INSTITUTE OF HEALTH TECHNOLOGY, DHAKA

(Affiliated with University of Dhaka)

Mohakhali, Dhaka-1212. Tel: 88029888940, Email: [email protected]

LOGBOOK
FOR
PHYSIOTHERAPY INTERNSHIP

LOGBOOK
OF

SOHRAF HOSSAIN
COURSE NAME: BACHELOR OF SCIENCE IN PHYSIOTHERAPY
DU REGISTRATION NO.: 6375
SESSION: 2015-2016

INSTITUTE OF HEALTH TECHNOLOGY, DHAKA

DEPARTMENT OF PHYSIOTHERAPY
MOHAKHALI, DHAKA-1212.
 PARTICULAR TO BE FILLED BY THE INTERN PHYSIOTHERAPIST
1) Name of the Intern Physio: ……………………………………………………………………………………………………………….
2) Father’s Name: …….…………………………………….………3) Mother’s Name: ……………...……...……………...……………..
4) Date of Birth : ………………………………………………………………………………………………………………………. ….
5) Address :-
Present Address- Permanent Address-

Village/House…………………………………………………… Village/House……………………………………………………
P.O:…………………..……....Thana/P.S:……………………… P.O:…………………..……....Thana/P.S:………………………
Dist:……………………Contact No:…………………………… Dist:……………………Contact No:……………………………

6) Course Name: …………………………………………………………………………………………………. ………………………….

7) Name of University: …………………………………….........................Faculty of………………............………………………………
8) University Reg. No: ……......................……. 9) Session : ………………… 10) Passing Year : …………………………………..
11) Name of the Hospital/Medical Institute where He placed for Internship;
 ………………………………………………………………………………………………………………………………………………
 ………………………………………………………………………………………………………………………………………………
 ………………………………………………………………………………………………………………………………………………
12) Duration of Internship:………………… Month/Year.
13) Period of Internship: From……………………………………………….……..to………….………………………………………...……
14) Date of joining: ………………………………………………. 15) Date of Completion: ………………………………………………..

Signature & Date of Intern Physiotherapist Signature & Date of the Dept. Head of Physiotherapy (IHT- Dhaka).
 List of Contains

CONTENTS PAGE NO.

SECTION –A 1-3
A.1 Purpose of this Logbook 1
A.2 Introduction of Physiotherapy 1
A.3 Goals of Physiotherapy 1-2
A.4 Objectives of Physiotherapy 2-3
A.5 Objectives of the Physiotherapy Internship Program 3
SECTION –B 4-6
B.1 Rules & Regulations for Intern Physiotherapist 4-5
B.2 Placement in other Discipline 5
B.3 Code of Medical Ethics-Geneva Declaration 6
SECTION –C 7-22
Internship report, Special Notes & Clearance Form 7-22
 SECTION –A
A.1 Purpose of this Logbook:
1. This logbook will form a part of the pre-requisite for joining internship training.
2. This logbook will help the internee physiotherapist to record his/her training in brief, so that experience can be recorded and deficiencies identified
and corrected.
3. This logbook will help the supervisor to assess the overall training and provide extra experiences for the trainees in the areas where it is most needed.

A.2 Introduction of Physiotherapy:

Physiotherapy is a health care profession concerned with human function and movement and maximizing potential. It uses physical approaches to
promote, maintain and restore physical, psychological, and social well-being, taking account of variations in health status. It is science-based and
committed to extending, applying, evaluating, and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical
judgment and informed interpretation is at its core (CSP, 2002).

Physiotherapy is a recognized autonomous healthcare profession that has a first contact status and physiotherapists are capable of assessing and treating
a patient within their scope of practice without the need for referral, supervision, or delegation by other healthcare practitioners. A physiotherapist works
in an open and equal professional partnership with a medical practitioner in the care of patients. From a medical practitioner not being legally or ethically
required before physiotherapy services are provided (WCPT declaration 1995).

A.3 Goals of Physiotherapy:

The role of physical therapy is to help regain and restore the pain-free and comfortable movement and overall health that a person experienced prior to
an injury, illness or disability.

