards are given:

DEPARTMENTAL AWARDS:

16.1 BEST IN ATTENDANCE

Certificate of Recognition for having Complete Attendance (no record of absences nor

tardiness) during the 10-month Clinical Internship/Externship period

16.2 OUTSTANDING INTERN (in selected affiliation center)

Certificate of Recognition for garnering the highest grade in the different affiliation centers

16.2.1 Qualifications

To achieve the abovementioned departmental award, an intern must have:

16.2.1.1 Garnered the highest average internship evaluation during

the internship period in an affiliation center.

16.2.1.2 No incurred unexcused absences of more than 5% of the

total required duty hours.

16.2.1.3 No record of any disciplinary action involving minor or major

offenses.

16.2.2 TIE-BREAKER

Should two or more interns garner an equal grade percentage of evaluation, the

recognition shall be given to the intern with:

16.2.2.1 No record or least record of tardiness16.2.2.2 No record of unexcused absences

16.2.2.3 No record of any form of misdemeanor or misconduct during

the clinical rotation

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INSTITUTIONAL AWARDS:

16.3 MOST OUTSTANDING OPTOMETRY INTERN

This honor is given to a student intern who has shown exemplary performance in

clinical duties and is consistently topping the proficiency examinations during the 10-

months internship period, thereby obtaining the HIGHEST OVER-ALL GRADE for Internship

16.3.1 Qualifications for the Most Outstanding Optometry Intern

To achieve this award, an intern must have:

16.3.1.1 Garnered the highest average internship grade during the 10-

months internship period.

16.3.1.2 No incurred unexcused absences of more than 5% of thetotal required duty hours.

16.3.1.3 No record of any disciplinary action involving minor or major

offenses either at the SPS or in this department.

16.4 BEST IN CLINICAL OPTOMETRY

This award is given to a student intern who has excelled and exhibited an

outstanding performance thereby obtaining the highest over-all grade in terms of clinical

Optometry subjects such as Clinical Contact Lens, Clinic and Conference, Clinical Neuro-

Optometry, Clinical Orthoptics and Pediatric Optometry, Clinical Low Vision and Geriatric

Optometry.

16.5 TIE-BREAKER

Should two or more interns garner an equal grade percentage in the

abovementioned institutional awards, the recognition shall be given to the intern with:

16.5.1 No record or least record of tardiness

16.5.2 No record of unexcused absences

16.5.3 No record of any form of misdemeanor or misconduct during

the clinical rotation.


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Commencement Ceremony

After completion of the six years Optometry curriculum, a

student is now ready to receive his/her diploma and be conferred the

baccalaureate degree of Doctor of Optometry in a prestigious and solemn

graduation ceremony.

17.1 Eligibility

To qualify for Graduation, a student must have:

17.1.1 Satisfactorily completed ALL the academic and non-academic

requirements from first year to sixth year.

17.1.2 Satisfactorily completed ALL the requirements of the Clinical

Internship/ Externship Training Program. This includes patient requirements, reports,

research paper, case presentations and portfolio of learning experiences.

17.1.3 Been fully-cleared from ALL obligations (e.g. financial, library) to

the school and affiliation centers. An intern with unsettled financial obligation with the

school will NOT be allowed to march during the Commencement Exercises.

17.1.4 Accomplished and finished ALL extension duties one (1) DAY

before the Commencement Exercises.

17.2 Cut-off Time

Cut-off time for submission of ALL academic and non-academic requirements,

financial obligations and any extension duties shall be at 3:00 pm one (1) DAY before

graduation. An intern who is unable to comply will NOT be allowed to march during the

Commencement Exercises.

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Clinical Internship

Forms

&Templates


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CONFORME SHEET and WAIVER

This is to certify that I have read and fully understood the Policies and

Implementing Guidelines governing the Optometry Clinical Internship/ Externship

Program of Davao Doctors College Inc. I attest that I am participating in the said

program in partial fulfillment of my requirements for the degree Doctor of Optometry.

Therefore I freely and voluntarily obligate myself to abide by the Policies and

Implementing Guidelines of both the school and affiliation centers where I will be

assigned. I shall do my best to act responsively in my capacity as an Optometry

intern of Davao Doctors College Inc.

With My Conformity:

_______________________________ _______________________________Student’s Signature over Printed Name Parent’s Signature over Printed Name

_________________ _________________Date Date

Witnessed by:

MYRA O. DE LEON, OD ERLYN B. HIPOLITO, OD, FIACLE, MAEd-HPEClinical Coordinator Optometry Program Chair

JOSHUA P. SERO, RRT, MAEd-HPE Dean, College of Allied Health Sciences


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PROFILE ofAFFILIATION

CENTERS


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At Eye Laser Center, DDC-Optometry Clinical interns will:

1. Have an opportunity to be trained by an outstanding practitioner in the person

of Dr. Raul Tolentino whose practice is into refractive surgery, cataract

management such as phaco-emulsification and management of retinal diseases.

