ALBERTA INNOVATES – HEALTH SOLUTIONS
2015 SUMMER STUDENTSHIP FINAL REPORT FORM
1500, 10104 – 103 Avenue, EDMONTON, AB T5J 4A7
Student
Report
Form
Phone: (780) 423-5727
Fax: (780)
429-3509
Email: grants.health@aihealthsolutions.ca
Student Report Form
NOTE: Please submit this report within one month of the completion of your summer studentship award.
The personal information collected through this form may be used to evaluate the AIHS Summer Student Program. The
information you share with us will be compiled with that of other summer students for analytic purposes. Only aggregate
results will be reported and responses will not be linked to particular individuals. The collection of this information is
authorized under Section 33(c) of the Freedom of Information and Protection of Privacy Act and the privacy protection
provisions of that Act will protect it.
SECTION 1:
PERSONAL DATA
Name: Surname, First Name, Initial(s)
Complete Mailing Address:
CONTACT NUMBERS:
Phone: xxx-xxx-xxxx
Email:
SECTION 2:
RESEARCH ACTIVITIES (Please provide a brief description of the research activities carried out during
the term of your award, specific techniques used/learned, summarize any significant results obtained, and identify any
publications/presentations resulting from your activities.)
SECTION 3:
RESEARCH TRAINING (Please rate how strongly you agree or disagree with each of the following
statements by placing a check mark in the appropriate box. Please include any comments to help us understand your
choices.)
Strongly
Disagree Not sure /
Agree
Strongly
disagree
Neutral
agree
The quality of the research training that I received this
summer was high.
The quality of the supervision that I received this
summer was high.
The quality of the facility where I worked this summer
was high.
I feel that I made an important contribution to my
supervisor’s research program.
The majority of training and supervision was provided by:
Graduate Student
Post-Doctoral Research Fellow
Research Assistant
Academic Supervisor (as listed in application)
Other (please specify):
I generally interacted with my academic supervisor (as listed in application):
Daily
Weekly
Monthly
Less Frequently/Never
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SECTION 4:
IMPACT OF SUMMER STUDENTSHIP (Please rate how strongly you agree or disagree with each of the
following statements by placing a check mark in the appropriate box. Please include any comments to help us understand
your choices.)
Strongly
Disagree
Not sure /
Agree
Strongly
disagree
Neutral
agree
I am more interested in pursuing a career in health
research as a result of my summer student
experience.
I have a greater appreciation of the practice and
importance of health research as a result of my
summer student experience.
Comments:
SECTION 5:
POST-AWARD OCCUPATION (Please indicate the program in which you will be enrolled, or the sector in
which you will be employed, immediately following the term of your summer studentship. Check one.)
Program
Undergraduate (same program as prior to summer studentship)
Undergraduate (different program than prior to summer studentship)
Graduate studies (Master's)
Graduate studies (PhD)
Doctor of Medicine (MD)
Academic employment (e.g., lab position at a university)
Private sector employment (e.g., pharmaceutical company)
Other (please specify):
If you indicated "Undergraduate" or "Graduate Studies" above, please indicate the subject of the program in which you will
be enrolled following completion of your summer studentship (e.g., Biochemistry, Pharmacy):
SECTION 6:
GENERAL COMMENTS (Please provide any general comments about the AIHS Summer Studentship
program including ways in which the program could be improved.)
Comments:
If you have any questions concerning the completion of this form, please contact Kari Larson, Coordinator, at (780) 4299334 or kari.larson@aihealthsolutions.ca.
Thank you for your assistance.
Carolina Koutras, PhD
Program Manager, Training and Early Career Development
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