To achieve this, the physical therapist will design and monitor a planned program using a holistic approach. The goal is both to restore physical health,
quality of life and overall wellness to the patient, while minimizing the risk of injury or illness in the future.

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Physical therapy can be helpful for people of all ages, with a wide range of health conditions. The role of the referring primary care physician and family
members or care-givers, will always be included in the plan, wherever this is appropriate or required.

A.4 Objectives of Physiotherapy:

The Specific Objectives will focus on the Competencies that students must acquire:

1. Know and understand the morphology, physiology, pathology and behavior of people, both healthy and sick, in the natural and social
environment.
2. Know and understand the sciences, models, techniques and instruments on which physiotherapy is based, articulated and developed.
3. Know and understand the methods, procedures and physiotherapeutic actions, aimed both at the therapy itself to be applied in the clinic for re-
education or functional recovery, as well as the performance of activities aimed at promoting and maintaining health.
4. Acquire adequate clinical experience that provides intellectual abilities and technical and manual skills; that facilitates the incorporation of ethical
and professional values; and to develop the ability to integrate the knowledge acquired; so that, at the end of their studies, the students know how
to apply them both to specific clinical cases in the hospital and extra-hospital environment, as well as to actions in primary and community care.
5. Assess the functional status of the patient, considering the physical, psychological and social aspects.
6. Diagnostic assessment of physiotherapy care according to the standards and with internationally recognized validation instruments.
7. Design the physiotherapy intervention plan taking into account criteria of adequacy, validity and efficiency.
8. Execute, direct and coordinate the physiotherapy intervention plan, using their own therapeutic tools and attending to the individuality of the
user.
9. Evaluate the evolution of the results obtained with the treatment in relation to the objectives set.
10. Prepare the discharge report for physiotherapy care once the proposed objectives have been covered.
11. Provide effective physiotherapy care, providing comprehensive assistance to patients.
12. Intervene in the areas of health promotion, prevention, protection and recovery.
13. Know how to work in professional teams as a basic unit in which the professionals and other personnel of healthcare organizations are structured
in a uni or multidisciplinary and interdisciplinary way.
14. Incorporate the ethical and legal principles of the profession into professional practice as well as integrate social and community aspects in
decision-making.
15. Participate in the development of physiotherapy care protocols based on scientific evidence, promoting professional activities that stimulate
physiotherapy research.
16. Carry out physiotherapeutic interventions based on comprehensive health care that involves multi professional cooperation, integration of
processes and continuity of care.

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 17. Understand the importance of updating the knowledge, abilities, skills and attitudes that make up the professional competencies of the
physiotherapist.

A.5 Objectives of the Physiotherapy Internship Program:

At the end of the training a physiotherapist should be able to:
1. Initial assessments of patients with symptoms related to general & special cases.
a. Obtaining pertinent history and keeping the records in writing.
b. Performing physical examinations correctly.
c. Formulating a working diagnosis.
d. Planning an inquiry strategy, ordering appropriate investigations, and interpreting results.
e. Deciding whether the patient requires:
 Ambulatory care or hospitalization
 Referral to other health professionals
2. Manage skillfully patients from emergency & OPD up to rehabilitation
a. Counseling individual patients.
b. Examining all relevant systems.
c. Detecting pre-existing problems.
d. Detecting and treating any complication occurring during the treatment period may be hazardous to the health of the patient.
e. Advising patient about rehabilitation.
f. Maintaining follow-up and records of patients including summarization and index.
g. 3. Undertake research and publish findings.

