Vumc School of Medical Sciences
(SII) List of agreements during a placement of the Vumc School of Medical Sciences
Information about students and teachers
Name student: ................................ stud.nr. ........................................... Year of introd. ......................
Address ........................................... pc/place .......................................... phone. ..................................
Email student .................................. mobile phone ..................................
First / Second* placement .............. ....................................................... *cross out what’s not preferred
Placement (Title) ............................ ....................................................... .............................................
........................................................ ....................................................... .............................................
Type of internship: Minor/ Major (Master Thesis)
Department / division ...................... ....................................................... .............................................
External placement: institution/ address ................................................. .............................................
Supervisor 1 (day-to-day) ........................ room ...............phone. .......... email .................................
Supervisor 2 (Principal investigator) ......... .room ................phone ........... email .................................
Internal supervisor (VUmc)** .................... .room ...............phone. .......... email .................................
**External internships outside the VUmc require an internal expert.
Agreements; use “Regulations for internships” to fill in this form
1. Period of placement............................. weeks
Start date .............. ...................................
Date of termination ...................................
2. Interruptions during placement
from ........................................ to .... ...................................
from ........................................ to .... ...................................
3. Are there any courses that need to be followed during the placement? If so, which course(s)?
…………………………..(……ECTS)
from ........................................ to .... ...................................
…………………………..(……ECTS)
from ........................................ to .... ...................................
4. Are there any courses that have to be followed before starting the placement? If so, which
course(s)?
............................................................. ......................... ..................... .......
5. At least two oral presentations have to be performed,
first one after
weeks, language: ....................... ..................... .......
second one after
weeks, language: ....................... ..................... .......
6. Meetings with guiding teacher take place ........................... .............. times per. ...........................
(at least once a week)
Meetings with the examiner take place times per. ................ .............. (at least once a month)
7. Date interim assessment
8. Final paper is written in the form of an article / report*
9. Where to reach the student?
Student’s room: ............................ ................................ phone. ...............................................
Laboratory:
.............................. phone. .....................
Signature Supervisor 1
Signature Supervisor 2
Signature Student
Date
Date
z
Vumc School of Medical Sciences
(SIII) Interim assessment form during an internship of the Vumc School of Medical Sciences
Name student: ................................ stud.nr. ........................................... Year of introd. ......................
Address ........................................... pc/place .......................................... phone. ..................................
Email student .................................. mobile phone ..................................
Placement (Title) ............................ ....................................................... .............................................
........................................................ ....................................................... .............................................
Department / division ...................... ....................................................... .............................................
Fill in this self reflection form based on the following questions and hand in the form 1 week before the
assessment date.
 What skills did I learn so far?
 What are my strong subjects?
 What are the issues that I have to improve?
 How is the guidance during the internship by the supervisors?
Student:
Supervisor: (see for assessment subjects page 2)
Signature supervisor,
Signature student,
__________________
___________________
Vumc School of Medical Sciences
Subjects for the interim evaluation as based on the criteria for the practical assessment on the end of
the internship
Practical work
Insufficient
Sufficient
Good
Excellent
(<5.5)
(5.5 – 6.5)
(7.0 – 8.0)
(8.5 – 10)
not applicable
Motivation
Eagerness of the student to work on the project and the responsibility of the student for the success of
the project
Autonomy
How independent a student can perform the experiments and critically interprets the results from the
experiments
Insight
Perspective of a student to perform the right experiments related to the research question, determine the
relevance of his/her results and design the next experiments accordingly
Safety
Knowledge and compliance of the student to the rules and regulations of a lab, in particular related to
the safety restriction levels of the labs the student works in
Planning
The timely completion and structure of experiments
Accuracy
How careful and precise the experiments are performed
Initiative
Does the student his/her self come up with any new suggestions for experiments to improve the project
Creativity
Can the student adjust the experiments and the design of the project in such a way as to improve the
project
Cooperation
How well the student can collaborate with colleagues and researchers from other disciplines that are
related to the project
Other criteria…
Vumc School of Medical Sciences
(SIV) List of assessment for internships of the Vumc School of Medical Sciences
Name student: ................................................. stud.nr. ........................................ year of introd. .........................
