General
Information:
The following is an example of a format to use for your internship log. The content in your log entries should clearly reflect activities related to neuropsychology as noted in this example. Please use the following checklist:
___ 1. Use first name and initials for the last name or initials for both first and last name for the patient/client.
___ 2. Please highlight those activities that involve direct supervision and record the cumulative hours
___ 3. Submit a hard copy of logs for each 100 hours of internship experience along with several sample-reports with all ID information deleted.
___ 4. Please make sure that both you and your supervisor sign the “ Internship Evaluation” form for each 100 hours of internship before they are submitted to myself. Please keep a copy of all three completed evaluations in case additional copies are requested from you.
___ 5. At the end of your internship experience, submit all the above items (e.g., logs and sample reports) on a CD – I may post some of them on my Web page.
___ 6. Use the descriptive information below at the top of each of your log submissions.
___ 7. It will be your responsibility to contact me and request a “change of grade” for your internship. Please ensure that all the above items are completed before the grade change is requested.
______________________________________________________________________________________________________________
Name: ___________________________ Email: _______________________ Date: _____________________
Rating Period: ______ (0-100 hrs): ______ (101-200 hrs.): _____ (201-300 hrs.)
Internship Location: ____________________________________________________________________________
Supervisor(s): _________________________ Email: _____________________ Phone: _______________________
___________________________________________________________________________________________________________________________
SAMPLE LOG
Internship Log for Activities at ------ Hospital
Name: Lori ------ Email: -------- Rating Period: 0-100
hours
Supervisor: Dr. ------ Phone: --------
|
Date |
Category
of Activity |
Type
of Case |
Client |
Activity
Details |
Hours |
Cum.
Hours |
|
6/17/02 |
Other |
|
|
Orientation |
1 |
1.0 |
|
|
Assessment |
Sleep Apnea & Language Delays |
Joshua M. |
Observed Testing Session (DAS, PPVT-III, NEPSY) |
1 |
2.0 |
|
|
Assessment |
Developmental Delays |
Stephen A. |
Observed Testing Session (PPVT-III and CELF) |
1 |
3.0 |
|
|
Professional Development |
|
|
Reading Test Manuals (NEPSY) |
1 |
4.0 |
|
|
Supervision |
|
|
Discuss Test Batteries and upcoming clients with Supervisor |
.5 |
4.5 |
|
|
Professional Development |
|
|
Reading over test manuals for CMS and PPVT-III,
uploading template, reading sample reports |
3.0 |
7.5 |
|
|
Professional Development |
|
|
Read Article on Nonverbal Learning Disabilities |
1.0 |
8.5 |
|
6/21/02 |
Assessment |
Epilepsy and Developmental Delays |
Clara M. |
Administered the DAS preschool version and
observed other assessments |
3.0 |
11.5 |
|
|
Professional Development |
|
|
Reading over test manuals for WJ-III, CELF, and
BRIEF. Reading article on epilepsy |
2.5 |
14.0 |
|
|
Supervision
|
|
|
Learning to use computerized scoring programs (BASC and BRIEF)
and discussing upcoming case |
2.0 |
16.0 |
|
|
Professional Development |
|
|
Continued reading chapter on epilepsy |
1.0 |
17.0 |
|
6/27/02 |
Professional Development |
|
|
Readings on Epilepsy and Fetal Alcohol syndrome |
1.5 |
18.5 |
|
|
Assessment |
Language Delays and Academic difficulties |
Max R. |
Observed assessment using CELF-3 and WJ-III |
1.5 |
20.0 |
|
|
Professional Development |
|
|
Readings on Fetal Alcohol Syndrome |
1.0 |
21.0 |
|
|
Supervision |
|
|
Discussed current test subject, scored protocols, reviewed CMS
and WJ-III, planned for upcoming tests, reviewed files, and discussed readings
on epilepsy |
2.0 |
23.0 |
|
|
Professional Development |
|
|
Scored BRIEF and BASC protocols, reviewed files
for upcoming tests |
1.5 |
24.5 |
|
|
Professional Development |
|
|
Finished readings on fetal alcohol syndrome |
1.0 |
25.5 |
|
6/28/02 |
Assessment |
Language Delays and Academic Difficulties |
Max R. |
Administered WISC-III and observed Tower of
London, WJ-III, and Animal Naming administration. Scored protocols. |
4.0 |
29.0 |
|
|
Professional Development |
|
|
Copied selected readings on dyslexia, the Tower
of London, and others related to Neuropsychological functioning. Read article on Central Auditory
Processing Disorder |
3.0 |
32.0 |
|
|
Professional Development |
|
|
Read article on Lead Poisoning and its effects
on learning and development |
1.0 |
33.0 |
