Undergraduate

Academic Record
Physiology

The TN Dr.M.G.R Medical

University
Chennai
 The Tamil Nadu
Dr.M.G.R. Medical University
Chennai

Under Graduate Academic Record

Department of Physiology

2
 Thanking....

“I thank all the illustrious faculty of Physiology

in the Medical Schools of this University for
their conscientious effort”

Dr. Sudha Seshayyan

3
 Preface
The new Graduate Medical Education Regulations attempts to stand
on the shoulder of the contributions and the efforts of resource persons,
teachers and students (past and present). It intends to carry forward the
process of learning enable the Indian Medical Graduate a consummate
provider of health care aligned to the evolving needs of the patients in every
socio-economic setting.
The thrust in the new regulations is the continuation and evolution of
thought in medical education making it more learner-centric, patient-centric,
gender sensitive, outcome -oriented and environment appropriate.
The result is an outcome driven curriculum which conforms to global
trends. Emphasis is made on alignment and integration of subjects both
horizontally and vertically while respecting the strengths and necessity of
subject-based instruction and assessment.
The importance of ethical values, responsiveness to the needs of the
patient and acquisition of communication skills is underscored by providing
dedicated curriculum time in the form of a longitudinal program based on
Attitude, Ethics and Communication (AETCOM) competencies. Great
emphasis has been placed on collaborative and inter-disciplinary teamwork,
professionalism, altruism and respect in professional relationships with due
sensitivity to differences in thought, social and economic position and
gender.
In addition to the above, an attempt has been made to allow students
from diverse educational streams and backgrounds to transition
appropriately through a Foundation Course. Dedicated time has been
allotted for self-directed learning and co-curricular activities. With this view
in mind the log book has been designed as per the guidelines of
competency based curriculum.
This Academic Record/Logbook for Undergraduate Medical Students
is to be maintained by the student and is part of the learner's personal
progress assessment toolkit. The learner shall present the Academic
Record/Logbook to the staff facilitator / mentor at the end of all class room
learning / practical sessions / integrated learning sessions / ECE / SDL /
AETCOM sessions and feedback sessions as called for by the faculty
facilitators / mentors. The progress shall be recorded in the various
segments of the record/Logbook and signed by the facilitator / mentor.

4
 Certificate

This is to certify that

Mr/ Ms. _________________________________
University Registration No __________ has
satisfactorily attended and completed all academic
activities as assigned in this logbook as per the
guidelines prescribed under the Tamil Nadu Dr.
M.G.R. Medical University in subject of
Physiology.

Head of Department

Date:
Place:

5
 Table of Contents

No Content Page

1 Background of the Course

2 Curriculum Vitae

3 Time Table

4 Haematology Record

5 Clinical Physiology Record

6 Assignment Response Record

7 Record of Integrated Sessions

8 Early Clinical Exposure

9 Self-Directed Learning

10 AETCOM Learning

11 Formative Feedback Record

12 Internal Assessment

13 Certification of Skills

14 Record of Project(s)

15 Photos Story

16 Co-Curricular Achievements

6
 1. Background of the Course
i) GOAL
The broad goal of the teaching of undergraduate students in
Physiology aims at providing the student comprehensive
knowledge of the normal functions of the organ systems of the
body to facilitate an understanding of the physiological basis of
health and disease.
ii) OBJECTIVES
a) KNOWLEDGE
At the end of the course the student will be able to:
(1) explain the normal functioning of all the organ systems and
their interactions for well-co-ordinated total body function.
(2) assess the relative contribution of each organ system to the
maintenance of the milieu interior.
(3) elucidate the physiological aspects of normal growth and
development.
(4) describe the physiological response and adaptations to
environmental stresses.
(5) list the physiological principles underlying pathogenesis and
treatment of disease.
b) SKILLS
At the end of the course the student should be able to:
(1) conduct experiments designed for study of physiological
phenomena.
(2) interpret experimental/investigative data.
(3) distinguish between normal and abnormal data derived as a
result of tests which he/she has performed and observed in the
laboratory.
c) INTEGRATION
At the end of the integrated teaching the student should acquire
an integrated knowledge of organ structure and function and its
regulatory mechanisms.

