Geriatric Log
STUDENT: ____________________________________________________
Rotation Site / Preceptor:_________________________________________
Rotation Date: _________________
Rotation Period #:______________
Clinical faculty review (mid-rotation):_________________________________________
(Clinical faculty signature / Date)
Clinical faculty review (end of rotation):________________________________________
(Clinical faculty signature / Date)
Students are required to complete the Student Log to receive credit for the rotation. The log’s purpose is to ensure that each student is exposed to the
depth and breadth of Geriatrics. The log outlines procedures that the student should perform. Please document the number of procedures in which
you performed.
For each procedure listed below, record either:
a) The number of procedures performed. (The target minimum is for your reference, but please record the total number of procedures performed)
b) If procedure was not performed, please mark appropriate column.
Procedure
Target
minimum
#(Numeric)
Performed
Example: History and Physical
10
9
Vital Signs
10
Started IV
4
Joint Injection
2
OMT
10
Inserted Foley Catheter
2
Venipuncture
3
Punch Biopsy
1
Suture/Staple Removal
4
Mini-Mental Exam
5
Suture/Staple Placement
3
Nail Removal
2
I&D
2
Cerumen Removal
3
History and Physical
10
Not Performed
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