RECORD OF EXPERIENCE AND ATTENDANCE
Please, record your attendance and interventions/procedures observed throughout your observational placement in the table provided following
the below.
BP
ECG
A-BP
A-ECG
TH
TA
ETT
Cath
PPM
Echo
Uni
ID
DS
O
EXPERIENCE KEY
Blood pressure
Electrocardiogram (IP / OP)
Ambulatory BP
Ambulatory ECG
Tape hook up
Tape analysis
Exercise tolerance testing
Left heart catheterisation
Pacemaker implantation
Echocardiography
University
Independent study
Directed study / assessment
Other (specify)
X
S
O
BH
ATTENDANCE KEY
Did not attend
Student off sick
Other (specify)
Bank holiday
RECORD OF ABSENCES MADE UP
Date
Number of made up hours
BLOCK 1
WEEK 1
Mon
Tue
pm
Experience
Attendance
am
Wed
pm
am
pm
Thu
pm
am
pm
WEEK 2
Fri
pm
am
pm
Sat
Sun
Mon
pm
pm
am
am
pm
Tue
pm
Wed
pm
am
pm
Thu
pm
am
pm
Fri
pm
am
pm
Sat
Sun
Sat
Sun
pm
am
pm
pm
PE signature
am
am
am
am
am
am
am
am
am
WEEK 3
Mon
Tue
pm
Experience
Attendance
am
Wed
pm
am
pm
am
pm
WEEK 4
Thu
pm
Fri
pm
am
pm
am
Sat
Sun
Mon
pm
am
pm
Tue
pm
am
pm
Wed
pm
am
pm
Thu
pm
am
pm
Fri
pm
am
pm
pm
am
pm
pm
PE signature
am
am
am
am
am
am
am
am
am
am
BLOCK 2
WEEK 1
Mon
Tue
pm
Experience
Attendance
am
Wed
pm
am
pm
Thu
pm
am
pm
WEEK 2
Fri
pm
am
pm
Sat
Sun
Mon
pm
pm
am
am
pm
Tue
pm
Wed
pm
am
pm
Thu
pm
am
pm
Fri
pm
am
pm
Sat
Sun
Sat
Sun
pm
am
pm
pm
PE signature
am
am
am
am
am
am
am
am
am
WEEK 3
Mon
Tue
pm
Experience
Attendance
am
Wed
pm
am
pm
am
pm
WEEK 4
Thu
pm
Fri
pm
am
pm
am
Sat
Sun
Mon
pm
am
pm
Tue
pm
am
pm
Wed
pm
am
pm
Thu
pm
am
pm
Fri
pm
am
pm
pm
am
pm
pm
PE signature
am
am
am
am
am
am
am
am
am
am
VERIFICATION OF ATTENDANCE TO PLACEMENT 1B
I verify that this is an accurate account
OUTSTANDING HOURS CARRIED FORWARD
Student signature
Work-based assessor signature