7
 2. Curriculum Vitae
1. Name of the Student
2. Date of Birth
3. Permanent Address

4. Contact Details
i. Residential Address

ii. Mobile No
iii. Land Line No
iv. Email ID
5. Name of Parent/Guardian
6. Residential Address

7. Land Line No (Home)

8. Mobile No Parents/Guardian

Signature

8
 3. Time Table

Week Mon Tue Wed Thur Fri Sat Sun

9
 4. Haematology Lab Record
Note:
1. This section captures the attainment of the various competency mile-stones
attained through haematology lab work.
2. The learner shall make observation in the lab and makes entries as mandated
in the concerned record book
3. The record books shall be verified by the faculty facilitator periodically / at the
end of each session or module and the completion of each such activity shall
be recorded in this section by the learner and signed by the facilitator.
4. The end of each session shall be appended by an end of training formative
assessment in the topic / session / module. eg: OSPE. Such sessional
outcomes and feed for such outcomes may be suitably entered in the
concerned documents.
No Test / Procedure / Experiment Date of Initials of
Completion Facilitator
1

10

10
No Test / Procedure / Experiment Date of Initials of
Completion Facilitator
11

12

13

14

15

16

17

18

19

20

11
 5. Clinical Physiology Lab Record
Note
1. This section includes academic mile stones attained through Clinical
Physiology lab work.
2. The learner shall make observation entries as mandated in the record book
3. The record note books shall be verified by the faculty facilitator at the end of
each session or module.
4. The completion of each such activity shall be recorded in this section by the
learner and signed by the facilitator
5. The end of each session shall be appended by an end of training formative
assessment in the topic / session / module. eg: OSPE, DOPS etc. Such
sessional outcomes and feed for such outcomes may be suitably entered in
the concerned documents.
No Test / Procedure / Date of Initials of
Experiment Completion Facilitator
1

10

11

12
No Test / Procedure / Date of Initials of
Experiment Completion Facilitator
12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

13
No Test / Procedure / Date of Initials of
Experiment Completion Facilitator
28

29

30

14
 6. Assignment Response Record
Note
1. This section includes academic mile stones attained through assignments /
out of class academic work.
2. The learner shall be given an assignment based on the “Nice to know” areas
of the curriculum and any other such topics as deemed necessary.
3. The learner shall submit the assignment in the offline / online module as
deemed by the individual institutions, which shall be assessed and graded by
the faculty facilitator.
4. The completion of such activity shall be recorded in this section by the learner
and signed by the facilitator

No Title of Assignment Date of Initials of

Submission Facilitator
1

10

11

15
No Title of Assignment Date of Initials of
Submission Facilitator
12

13

14

15

16

17

18

19

20

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 7. Record of Integrated Session
Note
1. This section includes academic mile stones attained through horizontal and
vertical integrated sessions.
2. The learner shall be attend all such integrated sessions and observe, interact
and understand the topic.
3. The learner shall submit the end of session assessment (eq: MCQ session of
15-20 MCQ questions)
4. The completion of such activity shall be recorded in this section by the learner
and signed by the facilitator

No Topic of the Integrated Date of Initials of

Session Session Facilitator
1

10

11

17
No Topic of the Integrated Date of Initials of
Session Session Facilitator
12

13

14

15

16

17

18

19

20

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 8. Early Clinical Exposure
Objectives of Early Clinical Exposure:
The objectives of early clinical exposure of the first-year medical learners are to
enable the learner to:
1. Recognize the relevance of basic sciences in diagnosis, patient care and
treatment
2. Provide a context that will enhance basic science learning
3. Relate to experience of patients as a motivation to learn.
4. Recognize attitude, ethics and professionalism as integral to the doctor-
patient relationship
5. Understand the socio-cultural context of diseases through the study of
humanities

Elements of ECE:
The three elements of ECE are:
1. Provision of clinical correlation to basic sciences learning.
2. Provision of authentic human contact in a social or clinical context that
enhances learning in the early/pre-clinical years of undergraduate education.
3. Introduction to humanities in medicine

Salient Principles:
The key principles underlying early clinical exposure are providing a clinical context
and ensuring patient centricity. Early clinical exposure provides for the three key
elements listed above. The clinical context can include case scenario, videos, actual
patient, simulated patient etc. The presence of actual patients in every session of
ECE, though not essential, is preferred. Therefore, ECE is exposure to the relevant
clinical context in earlier years. It must be noted that purpose of ECE is not to
prepone the conventional clinical teaching but to provide better understanding of
basic sciences through a clinical context.