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 SECTION –B
B.1 Rules & Regulations for Intern Physiotherapist:
1.Internship training should be for one year in different specialized hospitals/medical
institutes are selected by the mother institute or the choice by intern candidate.
2.Only after the satisfactory completion of the intern training, the trainee will be issued their internship completion certificate.
3.Facilities for the Internees:
a) Monthly remuneration: according to standard pay scale of Bangladesh health service.
b) Timetable: Saturday to Thursday from 8.00 am to 2.00 pm.
c) Leave: The student undergoing an internship may enjoy only 20 days of annual leave. He/she may enjoy all public holidays and weekly
holidays.
d) Sick Leave: Sick leave may be considered by the head of the department after having the approval of the concerned supervisor.
e) Any absence will be counted as anti-disciplinary and a penalty may be imposed as decided by the head of the concerned department.
f) Accommodation: Accommodation facilities will depend on availability.
4.Duties & Responsibilities:
a) To work as a full-time member of this department either at -
b) IPD; OPD; ICU; NICU; HDU; CCU or Emergency of hospitals or another base.
c) To be clinically accountable to a named supervisor and to be administratively accountable to the training course coordinator and head of the
department.
d) To be responsible for a caseload under the direction of the head of the department.
e) To be responsible for independently managing caseload efficiently.
f) To demonstrate a professional attitude at all times.
g) To work in the different specialties approved by mother institute on a rotational basis.
h) Responsible for developing a broader knowledge basis relevant to each specialty.
i) To be responsible for further improvement of clinical skills in assessment, treatment & evaluation of intervention appropriate to each specialty.
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 j) Responsible for co-coordinating, sharing ideas among departmental staff, and contributing to the multi-disciplinary team.
k) Responsible for maintaining accurate and up-to-date records of patients.
l) To commit to professional development via independent learning.
m) Responsible for attending departmental meetings and conferences.
n) To attend ward round.
o) Responsible for supervision of placement of physiotherapy students in specialized hospitals in Dhaka and other parts of the country if
necessary.
p) Responsible for maintaining Hospital /Institute rules & regulations and cooperation with all staff.
q) No private practice is allowed during internship training.

B.2 Placement in other Discipline:

1. The head of the department will select ward & intern’s specification.
2. All the interns will be supervised by the supervisors selected by the head of the department.

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B.3 Code of Medical Ethics:
GENEVA DECLARATION (As a Medical Professional):

1. I solemnly pledge to dedicate my life to the service of humanity;

2. The health and well-being of my patient will be my first consideration;
3. I will respect the autonomy and dignity of my patient;
4. I will maintain the utmost respect for human life;
5. I will not permit considerations of age, disease or disability, creed, ethnic origin,
gender, nationality, political affiliation, race, sexual orientation, social standing, or
any other factor to intervene between my duty and my patient;
6. I will respect the secrets that are confided in me, even after the patient has died;
7. I will practice my profession with conscience and dignity and in accordance with
good medical practice;
8. I will foster the honor and noble traditions of the medical profession;
9. I will give my teachers, colleagues, and students the respect and gratitude that is
due;
10. I will share my medical knowledge for the benefit of the patient and the
advancement of healthcare;
11. I will attend to my health, well-being, and abilities to provide care of the highest
standard;
12. I will not use my medical knowledge to violate human rights and civil liberties,
even under threat;
13. I make these promises solemnly, freely, and upon my honor.

……………………………………….
Signature of the Intern Physiotherapist Date:…..../……./………….

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 SECTION –C

Internship report, Special Notes & Clearance Form

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 National Institute of Cancer Research & Hospital (NICRH)
Mohakhali ; Dhaka-1212; Bangladesh.

Intern Student/Physiotherapist Evaluation Form

Department of Physical Medicine & Rehabilitation (Physiotherapy)

Name of the Intern: …………………………………………………………………………………………………………………................

Name of the Institute:………………………………………………………………………………………………………………………….
University Reg; No: …………………………………………… Academic Session: ………………………………………………………
Date of Joining :………………….……… Date of Completion: …………………………… Duration: ………………………………….

SL No. Evaluation Area Marks Obtain Range of Grades

01 Attitude: Relationship with supervisor, patients; collegue, & other 10 Marks Marks
staffs.
91-100 Excellent
02 Grooming: Self (Apron,Shirt, Hair, Nail ,Teeth,Shaving ;etc) & 10
Treatment (Grooming on treatment place). 81-90 Good
03 Time: Arrival time in hospital & Stay time. 10 71-80 Fair
04 Co-operation: Co-operation with supervisor;mates;patients & other 10
staffs. 61-70 Better than general
05 Attendance: 10 50 -60 General
06 Treatments (Practical skills): All type of procedures like ;Assesment, 10
investigations, exercises, manual skills, mechine operates, home
advices, etc.
07 Safety: Personal safety,patients safety & instruments safety. 10
08 Record Keeping: Patient records;Assesment ;Treatment, Improvement 10
& Lecture note records.
09 Academic Knowledge Gathering: Theoritical & Practical knowledge 10
about professional subject.
10 Professional Ethics/Medical Ethics- 10

Signature of the supervisor Signature of the Departmental Head Signature of the Director

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 Internship Report of the Intern Physiotherapist

Name of the Intern:…………………………………………………………………………………………………...……..……….………….