Address ........................................................... place ............................................ phone. ....................................
Department: ..........................................Supervisor 1 .......................................... phone. ....................................
Supervisor 2 .......................................... phone ...................................
Assessment of the practical work
Insufficient
Sufficient
Good
Excellent
(<5.5)
(5.5 – 6.5)
(7.0 – 8.0)
(8.5 – 10)
not applicable
Motivation
Eagerness of the student to work on the project and the responsibility of the student for the success of the project
Autonomy
How independent a student can perform the experiments and critically interprets the results from the experiments
Insight
Perspective of a student to perform the right experiments related to the research question, determine the relevance
of his/her results and design the next experiments accordingly
Safety
Knowledge and compliance of the student to the rules and regulations of a lab, in particular related to the safety
restriction levels of the labs the student works in
Planning
The timely completion and structure of experiments
Accuracy
How careful and precise the experiments are performed
Initiative
Does the student his/her self come up with any new suggestions for experiments to improve the project
Creativity
Can the student adjust the experiments and the design of the project in such a way as to improve the project
Cooperation
How well the student can collaborate with colleagues and researchers from other disciplines that are related to the
project
Other criteria…
partial (50%) mark*:
Signature supervisor 1/supervisor 2/internal supervisor**
Date
Notes:* mark is an estimation based on the selected scores in the table
** Please tick where appropriate
Vumc School of Medical Sciences
Assessment of presentation
Insufficient
Sufficient
Good
Excellent
(<5.5)
(5.5 – 6.5)
(7.0 – 8.0)
(8.5 – 10)
not applicable
Clear slides
Not too much text per slide, nice figures and good structure/order of the slides
Use of other media
Is the appropriate media used for explanation
Planning / duration
Is the presentation balanced and finished within the agreed time period
Overall story
The overall story is clear and well presented
Represents practical
training
Presentation reflects the project and gives a good “take home message” of the findings
Discussion
Student is capable to answer questions and discuss the results
partial (25%) mark*: .................
Signature supervisor 1/supervisor 2/internal supervisor**
Date
Notes:
* mark is an estimation based on the selected scores in the table
** Please tick where appropriate
Vumc School of Medical Sciences
List of assessment for internships of the Vumc School of Medical Sciences
Name student: ................................................. stud.nr. ........................................ year of introd. .........................
Address ........................................................... place ............................................ phone. ....................................
Department: ..........................................Supervisor 1 ........................................... phone. ....................................
Supervisor 2 .......................................... phone ...................................
Internal Supervisor (**) …………………..phone …………………………..
Assessment of the report
Insufficient
Sufficient
Good
Excellent
(<5.5)
(5.5 – 6.5)
(7.0 – 8.0)
(8.5 – 10)
not applicable
Process of writing
How much guidance was needed and how well was the student equipped to process the criticisms into
improvements of the report
Processing of
literature
Is the current literature on the topic well represented and does the student place his/her own results in the light of
the recent findings of others
Processing of results
How well are the experiments during the internship summarized in the results section. Are they represented well in
tables and figures
Overall concept
Are the headlines and the details separated well. Is the report balanced in structure. Does the lay-out appear well
taken care of. Does it reflect the internship
Abstract/summary
Is the abstract concise including the aim of the project, the relevant results and important conclusions
Introduction
Does it reflect the background of the project including the aim. Is it not too long with too many details
Materials and
methods
Is it accurate including the right details
Results
Are the main findings correctly reflected in either figures or tables
Discussion /
conclusions
Are the essentials and inessentials correctly separated and are the findings discussed in the context of the current
literature. Are the future perspectives discussed
partial (25%) mark*:
Signature supervisor 1/supervisor 2/internal supervisor**
Date
Notes:
* mark is an estimation based on the selected scores in the table
** Please tick where appropriate
Vumc School of Medical Sciences
Final assessment score ( examination board )
Supervisor 1
Supervisor 2
Internal VUmc
Supervisor
50% practical work
xxxxxxxxxxxxxxxxxxxxx
25% presentation
xxxxxxxxxxxxxxxxxxxxx
25% report
Total mark*
Signature
Date
Notes:
* mark is an estimation based on the selected scores in the table