Note:
1. This section includes academic mile stones attained through early clinical
exposure. The learner shall be assigned a specific learning objective for each
session.
2. The learner shall be assigned to such ECE sessions in groups as deemed
necessary by the individual institutions. The learner shall observe, interact,
understand and perceive the activity. They shall record a detailed synopsis of
the learning in this section. The student shall also record a detailed reflection
of their experience of what was observed.
3. The completion of such activity shall be recorded in this section by the learner
and signed by the facilitator.

19
ECE Session 1:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

20
ECE Session 2:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

21
ECE Session 3:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

22
ECE Session 4:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

23
ECE Session 5:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

24
ECE Session 6:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

25
ECE Session 7:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

26
ECE Session 8:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

27
ECE Session 9:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

28
ECE Session 10:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

29
ECE Session .....:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

30
ECE Session .....:
Date Initial of Facilitator

Objective of
ECE Session

Synopsis of Learning

Reflections

31
 9. Self-Directed Learning
SDL helps in empowering the student to perform an objective self-assessment of
knowledge and skills, continue learning, refine existing skills and acquire new skills,
to apply newly gained knowledge or skills to the care of the patient, to introspect and
utilize experiences, to enhance personal and professional growth and learning, to
search (including through electronic means), and critically evaluate the medical
literature and apply the information in the care of the patient and to identify and
select an appropriate career pathway that is professionally rewarding and personally
fulfilling.

Note:
1. This section includes academic mile stones attained through self-directed
learning. The learner shall be assigned a specific learning objective for each
session.
2. The learner shall be given an assignment based on the “Desirable to know”
areas of the curriculum and any other such topics as deemed necessary.
3. They shall record a detailed synopsis of the learning in this section. The
student shall also record a list of the books/journals referred in Vancouver
format.
4. The completion of such activity shall be recorded in this section by the learner
and signed by the facilitator

32
SDL Session 01:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

33
SDL Session 02:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

34
SDL Session 03:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

35
SDL Session 04:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

36
SDL Session 05:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

37
SDL Session 06:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

38
SDL Session 07:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

39
SDL Session 08:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

40
SDL Session 09:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

41
SDL Session 10:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

42
SDL Session 11:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

43
SDL Session 12:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

44
SDL Session 13:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

45
SDL Session 14:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

46
SDL Session 15:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

47
SDL Session 16:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

48
SDL Session 17:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

49
SDL Session 18:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

50
SDL Session 19:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

51
SDL Session 20:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

52
SDL Session 21:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

53
SDL Session 22:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

54
SDL Session 23:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

55
SDL Session 24:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

56
SDL Session 25:
Date Initial of Facilitator

Topic of SDL

Synopsis of the Study

Bibliography

57
 10. Attitudes, Ethics & Communications

The “Indian Medical Graduate” (IMG) shall possess requisite knowledge, skills,
attitudes, values and responsiveness, so that he or she may function appropriately
and effectively as a doctor of first contact of the community while being globally
relevant. In order to fulfill this goal, the IMG must be able to function in the following
ROLES appropriately and effectively:

1. Clinician who understands and provides preventive, promotive, curative,

palliative and holistic care with compassion.
2. Leader and member of the health care team and system with capabilities to
collect, analyse, synthesize and communicate health data appropriately.
3. Communicator with patients, families, colleagues and community.
4. Lifelong learner committed to continuous improvement of skills and
knowledge.
5. Professional, who is committed to excellence, is ethical, responsive and
accountable to patients, community and profession.

