Work Based Activities Instructional Plan

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1. Work-based activities have objectives appropriate for the respective program Medical Assistant and are properly planned and supervised. (Required.)

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2. Each work-based activity has a written instructional plan for students specifying the particular objectives, experiences, competencies, and evaluations that are required. (Required.)

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3. The instructional plan designates the on-site employer representative responsible for guiding and overseeing the students’ learning experiences and participating in the students’ written evaluations. (Required.)

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4. All work-based activities conducted by the institution are supervised by a designated employee possessing appropriate qualifications. (Required.)

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5. Comments:

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7. Print Name - (Thank you for your participation!) (Required.)

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8. Today's Date (Required.)

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