Sample webform for Independent Study satisfying Medical Humanities Capstone

Note: This is not the actual webform but it looks something like the one you will fill in once you have registered for PHIL366000. You can use the information filled in here as a guide and as a source to copy and paste standard language.

 

Independent Study and DLE Agreement

Students will originate the form, which will outline specific student and faculty guidelines to be performed in order to earn credit for individual research or reading project. This form serves as the contract between student and instructor. If this independent study is to be a Discovery Learning Experience (DLE), additional student learning goals are completed.

Questions? Contact the department offering the Independent Study Course.


 Student information

Student:

 

Ed Sample (7000xxxx)

Address:

 

12 Main St. Newark, DE 19702. United States

E-mail:

 

jstudent@udel.edu

Phone:

 

302-555-5555

 

 Course information

Course:

 

[year and semester] - PHIL366000 INDEPENDENT STUDY

Credits:

 

1

Do you intend to take this as an honors course?

 

No

Do you intend to take this as a Discovery Learning Experience (DLE)?

 

No

Course title:

 

INDEPENDENT STUDY

Faculty supervisor:

 

Mark Greene  (mkgreene@udel.edu)
302-831-0448

 

 Independent study information

Independent study start date:

 

mm/dd/yyyy

Independent study end date:

 

mm/dd/yyyy

Schedule:

 

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

0

0

1

0

0

0

0

TOTAL HOURS:

1

Title of independent study project:

 

MED HUMANITIES CAPSTONE

Description of independent study project:

 

Reflect upon and discuss overall experience in medical humanities courses. Prepare essay discussing the insights gained from the minor. Redraft in light of discussion and comments from faculty advisor.

Description of what student expects to learn from experience:

 

Draw together interdisciplinary themes from courses in the Medical Humanities Minor. Ability to state and defend own thesis on the role of humanities in medical study or practice. Refine writing skills.

Description of how experience fits into overall academic goals:

 

Completes requirements for Medical Humanities Minor.

Description of student obligations:

 

Meeting with faculty advisor as. Timely completion of draft and final versions of essay.

 

This section is to be completed by the faculty supervisor. Refer to the Resources for Independent Study or DLE courses for additional information.

Description of faculty supervisor obligations:

 

Describe how you will share with the student your expectations about the quantity and quality of the experience and the required products. Note that your expectations for student learning must be on the syllabus or otherwise communicated to the student in writing.
4000 characters left.

 

How often will you meet with the student to assess progress, advances, and roadblocks?

 

500 characters left.

As often as needed.

How often and in what format will you give feedback on the quality of the student’s progress and on the intermediate products/assignments?

 

500 characters left.

In meetings, by email, and written comments on drafts of essay.

Explanation of experiential learning experience:

 

Explain how this course is an experiential learning experience and how it involves out-of-class and beyond typical curriculum instructional experiences.
4000 characters left.

Critical reflection on the relationships between a range of courses across different disciplines. Assessment of own experience in Medical Humanities classes. Improvement of written communication through self-editing and responding to verbal and written comments on drafts of essay.

 

Explanation of critical thinking skills learning goal:

 

Explain assignments or other experiences that offer opportunities for the student to apply critical thinking skills and academic knowledge/concepts to develop effective responses to, and make informed decisions about, problems or situations encountered in the course of the learning experience.
4000 characters left.

 


Critical thinking assessment:

 

Assessment of critical thinking learning goal - Explain how you will measure or know if student has achieved the critical thinking learning goal to your satisfaction. (Note that you will be provided with a short form to indicate how well your student met this learning goal, which must be returned to the Center for Educational Effectiveness at the completion of this project.

 


Explanation of reflection learning goal:

 

Explain assignments or other experiences that offer opportunities for student to engage in reflection, which incorporates self-assessment and analysis of the learning that has occurred as a result of their participation in the DLE. At a minimum, students will be expected to examine and demonstrate what they have learned as a result of the DLE, how they have learned it, the impact of their learning on their personal and professional growth, and how to apply that learning in other situations or contexts.
4000 characters left.

 


Reflection learning goal assessment:

 

Explain how you will measure or know if student has achieved the reflection learning goal to your satisfaction. Note that you will be provided with a short form to indicate how well your student met this learning goal, which must be returned to the Center for Educational Effectiveness at the completion of this project.

Description of honors work:

 

Describe the elements which will distinguish the Honors independent study from a non-Honors one. Specifically how will this challenge, enrich, and enhance the academic experience of the honors student(s) beyond what would be obtained in a regular independent study?
4000 characters left.

 


 

 Off-site study information

Company or Organization:

 

University of Delaware

Site supervisor's name:

 

Jane Sitesuper

Site supervisor's title:

 

Manager

Site supervisor's address:

 

12 Main St.
Newark, DE 19702
United States (USA)

Site supervisor's e-mail::

 

janesup@udel.edu

Site supervisor's phone:

 

302-831-6666

Site supervisor's fax:

 

 

 

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