Survey: Affective Clinical Evaluation Level I

Reviewer: Clinical Instructors (LIN, Tiffany)

Reviewee: Students (Song, Stacey)
Survey Period: 2/23/2023
Completed: 2/24/2023 12:17:06 AM CT

1. First semester Evaluation:

1st Evaluation

3. Communications

Explains medical dosimetry procedures to Meets Expectations [10

patient as appropriate to situation (e.g. pts]
when assisting with procedures in
treatment room or simulation).

Respects patient's rights to privacy and Meets Expectations [10

confidentiality. pts]

Acts and speaks in a respectful manner Meets Expectations [10

with staff members. pts]

Asks questions in an appropriate manner. Meets Expectations [10

pts]

Accepts correction and direction in a Meets Expectations [10

professional manner. pts]

Contributes as a member of the medical Meets Expectations [10

dosimetry team. pts]

Uses effective verbal communication skills Meets Expectations [10

with physician during plan consultation pts]
and review.

Uses effective written communication Meets Expectations [10

skills for chart, plan, and dosimetry note pts]
documentation.

Mean: 10.00 of 10 Points: 80 Score: 100.0%

4. Accuracy

Follows through instructions with attention Meets Expectations [10

to detail. pts]

Accurately enters information into chart or Meets Expectations [10

R & V system. pts]

Mean: 10.00 of 10 Points: 20 Score: 100.0%

5. Safety

Double checks all student work to include Meets Expectations [10

calculations and treatment plans with pts]
dosimetrist/physicist.

Mean: 10.00 of 10 Points: 10 Score: 100.0%

6. Dependability

Arrives promptly as scheduled. Meets Expectations [10

pts]

Schedules breaks, lunches, and other Meets Expectations [10

time needs with clinical instructors. pts]

Adheres to attendance standards of the Meets Expectations [10

program. pts]

Uses clinical time wisely. Meets Expectations [10

pts]

Follows school and hospital policies and Meets Expectations [10

procedures. pts]

Takes initiative in observing and assisting Meets Expectations [10

in dosimetry activities. pts]

Mean: 10.00 of 10 Points: 60 Score: 100.0%

 7. Application of Knowledge

Demonstrates a basic understanding of Meets Expectations [10

physics concepts and principles. pts]

Is able to retrieve imaging study (CT) and Meets Expectations [10

bring into patient file. pts]

Is able to identify anatomy and contour Partially Meets Expectations [5 pts]

appropriate structures. Additional Comment: contours still need some
editing, but but mostly accurate

Understands the use of the computer for Meets Expectations [10

treatment planning. pts]

Is able to enter information into the Meets Expectations [10

computer and design a basic treatment pts]
plan in accordance with prescription.

Mean: 9.00 of 10 Points: 45 Score: 90.0%

8. General Dosimetry Skills

Performs calculations in a timely manner. Meets Expectations [10

pts]

Accurately uses dose calculation N/A

databooks to perform hand calculations.

Is able to prioritize and organize duties to Meets Expectations [10

efficiently complete requirements. pts]

Exhibits a basic knowledge of anatomy, Meets Expectations [10

tissue dose tolerance, definitive tumor pts]
dose, and typical field arrangement.

Mean: 10.00 of 10 Points: 30 Score: 100.0%

9. I have reviewed this evaluation with the student.

Yes

10. Additional Comments:

Stacey is very eager to lean as much as she can and is very willing to help others with any and all
steps of the treatment planning process. Contouring skills can still be improved, but she will definitely
increase with speed and accuracy as she gets more practice and encounters different treatment sites.

Total points for all rating scale questions: 245 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 98.3% Response as of 2/24/2023 12:17:15 AM CT