Survey: 2nd & 3rd Semester Affective Clinical Evaluation

Reviewer: Clinical Instructors (SANTOS, Art)

Reviewee: Students (Deere, Will)
Survey Period: 6/24/2019
Completed: 6/24/2019 5:59:26 PM CT

1. Evaluation:

1st of 3 - Summer Semester

3. Communications

Explains medical dosimetry procedures to Meets Expectations [10

patient as appropriate to situation (e.g. pts]
when participating in procedures in the
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

Performs dose calculations accurately. Meets Expectations [10

pts]

Reads radiation measurement devices Meets Expectations [10

accurately and carefully. (eg, TLD, pts]
Diodes, Film, Ion Chamber)

Accurately designs plans by computer or Meets Expectations [10

manual computation in accordance with pts]
prescription.

Accurately enters information into chart or Meets Expectations [10

R & V system. pts]

Mean: 10.00 of 10 Points: 40 Score: 100.0%

5. Safety

Takes appropriate precautions in Meets Expectations [10

Radiation Safety. pts]

Double checks all calculations and Meets Expectations [10

treatment plans with dosimetrist/physicist. pts]

Performs Quality Assurance per Meets Expectations [10

recommended guidelines and reviews pts]
with dosimetrist/physicist.

Uses time, distance, shielding practices & Meets Expectations [10

principles. pts]

Mean: 10.00 of 10 Points: 40 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

Understands the technique and use of Meets Expectations [10

special calculation methods. pts]

Is able to enter information into the Meets Expectations [10

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

Is able to identify anatomy and contour Meets Expectations [10

appropriate structures. pts]

Utilizes critical thinking/problem solving Meets Expectations [10

skills in approaching treatment planning. pts]

Understands how clinical oncology Meets Expectations [10

information is used in treatment planning pts]
(e.g. type, grade, stage of cancer).

Utilizes critical thinking skills when Meets Expectations [10

evaluating dose volume histograms. pts]

Uses problem solving skills when Meets Expectations [10

comparing various treatment plans for a pts]
specific treatment case.

Is able to design optimal treatment plans Meets Expectations [10

based on calculations, dose volume pts]
histograms, prescription, and treatment
implementation.

Mean: 10.00 of 10 Points: 80 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 dose out (complete) chart per Meets Expectations [10

prescription and plan. pts]

Exhibits knowledge of anatomy, tissue Meets Expectations [10

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

Is able to independently produce Meets Expectations [10

treatment plans as required by pts]
competency list for the semester.

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

efficiently complete requirements. pts]

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

9. I have reviewed this evaluation with the student.

Yes

10. Please provide a comment to let the student know of any weakness they can work on, and/or any strength to
commend:

Will continues to perform at a competent and high level. He has become increasingly active and
independent. He consistently and actively seeks new procedures and plans to work on. Recently he
attended the AAPM conference in Los Angeles and has learned a lot about the Dosimetry field.

Total points for all rating scale questions: 360 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 8/16/2019 7:25:01 PM CT
 Survey: 2nd & 3rd Semester Affective Clinical Evaluation
Reviewer: Clinical Instructors (SANTOS, Art)
Reviewee: Students (Deere, Will)
Survey Period: 7/22/2019
Completed: 7/24/2019 1:10:29 PM CT

1. Evaluation:

2nd of 3 - Summer Semester

3. Communications

Explains medical dosimetry procedures to Meets Expectations [10

patient as appropriate to situation (e.g. pts]
when participating in procedures in the
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

Performs dose calculations accurately. Meets Expectations [10

pts]

Reads radiation measurement devices Meets Expectations [10

accurately and carefully. (eg, TLD, pts]
Diodes, Film, Ion Chamber)

Accurately designs plans by computer or Meets Expectations [10

manual computation in accordance with pts]
prescription.

Accurately enters information into chart or Meets Expectations [10

R & V system. pts]

Mean: 10.00 of 10 Points: 40 Score: 100.0%

5. Safety

Takes appropriate precautions in Meets Expectations [10

Radiation Safety. pts]

Double checks all calculations and Meets Expectations [10

treatment plans with dosimetrist/physicist. pts]

Performs Quality Assurance per Meets Expectations [10

recommended guidelines and reviews pts]
with dosimetrist/physicist.

