NR630: Executive Practicum
Student Activities Log
Student's Name: Meghan Wenzel D#: 40469201
Mentor's Name: Michelle Thorne Name of Facility: Calhoun County Health Dep
Instructions: Complete information for each week onto this form adding rows as needed for
additional activities. See Practicum Guidelines in Course Resources for further details.
Required Hours: Minimum of 100 hours. Up to 40% (40 hours) of student activities can consist of: 1.
preparation for Management Activity Project; 2. research associated with the practicum experience
or teaching project; 3. research requested by mentor, agency or faculty; 4. attendance at a
professional meeting and any preparation for that meeting; 5. meeting with mentor and/or site
orientation prior to course opening, and 6. other activities that directly relate to the site
experience. All hours must be documented on Student Activity Log. Travel time to and from the
practicum site and time spent working on practicum portfolio requirements cannot be included in
the 100 hours. Documentation must demonstrate activities related to course outcomes, specialty
competencies and the student’s learning agreement.Please document activities from this 40% of
hours in the blue shaded areas each week.
Due dates: submitted each week (weeks 1 – 7) by 11:59 pm MT Sunday; completed and signed
activities log due by 11:59 pm MT Saturday of Week 8. Student and mentor must sign to verify
completion of hours before final submission Saturday of week 8.
Total Possible Points: 50
Note: 5 points will be deducted for each week the activities log was submitted past the deadline.
Instructions: Enter date of activity, description of activity, and duration of activity. Enter as
fractions of hours, such as "1.75" (1 hour 45 minutes). Record activites from the other 40% category
in the shaded blue area.
DATE DESCRIPTION OF PRACTICUM ACTIVITY Duration
Week 1
7/12/18 assisted with rabies/animal control issue, Learning Agreement, Phone Conferenc 7h
Child Lead Exposure Elimination Commission Action Plan Mtg, 2h
6/1/18 Meeting with mentor and site orientation prior to course opening 1h
7/12/18 Researched and reviewed MI Public Health Code 30m
7/12/18 researched DEA Medication Disposal Site 1h 30m
1
, Total Week 1 12h
Week 2
7/16/18 Albion Interviews
7/17/18 Toller staff mtg
Total Week 2 0.00
Week 3
7/24/18 Michelle Datema, MS, RN, Nurse-Family Partnership Manager
7/26/18
7/27/18 Community Provider Meeting
Total Week 3 0.00
Week 4
8/1/18
8/2/18
Total Week 4 0.00
Week 5
8/8/18
8/9/18
2
Student Activities Log
Student's Name: Meghan Wenzel D#: 40469201
Mentor's Name: Michelle Thorne Name of Facility: Calhoun County Health Dep
Instructions: Complete information for each week onto this form adding rows as needed for
additional activities. See Practicum Guidelines in Course Resources for further details.
Required Hours: Minimum of 100 hours. Up to 40% (40 hours) of student activities can consist of: 1.
preparation for Management Activity Project; 2. research associated with the practicum experience
or teaching project; 3. research requested by mentor, agency or faculty; 4. attendance at a
professional meeting and any preparation for that meeting; 5. meeting with mentor and/or site
orientation prior to course opening, and 6. other activities that directly relate to the site
experience. All hours must be documented on Student Activity Log. Travel time to and from the
practicum site and time spent working on practicum portfolio requirements cannot be included in
the 100 hours. Documentation must demonstrate activities related to course outcomes, specialty
competencies and the student’s learning agreement.Please document activities from this 40% of
hours in the blue shaded areas each week.
Due dates: submitted each week (weeks 1 – 7) by 11:59 pm MT Sunday; completed and signed
activities log due by 11:59 pm MT Saturday of Week 8. Student and mentor must sign to verify
completion of hours before final submission Saturday of week 8.
Total Possible Points: 50
Note: 5 points will be deducted for each week the activities log was submitted past the deadline.
Instructions: Enter date of activity, description of activity, and duration of activity. Enter as
fractions of hours, such as "1.75" (1 hour 45 minutes). Record activites from the other 40% category
in the shaded blue area.
DATE DESCRIPTION OF PRACTICUM ACTIVITY Duration
Week 1
7/12/18 assisted with rabies/animal control issue, Learning Agreement, Phone Conferenc 7h
Child Lead Exposure Elimination Commission Action Plan Mtg, 2h
6/1/18 Meeting with mentor and site orientation prior to course opening 1h
7/12/18 Researched and reviewed MI Public Health Code 30m
7/12/18 researched DEA Medication Disposal Site 1h 30m
1
, Total Week 1 12h
Week 2
7/16/18 Albion Interviews
7/17/18 Toller staff mtg
Total Week 2 0.00
Week 3
7/24/18 Michelle Datema, MS, RN, Nurse-Family Partnership Manager
7/26/18
7/27/18 Community Provider Meeting
Total Week 3 0.00
Week 4
8/1/18
8/2/18
Total Week 4 0.00
Week 5
8/8/18
8/9/18
2
