Overview of clinical/practicum placement sites
Criteria 3.1 and 3.5
(personnel and resources)
Template 3B
Note: A separate form should be completed for each clinical/practicum site. Clinical/practicum sites include hospitals, clinics and/or emergency medical services that provide student
placements. Provide the sample and the blank template to each clinical/practicum site.
Clinical/practicum site
[Name of clinical/practicum site]
Criterion 3.1 — Personnel involved in supervising and evaluating students
Person(s) responsible for liaison with the program
and coordination of student placements
Person(s) responsible for training, supervision, assessment and evaluation of students
(roles, designation, number )
Others involved in the training and
supervision of students
(no assessment)
(roles, designation, number)
Criterion 3.5 — Resources
Clinical program components provided
and
Duration of student placement within each
component
Maximum number of students
(per placement at any one time, as
applicable)
Major equipment available for student
education
Total annual volume
and
Volume by clinical program components
Template 3B revised by CMA Accreditation in January 2014