Uses time, distance, shielding practices & Meets Expectations [10

principles. pts]

Mean: 10.00 of 10 Points: 40 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

Understands the technique and use of Meets Expectations [10

special calculation methods. pts]

Is able to enter information into the Meets Expectations [10

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

Is able to identify anatomy and contour Meets Expectations [10

appropriate structures. pts]

Utilizes critical thinking/problem solving Meets Expectations [10

skills in approaching treatment planning. pts]

Understands how clinical oncology Meets Expectations [10

information is used in treatment planning pts]
(e.g. type, grade, stage of cancer).

Utilizes critical thinking skills when Meets Expectations [10

evaluating dose volume histograms. pts]

Uses problem solving skills when Meets Expectations [10

comparing various treatment plans for a pts]
specific treatment case.

Is able to design optimal treatment plans Meets Expectations [10

based on calculations, dose volume pts]
histograms, prescription, and treatment
implementation.

Mean: 10.00 of 10 Points: 80 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 dose out (complete) chart per Meets Expectations [10

prescription and plan. pts]

Exhibits knowledge of anatomy, tissue Meets Expectations [10

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

Is able to independently produce Meets Expectations [10

treatment plans as required by pts]
competency list for the semester.

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

efficiently complete requirements. pts]

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

9. I have reviewed this evaluation with the student.

Yes

10. Please provide a comment to let the student know of any weakness they can work on, and/or any strength to
commend:

Will continues to improve on his dosimetry skills. He is consistently finding new work, new
information and new techniques to utilize. Very good work, pleasure to have in the clinic.

Total points for all rating scale questions: 360 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 8/16/2019 7:25:11 PM CT
 Survey: 2nd & 3rd Semester Affective Clinical Evaluation
Reviewer: Clinical Instructors (SANTOS, Art)
Reviewee: Students (Deere, Will)
Survey Period: 8/16/2019
Completed: 8/16/2019 5:45:35 PM CT

1. Evaluation:

3rd of 3 - Summer Semester

3. Communications

Explains medical dosimetry procedures to Meets Expectations [10

patient as appropriate to situation (e.g. pts]
when participating in procedures in the
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

Performs dose calculations accurately. Meets Expectations [10

pts]

Reads radiation measurement devices Meets Expectations [10

accurately and carefully. (eg, TLD, pts]
Diodes, Film, Ion Chamber)

Accurately designs plans by computer or Meets Expectations [10

manual computation in accordance with pts]
prescription.

Accurately enters information into chart or Meets Expectations [10

R & V system. pts]

Mean: 10.00 of 10 Points: 40 Score: 100.0%

5. Safety

Takes appropriate precautions in Meets Expectations [10

Radiation Safety. pts]

Double checks all calculations and Meets Expectations [10

treatment plans with dosimetrist/physicist. pts]

Performs Quality Assurance per Meets Expectations [10

recommended guidelines and reviews pts]
with dosimetrist/physicist.

Uses time, distance, shielding practices & Meets Expectations [10

principles. pts]

Mean: 10.00 of 10 Points: 40 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

Understands the technique and use of Meets Expectations [10

special calculation methods. pts]

Is able to enter information into the Meets Expectations [10

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

Is able to identify anatomy and contour Meets Expectations [10

appropriate structures. pts]

Utilizes critical thinking/problem solving Meets Expectations [10

skills in approaching treatment planning. pts]

Understands how clinical oncology Meets Expectations [10

information is used in treatment planning pts]
(e.g. type, grade, stage of cancer).

Utilizes critical thinking skills when Meets Expectations [10

evaluating dose volume histograms. pts]

Uses problem solving skills when Meets Expectations [10

comparing various treatment plans for a pts]
specific treatment case.

Is able to design optimal treatment plans Meets Expectations [10

based on calculations, dose volume pts]
histograms, prescription, and treatment
implementation.

Mean: 10.00 of 10 Points: 80 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 dose out (complete) chart per Meets Expectations [10

prescription and plan. pts]

Exhibits knowledge of anatomy, tissue Meets Expectations [10

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

Is able to independently produce Meets Expectations [10

treatment plans as required by pts]
competency list for the semester.

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

efficiently complete requirements. pts]

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

9. I have reviewed this evaluation with the student.

Yes

10. Please provide a comment to let the student know of any weakness they can work on, and/or any strength to
commend:

Continues to be a great student!

Total points for all rating scale questions: 360 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 8/16/2019 6:18:54 PM CT