Name of the Institute:………………………………………………………………………………….……………...………..………………..
Reg; No.:………………..…. Session:……………..……….…………Passing Year:……….…..…… (Held in )…………….……………....
1. Name of the Hospital /Institute:…………………………………………………………………..………………………………..…………
2. Name of the Clinical Department: ……………..………………………………………………………………….…………………………
3. Period of Placement:…………………………………..….. From………………..…..………….…to………………….…………………..
4. Date of Joining:.………..…./……….……/…………….……… 5. Date of Completion: ………..,….../.……………../……..……………
6. Placement Report:

DURATION OF TRAINING REMARKS

Signature of the Supervisor Signature of the Departmental Head

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 SPECIAL NOTES

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 SPECIAL NOTES

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 Recommendation for Internship Certificate

This to certify that; Mr.………………………………………………………………………………………………….

Father………………………………………..…………………….Mother…………………….………………………,
Institute/University……………………………………………………………………………….……………………..
Course…………………………………………………………………………………………….……………………..
Session……………………………University Reg.No…………………………….……Has successfully complete his
internship training from………………………………..to…………………………….. as an intern Physiotherapist at
…………………………………………………………………………………………………………………………..
…………………………………………………… under the Department of………………………………………….
……………………………………………………………………………………………………………………

So, he may be issued a one-year internship training completion certificate from the office of the Institute of Health
Technology, Dhaka.

I wish every success in his life.

Signature of the Departmental Head

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 National Institute of Traumatology & Orthopaedic Rehabilitation
(NITOR) Sher -E-Bangla Nagar; Dhaka-1207.
Intern Student/Physiotherapist Evaluation Form
Department of Physiotherapy

Name of the Intern: …………………………………………………………………………………………………………………................

Name of the Institute:………………………………………………………………………………………………………………………….
University Reg; No: …………………………………………… Academic Session: ………………………………………………………
Date of Joining :………………….……… Date of Completion: …………………………… Duration: ………………………………….

SL No. Evaluation Area Marks Obtain Range of Grades

01 Attitude: Relationship with supervisor, patients; collegue, & other 10 Marks Marks
staffs.
91-100 Excellent
02 Grooming: Self (Apron,Shirt, Hair, Nail ,Teeth,Shaving ;etc) & 10
Treatment (Grooming on treatment place). 81-90 Good
03 Time: Arrival time in hospital & Stay time. 10 71-80 Fair
04 Co-operation: Co-operation with supervisor;mates;patients & other 10
staffs. 61-70 Better than general
05 Attendance: 10 50 -60 General
06 Treatments (Practical skills): All type of procedures like ;Assesment, 10
investigations, exercises, manual skills, mechine operates, home
advices, etc.
07 Safety: Personal safety,patients safety & instruments safety. 10
08 Record Keeping: Patient records;Assesment ;Treatment, Improvement 10
& Lecture note records.
09 Academic Knowledge Gathering: Theoritical & Practical knowledge 10
about professional subject.
10 Professional Ethics/Medical Ethics- 10

Signature of the supervisor Signature of the Departmental Head Signature of the Director

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 Internship Report of the Intern Physiotherapist

Name of the Intern:…………………………………………………………………………………………………...……..……….………….

Name of the Institute:………………………………………………………………………………….……………...………..………………..
Reg; No.:………………..…. Session:……………..……….…………Passing Year:……….…..…… (Held in )…………….……………....
1. Name of the Hospital /Institute:…………………………………………………………………..………………………………..…………
2. Name of the Clinical Department: ……………..………………………………………………………………….…………………………
3. Period of Placement:…………………………………..….. From………………..…..………….…to………………….…………………..
4. Date of Joining:.………..…./……….……/…………….……… 5. Date of Completion: ………..,….../.……………../……..……………
6. Placement Report:

DURATION OF TRAINING REMARKS

Signature of the Supervisor Signature of the Departmental Head

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 SPECIAL NOTES

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 SPECIAL NOTES

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 Recommendation for Internship Certificate

This to certify that; Mr.………………………………………………………………………………………………….

