GHANA COLLEGE OF NURSES & MIDWIVES
DISSERTATION SUPERVISION RECORD
*Membership/Fellowship supervision record (to be completed by residents and confirmed by supervisor[s]) *
Resident ID……………………… Year……………………
Date…………………………..
Name of Resident
Name of Supervisor
Date of meeting
Face-to-face [ ]
Virtual [ ]
Mode of meeting
Duration of meeting
Summary of issues discussed (To be filled by resident):
Recommendations made (To be filled by resident):
Targets for next meeting:
Is this a true record? (supervisor) Yes [ ]
Further supervisor comments:
No [ ] (comments if NO)
…………………………………
Resident Signature
…………………………………
Supervisor Signature