Clinical Education LogoClinical Education Guide

Resources for Clinical Educators, Site Coordinators and MHSc Students

Clinical Education Handbook

Clinical Education Guide – 2020-2021

Handbook Appendices

Appendix A – Coursework and Expectations

Course Outlines

Coming Soon

Recommended Course Schedule

Coming Soon


A3.1 Curriculum Map

Appendix B – Planning Documents

B1.1 Internship Practicum Contract – One-site

B1.2 Internship Practicum Contract-Two site

B1.3 Background Questionnaire

B1.4 Student Clinical and Professional Development Goals

Appendix C – Assessment Forms

Summative Feedback

C1.1 Feedback Log

C1.2 Learning Conference Form

Assessment Forms – 

C.2.1 Assessment of Student Performance and Grading Rubric – Unit-3-7-9

Appendix D – Embedded Placement Activities

Teaching Clinics

D1.1 Teaching Clinic Ground Rules

D1.2 Release of Video Recordings or Audio Recordings for Teaching Purposes

D1.3 Instructions for the preparation of video recordings

Guided Observation Activities

D2.1 Guided Observation Form – Child


Interprofessional Education (IPE) Component in a Clinical Placement – Flexible Model Activities

D3.1 Flexible Model Activity 1: Shadowing and/or Interviewing Team Members

D3.2 Flexible Model Activity 2: Analyzing Interprofessional Interactions of Team Members

D3.3 Flexible Activity 3: Collaborating with Team Members

Supplemental Placements

D4.1 Supplemental Placement 

a signed Summary of Clinical Practice Hours form must accompany this form if the student intends to claim these hours. See Appendix E1.1.

Appendix E – Hours Requirements and Tracking

NEW – E1.3 – Program Summary of Clinical Practice Hours Form – CLASS of 2021 and 2022 use this form to report hours accrued.

E.1 General Guidelines for Clinical Activities in Practicum Courses

CAUTION: Class of 2021 and 2022 – use the NEW form above moving forward (E1.3). For your references, here is the link to the old on-line hours database: (LINK).

Appendix F – Health and Immunization Requirements and Forms

Health Forms – This form is managed through the offices of the Graduate Coordinator and Student Affairs Assistant.

Note: you will need these forms several times over the course of the next two years, make multiple copies before submitting to U of T.

Appendix G – Student Support Services – Partial Funding Reimbursement

G1.1 Partial Funding Reimbursement Forms (excel)

G1.2 Travel Journal

Appendix H – Insurance – Accident or Injury while on placement

Declaration Forms

H1.1 Declaration-of-Understanding-Student

H1.2 Declaration of Understanding – Placement Site

COVID – 19 Insurance Updates Placements

The University’s general liability insurance remains in place and we have no exclusion for liability arising out of communicable disease. The Ministry of Colleges and Universities has confirmed that their workplace insurance coverage for unpaid placement continues for students during the COVID-19 pandemic and covers both students working remotely and in person.

In the event that a Student incurs a workplace injury or illness while in the course of the Placement, the Placement Site will immediately notify the University’s Placement Coordinator and will work with the University to complete the appropriate WSIB (or Chubb Insurance) claim form(s). For a COVID-19 claim to be allowed, evidence must show that the student’s risk of contracting the disease through their placement is greater than the risk to which the public at large is exposed and that work significantly contributed to the student’s illness.

In the Event of an Injury while on Placement

The Placement Employer has three days after learning of a placement incident to inform the University that the incident occurred. Please contact and cc the UofT course instructor. You will be guided to complete the H2.1 Letter of Authorization to Represent Employer, a claim form ( as per the Guidelines for Workplace Insurance for Postsecondary Students of Publicly Assisted Institutions on Unpaid Work Placements) and an accident report H2.2 U of T Accident Report/ The three completed forms will be submitted to