Father………………………………………..…………………….Mother…………………….………………………,
Institute/University……………………………………………………………………………….……………………..
Course…………………………………………………………………………………………….……………………..
Session……………………………University Reg.No…………………………….……Has successfully complete his
internship training from………………………………..to…………………………….. as an intern Physiotherapist at
…………………………………………………………………………………………………………………………..
…………………………………………………… under the Department of………………………………………….
……………………………………………………………………………………………………………………

So, he may be issued a one-year internship training completion certificate from the office of the Institute of Health
Technology, Dhaka.

I wish every success in his life.

Signature of the Departmental Head

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 National Institute of NeuroSciences & Hospital (NINS)
Sher-E-Bangla Nagar; Dhaka-1207; Bangladesh .
Intern Student/Physiotherapist Evaluation Form
Department of Physical Medicine & Rehabilitation (Physiotherapy)

Name of the Intern: …………………………………………………………………………………………………………………................

Name of the Institute:………………………………………………………………………………………………………………………….
University Reg; No: …………………………………………… Academic Session: ………………………………………………………
Date of Joining :………………….……… Date of Completion: …………………………… Duration: …………………………………

SL No; Evaluation Area Marks Obtain Range of Grades

01 Attitude: Relationship with supervisor,patients;collegue,& other staffs. 10 Marks Marks
02 Grooming: Self (Apron,Shirt, Hair, Nail ,Teeth,Shaving ;etc) & 10
91-100 Excellent
Treatment (Grooming on treatment place).
03 Time: Arrival time in hospital & Stay time. 10 81-90 Good
04 Co-operation: Co-operation with supervisor;mates;patients & other staffs. 10 71-80 Fair
05 Attendance: 10
61-70 Better than
06 Treatments (Practical skills): All type of procedures like ;Assesment, 10
general
investigations, exercises, manual skills, mechine operates, home advices, etc.
50 -60 General
07 Safety: Personal safety,patients safety & instruments safety. 10
08 Record Keeping: Patient records;Assesment ;Treatment, Improvement & 10
Lecture note records.
09 Academic Knowledge Gathering: Theoritical & Practical knowledge about 10
professional subject.
10 Professional Ethics/Medical Ethics- 10

Signature of the supervisor Signature of the Departmental Head Signature of the Director
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 Internship Report of the Intern Physiotherapist

Name of the Intern:…………………………………………………………………………………………………...……..……….………….

Name of the Institute:………………………………………………………………………………….……………...………..………………..
Reg; No.:………………..…. Session:……………..……….…………Passing Year:……….…..…… (Held in )…………….……………....
1. Name of the Hospital /Institute:…………………………………………………………………..………………………………..…………
2. Name of the Clinical Department: ……………..………………………………………………………………….…………………………
3. Period of Placement:…………………………………..….. From………………..…..………….…to………………….…………………..
4. Date of Joining:.………..…./……….……/…………….……… 5. Date of Completion: ………..,….../.……………../……..……………
6. Placement Report:

DURATION OF TRAINING REMARKS

Signature of the Supervisor Signature of the Departmental Head

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 SPECIAL NOTES

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 SPECIAL NOTES

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 Recommendation for Internship Certificate

This to certify that; Mr.………………………………………………………………………………………………….

Father………………………………………..…………………….Mother…………………….………………………,
Institute/University……………………………………………………………………………….……………………..
Course…………………………………………………………………………………………….……………………..
Session……………………………University Reg.No…………………………….……Has successfully complete his
internship training from………………………………..to…………………………….. as an intern Physiotherapist at
…………………………………………………………………………………………………………………………..
…………………………………………………… under the Department of………………………………………….
……………………………………………………………………………………………………………………

So, he may be issued a one-year internship training completion certificate from the office of the Institute of Health
Technology, Dhaka.

I wish every success in his life.

Signature of the Departmental Head

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