Note:
1. This section includes academic mile stones attained AETCOM learning. The
learner shall be assigned a specific learning objective for each session.
2. The learner shall be given an assignment based on the AETCOM topics of the
curriculum.
3. They shall record a detailed synopsis of the skill learnt in this section. The
student shall also record a reflection of the learning and learning process.
4. The completion of such activity shall be recorded in this section by the learner
and signed by the facilitator

58
AETCOM Session 01:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

59
AETCOM Session 02:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

60
AETCOM Session 03:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

61
AETCOM Session 04:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

62
AETCOM Session 05:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

63
AETCOM Session 06:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

64
AETCOM Session 07:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

65
AETCOM Session 08:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

66
AETCOM Session 09:
Date Initial of Facilitator

Topic of AETCOM

Synopsis of the Skill Learnt

Reflections

67
 11. Formative Feedback Record
Note:
1. This section captures the process of formative support of the faculty mentors
of the department during the learning and at the end of each section of study /
module of learning.
2. The mentor shall peruse the academic performance, progression and specific
academic needs of the learner.
3. The learner shall record in this section the type of formative assessment, topic
for which it was done, the performance and the feedback given by the learner
to the mentor on the performance, problems in learning, remedial required if
any and the feedback of the mentor.

68
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1. Classroom Learning [ ]

2. Assignment [ ]
3. Integrated Learning [ ]
4. Early Clinical Exposure [ ]
5. Self-Directed Learning [ ]
6. AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

69
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

70
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

71
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

72
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

73
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

74
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

75
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

76
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

77
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

78
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

79
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

80
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

81
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

82
Feedback Session No:
Date Time Initial of Facilitator

Type of Formative Assessment 1.Classroom Learning [ ]

2.Assignment [ ]
3.Integrated Learning [ ]
4.Early Clinical Exposure [ ]
5.Self-Directed Learning [ ]
6.AETCOM [ ]
Formative Assessment Done
For: (Topic / Section / Module of
Learning)
Feedback Given by the Learner

Feedback given by the Facilitator

83
 12A. Internal Assessment Record-Theory
Note:
1. This section captures the process of Assessment data of the learner at the
end of each section of study / module of learning.
2. The learner shall record their performance and get it verified by the facilitator

No Assessment Total Marks Marks Scored Initials of the

Topic Facilitator

4
5
6

10

11

12

13
14
15

16

84
 12B. Internal Assessment Record-Practical
Note:
1. This section captures the process of Assessment data of the learner at the
end of each section of study / module of learning.
2. The learner shall record their performance and get it verified by the facilitator

No Assessment Total Marks Marks Scored Initials of the

Topic Facilitator

4
5
6

10

11

12

13
14
15

16

85
 13. Certification of Skills
Note:
1. This section captures the skills and competencies obtained by the learner
during the course work in the department.
2. The facilitator shall assess the learner for the specific certifiable competency
and those certifiable competencies which the learner has acquired shall be
entered in this section. A record of these is also maintained in the assessment
record. (certifiable competencies for which the learner has not successfully
passed the assessment shall not be recorded here)

No List of Skills to be certified Initials of the

Facilitator
1

10

11

12

13

86
No List of Skills to be certified Initials of the
Facilitator
14

15

87
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

88
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

89
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

90
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning
Activity
Performed for
Assessment

Certified by

Signature of
Learner

91
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

92
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

93
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment
Certified by

Signature of
Learner

94
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

95
Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment
Certified by

Signature of
Learner

Certification of Skills
Type of Skill

Activity
Performed for
Learning

Activity
Performed for
Assessment

Certified by

Signature of
Learner

96
 14. Record of Project(s)
Note:
1. The learner may undertake a scholastic project of 1-2 months in the form of a
clinical project or community project or research project.
2. These are based on the preferences of individual institutes.
3. The projects are voluntary activity and not included for internal assessment.

Clinical Project [ ]
Type of Project Community Project [ ]
Research Project [ ]
Title of Project

Synopsis of the Work

97
Signature of
Facilitator

98
 15. Photo Story
Note:
1. This section shall include the important moments of the process of
development which shall be documented for the student and the department
2. These may be eg: prizes won, competitions attended, department activities
etc.
3. These are based on the preferences of individual institutes.
4. The projects are voluntary activity and not included for internal assessment.

99
 16. Co-Curricular Achievements
Note:
1. This section shall include the important co-curricular activities in which the
student is involved during the academic year which shall be documented for
the student and the department
2. These may be eg: prizes won, competitions attended, etc.
3. These are based on the preferences of individual institutes.
4. The projects are voluntary activity and not included for internal assessment.

100