Survey: Affective Clinical Evaluation Level I

Reviewer: Clinical Instructors (MELBY, Patrick)

Reviewee: Students (Wittmann, Milo)
Survey Period: 2/23/2024
Completed: 2/23/2024 11:59:03 AM CT

1. First semester Evaluation:

1st Evaluation

3. Communications

Explains medical dosimetry procedures to N/A

patient as appropriate to situation (e.g. Additional Comment: We have very little to no
when assisting with procedures in contact with the patients
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: 70 Score: 100.0%

4. Accuracy

Follows through instructions with attention Meets Expectations [10

to detail. Additional Comment: Keep up the attention to pts]
detail! We have all been very impressed on his
ability to pay attention to our instructions, take
notes, and then follow through with those
instructions on future patients.

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 Meets Expectations [10

appropriate structures. pts]

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: 10.00 of 10 Points: 50 Score: 100.0%

8. General Dosimetry Skills

Performs calculations in a timely manner. Meets Expectations [10

pts]

Accurately uses dose calculation Meets Expectations [10

databooks to perform hand calculations. pts]

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: 40 Score: 100.0%

9. I have reviewed this evaluation with the student.

Yes

10. Additional Comments:

MIlo is doing excellent. He is taking in new information everyday and applying it to future cases. He is
successfully planning 3D plans using weighting, wedges, and FIF, and is demonstrating that he is
understand when and where to use each accessory. He is very positive with all the feedback and
adjustment that I give him and seems to be becoming part of the team. If he continues like this he will
have a very successful year and become a great dosimetrist.
Total points for all rating scale questions: 250 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 5/8/2024 10:04:57 AM CT