2. Be exposed on latest trends in eye diagnostic procedures and instruments such

as:

a. Ocular Coherence Tomography (OCT)

b. Yag Laser c. Perimetry

d. Aberrometer

e. Corneal Topographer

f. Non-contact Tonometer

3. Learn how to interpret findings from the instruments mentioned above.

4. Have the opportunity to watch an actual cataract phaco-emulsification

procedures inside the operating room.

5. Participate in the provision of Optometric services such as refraction and visual

acuity taking under the direct supervision of an in-house Optometrist.

6. Experience the use of common diagnostic and therapeutic procedures involved

in the problem solving stages of the delivery of eye care.

LEARNING OUTCOMES @ EYE LASER CENTER


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LEARNING OUTCOMES @ RESOURCES FOR THE BLIND

At Resources for the Blind Inc., DDC-Optometry Clinical interns will:

1. Assess patients with low vision problems through the assistance of low vision

practitioners.

2. Be assigned to various areas of the facility and help provide assistance to

pediatric patients with low vision problem during their training.

3. Be exposed to patients with visual impairment who are learning how to use

low vision devices and Braille in order to read.

4. Be assigned a particular case and prepare a case presentation or report.5. Design an appropriate activity plan for patients with visual impairment.

6. Outline a patient management plan and rehabilitation.


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LEARNING OUTCOMES @ DAVAO EYE CENTER

At Davao Eye Center, DDC-Optometry Clinical interns will:

1. Experience an exposure and observations on the following diagnostic

procedures:

a. Fluorescein Angiogram (FA)b. Ocular Coherence Tomography (OCT)c. IOL Master (Non-contact)d. Biometry (Contact)

e. Perimetry (Octopus 101)f. B-scang. Yag Laser for non-invasive eye surgeries

h. Argon Laser for patients with diabetes, vein/artery occlusion andglaucomai. Minor Operating Procedures

2. Experience clinical exposure to areas of general ophthalmology procedures.

3. Have an understanding of the role of a "health team" in patient management

and continuity of care including relationships with other professionals in the

field of eyecare.

4. Experience how preventive eyecare plays an importance role in an early

diagnosis of ocular and vision anomalies, including ocular-related disorders.

5. Develop the ability to respect other professionals involved in eyecare.

6. Develop the habit of updating oneself in the field of eyecare by attending

seminars and forums given by residents or practitioners in their own fields of

expertise.


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LEARNING OUTCOMES @ DR. GESTUVO EENT CLINIC

At Dr. Gestuvo EENT Clinic , DDC-Optometry Clinical interns will:

1. Experience clinical exposure to areas of general ophthalmology practice, such

as management of simple ocular diseases.




and continuity of care including relationships with other professionals in thefield of eyecare.



5. Develop the ability to respect other professionals involved in eye care.

6. Appreciate the eye and vision as part of a composite system or senses in

relation to hearing, taste and smell.


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LEARNING OUTCOMES @ MORADA CATARACT AND EYE DISEASESCLINIC

At Morada Cataract and Eye Diseases Clinic, DDC-Optometry Clinical interns will:

1. Experience clinical exposure to areas of general ophthalmology practice, such

as cataract management and anterior ocular diseases.

2. Participate in the provision of Optometric services such as refraction, visual

acuity taking and external eye procedures under the direct supervision of an in-

house Ophthalmologist.




and continuity of care including relationships with other professionals in the

field of eyecare.



6. Develop the ability to respect other professionals involved in eye care.

7. Develop the attitude and passion for continuous reading for updates regardingvision and eyecare.


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LEARNING OUTCOMES @ IDEAL VISION CENTER (IVC)

At Ideal Vision Center, DDC-Optometry Clinical interns will:

1. Be exposed to the changing patterns of Optometric care and familiarize with

emerging patterns of eye care delivery in a commercial setting.

2. Have hands-on-experience with actual patients on clinical procedures in

Optometry such as contact lens fitting, refraction and patient dispensing.

3. Have practical experience in office management and business aspects of

Optometric practice.

4. Experience how to trouble –shoot problems encountered with patients and

realize the role of Optometrists in patient education.

5. Learn how to do marketing strategies to boost sales.

6. Familiarize with current trends in Optometric practice, latest eyewear, lens

products and new technologies in relation to vision care.


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LEARNING OUTCOMES @ DELOS REYES OPTICAL

At Delos Reyes Optical, DDC-Optometry Clinical interns will:




Optometry contact lens fitting, refraction and patient dispensing.






6. Review on benchwork procedures from frame selection, pattern making, cutting,

edging and final lens mounting to dispensing procedures.




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LEARNING OUTCOMES @ VISUAL SENSE OPTICAL CLINIC

At Visual Sense Optical Clinic, DDC-Optometry Clinical interns will:




Optometry contact lens fitting, refraction and patient dispensing.