|
7/1/02 |
Assessment |
Academic Difficulties and Cerebral Palsy |
Stacy J. |
Administered WJ-III and PPVT-III. |
1.5 |
34.5 |
|
|
Assessment |
Language and Behavioral Difficulties (Beckwith
Wiedeman Syndrome) |
Zachary C. |
Administered WISC-III and WRAT-3. Scored
protocols for Stacy and Zach. |
2.5 |
37.0 |
|
|
Assessment |
TBI |
Chrisopher L. |
Administered WISC-III, WRAT-3, VMI, and
PPVT-III. Scored protocols |
3.5 |
40.5 |
|
|
Professional Development |
|
|
Continued readings on effects of lead poisoning. |
1.5 |
42.0 |
|
7/8/02 |
Assessment |
Academic Difficulties and Cerebral Palsy |
Stacy J. |
Administered the WISC-III, CMS, VMI and Finger
Windows. Scored Protocols. |
3.0 |
45.0 |
|
|
Professional Development |
|
|
Continued reading articles on dyslexia. |
1.0 |
46.0 |
|
|
Assessment |
TBI |
Rachel O. |
WASI, WRAT-3, VMI. Scored Protocols |
2.0 |
48.0 |
|
|
Supervision |
|
|
Discussed today’s cases and planned for upcoming cases. Met upcoming inpatient clients. |
1.5 |
49.5 |
|
7/12/02 |
Assessment |
TBI |
Edward D. |
Administered DAS, VMI, PPVT-3. Scored Protocols. |
2.5 |
52.0 |
|
|
Assessment
|
TBI |
Ryan L. |
Observed administration of the DKEFS Tower and
other assessment measures. |
.5 |
52.5 |
|
|
Supervision
|
|
|
Discussed the afternoon testing schedule |
.5 |
53.0 |
|
|
Assessment |
TBI |
Ryan L. |
Prepared for testing
and administered WISC-III, WJ-3, VMI and PPVT-3. |
4.0 |
57.0 |
|
7/15/02 |
Assessment |
Academic Difficulties |
Christopher P. |
Administered WISC-III, WJ-3, VMI and
PPVT-3. Scored protocols. |
4.0 |
61.0 |
|
|
Supervision |
|
|
Discussed morning case and those coming up in the afternoon. |
1.0 |
62.0 |
|
|
Assessment |
TBI |
Rachel O. |
Administered the CMS and Finger Windows |
1.5 |
63.5 |
|
|
Professional Development |
|
|
Copying and reading articles on memory and
epilepsy. |
2.0 |
65.5 |
|
7/19/02 |
Assessment |
TBI |
Edward D. |
Administered Finger Windows, Peg Board, CMS, and
WRAT-3. Scored protocols. |
2.5 |
68.0 |
|
|
Professional Development |
|
|
Reviewed DKEFS test and read article on TBI |
1.5 |
69.5 |
|
|
Assessment |
Behavioral Concerns |
David L. |
Administered CMS and Finger Windows and observed
DKEFS. |
2.0 |
71.5 |
|
|
Supervision |
|
|
Discussed research related to neuropsychology, discussed how
the internship was going thus far, and planned for upcoming week. |
1.0 |
72.5 |
|
|
Professional Development |
|
|
Continued Readings on TBI |
1.5 |
74.0 |
|
7/22/02 |
Assessment |
Day School Patient for Behavior Problems and
Suicidal Ideation |
Jamal M. |
Observed WISC3 and VMI administration by Masters
Level Student. Gave the PPVT3 and
WRAT-3. Scored Protocols. |
3.0 |
77.0 |
|
|
Professional Development |
|
|
Organized articles by subject manner for ease in
reading and reference. |
1.0 |
78.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Input scores into template and began to mentally
organize ideas for neuropsychological report. |
2.0 |
80.0 |
|
|
Supervision |
|
|
Went over case that I will be writing neuropsychological report
on. |
1.0 |
81.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Began Writing Neuropsychological Report by
reviewing DKEFS manual. |
.5 |
81.5 |
|
7/24/02 |
Supervision |
|
|
Discussed the day’s upcoming cases and prepared for
assessments. |
.5 |
82.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Worked on writing neuropsychological report. |
4.0 |
86.0 |
|
|
Assessment |
Seizures |
Tonea K. |
Administered CMS, PPVT-3, WASI, WRAT-3, Finger
Windows, Pegboard, and VMI. Scored Protocols. |
3.5 |
89.5 |
|
7/25/02 |
Supervision |
|
|
Discussed upcoming cases and planned for assessments |
.5 |
90.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Worked on writing neuropsychological report. |
1.0 |
91.0 |
|
|
Assessment |
TBI |
James B. |
Administered WRAT-3, VMI and PPVT-3. |
1.0 |
92.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Continued writing neuropsychological report. |
.5 |
92.5 |
|
|
Assessment |
TBI |
James B. |
Administered Token Test. Scored Protocols. |
.5 |
93.0 |
|
|
Report Writing |
Academic Difficulties |
Christopher P. |
Continued writing neuropsychological report. |
1.5 |
94.5 |
|
|
Assessment |
TBI |
Edward D. |
Scored Protocols. |
.5 |
95.0 |
|
|
Professional Development |
|
|
Readings on Attention Deficit Hyperactivity
Disorder (ADHD) and Executive Functions. |
2.5 |
96.0 |
|
|
Professional Development |
|
|
Readings on closed head injuries. |
1.0 |
98.5 |
|
7/26/02 |
Professional Development |
|
|
Copying Best Practices Guide for TBI Assessments
and other articles on administration of the Tower of London. Readings on
Developmental Dyslexia. |
1.5 |
100.00 |