Typhon Group: EASI - Evaluation & Survey Instrument

5/8/15, 10:11 PM

Responses About You - Details - "1st Semester Clinical Affective Evaluation"

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Evaluation by:

Clinical Instructors (FRANCIS, Louise)

Evaluation of:

Students (Polishchuk, Tayisiya)

Evaluation Period:
Survey Completed:

5/4/2015
5/7/2015 9:55:00 AM CT
Add your comments

Evaluation Period:
April-May

Communications
Explains medical dosimetry procedures to patient as appropriate to situation (e.g. when
assisting with procedures in treatment room or simulation). - N/A
Respects patient's rights to privacy and confidentiality. - Meets Expectations [10 pts]
Acts and speaks in a respectful manner with staff members. - Meets Expectations [10 pts]
Asks questions in an appropriate manner. - Meets Expectations (Additional Comment: Tayisiya's
questions reflect a good understanding of the task at hand. ) [10 pts]
Accepts correction and direction in a professional manner. - Meets Expectations [10 pts]
Contributes as a member of the medical dosimetry team. - Meets Expectations (Additional
Comment: Tayisiya readily seeks cases to assist the dosimetry team with their planning
workload. Upon review by the assigned CMD, Tayisiya's planning and chart write-up are usually
without error, thanks to her well organized notes. ) [10 pts]
Uses effective verbal communication skills with physician during plan consultation and review. Meets Expectations (Additional Comment: Tayisiya engages with the physician to get a better
understanding of their objectives regarding plan outcomes.) [10 pts]
Uses effective written communication skills for chart, plan, and dosimetry note documentation.
- Meets Expectations (Additional Comment: Tayisiya understands the need for additional
documentation for bolus placemnt, setup info etc., when needed. She understands that that this
may come in the form of a picture, an addtional written descriptor, a conversation with the
therapists, or any combination of the aforementioned methods.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

Accuracy
Follows through instructions with attention to detail. - Meets Expectations [10 pts]
Accurately enters information into chart or R & V system. - Meets Expectations (Additional
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Typhon Group: EASI - Evaluation & Survey Instrument

5/8/15, 10:11 PM

Comment: Tayisiya is proficient at entering informaiton into the ARIA record and verify
system.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

Safety
Double checks all student work to include calculations and treatment plans with
dosimetrist/physicist. - Meets Expectations (Additional Comment: All of Tayisiya's plans are
reviewed with the assigned dosimetrist, prior to the final physics check.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

Dependability
Arrives promptly as scheduled. - Meets Expectations [10 pts]
Schedules breaks, lunches, and other time needs with clinical instructors. - Meets
Expectations [10 pts]
Adheres to attendance standards of the program. - Meets Expectations [10 pts]
Uses clinical time wisely. - Meets Expectations [10 pts]
Follows school and hospital policies and procedures. - Meets Expectations [10 pts]
Takes initiative in observing and assisting in dosimetry activities. - Meets
Expectations (Additional Comment: Tayisiya has been observing brachytherapy procceedures,
and has asked appropriate questions for her level of experience.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

Application of Knowledge
Demonstrates a basic understanding of physics concepts and principles. - Meets
Expectations [10 pts]
Is able to retrieve imaging study (CT) and bring into patient file. - Meets Expectations [10 pts]
Is able to identify anatomy and contour appropriate structures. - Meets
Expectations (Additional Comment: Tayisiya has exhibited a solid cross-sectional anatomy
foundation. In addition, she consults the RTOG Contouring Atlas whenever necessary) [10 pts]
Understands the use of the computer for treatment planning. - Meets Expectations [10 pts]
Is able to enter information into the computer and design a basic treatment plan in accordance
with prescription. - Meets Expectations (Additional Comment: Tayisiya has become proficient in
generating basic treatment plans in accordance with a given prescription.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

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Typhon Group: EASI - Evaluation & Survey Instrument

5/8/15, 10:11 PM

General Dosimetry Skills

Performs calculations in a timely manner. - Meets Expectations [10 pts]
Accurately uses dose calculation databooks to perform hand calculations. - Meets
Expectations [10 pts]
Is able to prioritize and organize duties to efficiently complete requirements. - Meets
Expectations [10 pts]
Exhibits a basic knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical
field arrangement. - Meets Expectations (Additional Comment: Tayisiya has progressed well in
this area. Her therapy background assisits with her making the conection between field
arrangements, tissue tolerance, and achieveing the desired tumor dose.) [10 pts]
MEAN: 10.00 (out of possible 10), % SCORE: 100.0%

I have reviewed this evaluation with the student.

Yes (Additional Comment: Tayisiya is in agreement with current evaluation.)

Additional Comments:
Tayisiya is progressing very well, and is a pleasure to have in clinic.

Mean percentage score for all rating scale questions: 100.0%

(Each main question equally weighted)
Responses as of 5/8/2015 9:11:19 PM CT

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