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LEARNING OUTCOMES @ GEORGE OPTICAL CLINIC

At George Optical Clinic, DDC-Optometry Clinical interns will:



2. Have hands-on-experience with actual patients on clinical procedures in Optometry

contact lens fitting, refraction and patient dispensing.

3. Observe and participate during cycloplegic refraction procedures.



5. Experience how to trouble–shoot problems encountered with patients and realize

the role of Optometrists in patient education.




8. Familiarize with current trends in Optometric practice, latest eyewear, lens products

and new technologies in relation to vision care.


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linical Internship

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ROTATION 1 Affiliation:_____________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ROTATION2 Affiliation:_____________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________

___________________________________________________________________________

ROTATION3 Affiliation:_________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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ROTATION4 Affiliation:___________________

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ROTATION5 Affiliation:___________________

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________

_________________________________________________________________________

ROTATION6 ____Affiliation:_________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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ROTATION 1 Affiliation:_____________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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____________________________________________________________________________________

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___________________________________________________________________________


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ROTATION4 Affiliation:____________________

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________

__________________________________________________________________________


___________________________________________________________________________________

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__________________________________________________________________________


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EV LU TION OF

STUDENT-INTERN

EXPERIENCES


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DAVAO DOCTORS COLLEGEGen. Malvar St., Davao City 8000

Tel. Nos.: (082) 222 - 0850 to 53 Fax: 221-1074 E-mail: [email protected]

Web: www.davaodoctors.edu.ph

EVALUATION TOOL

Department: _____________________ Name: __________________________

Course & Year____________________ Semester / Term __________________

Please give us your views so that training/practicum quality can be improved. You are encouraged

to be frank and constructive in your comments. Kindly encircle the number that corresponds to

your view.

5- Strongly Agree 4- Agree 3- Uncertain 2- Disagree 1- Strongly Disagree

No. ITEMS 5 4 3 2 1

A. PERSONNEL

1 The staff, preceptors and doctors in the eye centers are caring andhelpful.

5 4 3 2 1

2The staff, preceptors and doctors are fair in their treatment to studentinterns and to the clinical instructor. 5 4 3 2 1

3 Administrators/ supervisors are available to hear the clinical instructor’sand student interns’ concerns. 5 4 3 2 1

4 Clinical instructors and student interns feel welcome in the institution.5 4 3 2 1

5The staff, preceptors and doctors readily guide or advise student internson some procedures in the absence of clinical instructors in a certain

time.

5 4 3 2 1

B. SERVICES

1 Gives orientation to student interns 5 4 3 2 1

2Implements the Optometry affiliation guidelines in dealing with studentdisciplinary procedures. 5 4 3 2 1

3 Provides exposure to help student interns to achieve performance goals 5 4 3 2 1

4 Accords student interns the opportunity to handle special cases 5 4 3 2 1

5 Provides opportunity for special area/s of assignment 5 4 3 2 1

C. FACILITIES

1Provides safe and secure area and facilities for student interns.

5 4 3 2 1

2 Provides adequate and safe location for student interns to stay 5 4 3 2 1

3 Allows access and use of needed facilities for learning 5 4 3 2 1

4Provides adequate facilities that enhance students intern’ competencies

5 4 3 2 1

5 Provides facilities for training and other related activities 5 4 3 2 1


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D. Additional core questions: Please answer briefly and honestly.

1. Did you gain additional knowledge from the exposure in the affiliation center? Explain.

________________________________________________________________________________ ________________________________________________________________________________

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ___________________________________

2. Did you develop the necessary skills intended to be learned during the exposure? Explain.

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ___________________________________

3. Did you develop the right attitudes necessary for the practice of the profession? Explain.

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ___________________________________

4. How did the teaching skills of your clinical instructors and preceptors affect your learning?

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ___________________________________

5. Was the atmosphere in the training center helpful to your training? Explain.

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ___________________________________

Thank you very much!

mds/mlfv/maccp/jps/lbb


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EVALUATION TOOL

Preceptor’s name: _______________________________ Date: _________________

Affiliation Center: ________________________________

Please give us your views so that training quality can be improved. You are encouraged to be frank and

constructive in your comments. Please answer briefly and honestly.

A. Students Performance(Dealing & handling patients, dealing with Supervisors & staff)

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

B. Internship Program Processes

(Training program, Duties & responsibilities) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

C. Clinical Instructor

(Attendance, dealing with supervisors & staff)

______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________


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CHED CMO.38 s 2007

CHED CMO.26 s.2009

DDC Student Handbook 2014 edition

Policies, Standards and Guidelines for Optometry Program

http://www.blind.org.ph

http://brokenshire.org/bmh

http://www.ddh.com.ph

http://www.delosreyesoptical.com.ph

https://www.facebook.com/pages/Eye-Crafter-Optical-Clinic

https://www.facebook.com/pages/Maria-Lalaine-Dumangas

http://www.idealvisioncenter.com.ph

http://www.georgeoptical.com.ph

Documents

GUIDEBOOK to Clinical Optometry Internship 2016