CLINICAL INSTRUCTION LOG BOOK 2002
All items must be completed in full & signed for CME credits to be received! 2002 All rights reserved.

Clinical Instructor (full name):_______________ Registry Number(s):____________

Clinical Site:______________________________________________

Inclusive Dates of Instruction

Number of 10-minute Instructional Segments x exam type (5 x ABD)

Student's Signature

Clinical 
Instructor's Signature

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Please use copies of this form for each Clinical Instructor. Summarize from the Student's Case Logs.
Number of cases the student participated in during this period:_______

Total Number of 10-minute segments: __________ (Twelve segments = 2 hours of instruction = 1 CME credit hour.

Program Director's Signature:________________________________________________
"CLINICAL INSTRUCTORSHIP - Clinical instructors in affiliates of CAAHEP programs may qualify for continuing medical education credits. The qualifying instructorship must consist of specific data oriented clinical teaching. The clinical instructor Instructs before, during, or after the student scans, and/or the student and instructor must review individual case studies. The program director of the CAAHEP accredited school must apply to SDMS for this type of credit. Credit will not be given for time the Instructor scans while the student watches."

"Documentation consists of a log record to be maintained and submitted to the Program Coordinator of the diagnostic medical sonography program. The log should be signed by both the student and instructor. Logging of clinical instructorship can be done in ten-minute segments - twelve of which constitute two hours of instruction. Every two hours is awarded one credit hour of CME. The maximum number of credits of this type is 10 in the instructor's triennium."

"Credit of this type is issued under the category of Short-Term Educational Program. A course syllabus should accompany the application describing the course objectives for the student."

Adapted from the Society of Diagnostic Medical Sonographers' Continuing Medical Education Credit: General Information and Application. SDMS, 12770 Coit Road, Suite 708, Dallas, Texas 75251; 972-239-7367.

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