Survey: 2nd & 3rd Semester Affective Clinical Evaluation

Reviewer: Clinical Instructors(CREBO, Donald) Reviewee: Students (Hufnal, Stephanie)

Survey Period: 10/4/2019 Completed: 10/4/2019 3:30:34 PM CT

1. Evaluation:

1st of 3 - Fall Semester

3. Communications

Explains medical dosimetry procedures to

patient as appropriate to situation (e.g. Meets Expectations [10 pts]
when participating in procedures in the
treatment room or simulation).
Respects patient's rights to privacy and Meets Expectations [10 pts]
confidentiality.
Acts and speaks in a respectful manner Meets Expectations [10 pts]
with staff members.
Asks questions in an appropriate manner. Meets Expectations [10 pts]
Accepts correction and direction in a Meets Expectations [10 pts]
professional manner.
Contributes as a member of the medical Meets Expectations
dosimetry team. Additional Comment: Needs to be
assertive and confident in her abilities. [10 pts]
You know what you are doing so just do
it.
Uses effective verbal communication skills
with physician during plan consultation Meets Expectations [10 pts]
and review.
Uses effective written communication
skills for chart, plan, and dosimetry note Meets Expectations [10 pts]
documentation.
Mean: 10.00 of 10 Points: 80 Score: 100.00%
4. Accuracy

Performs dose calculations accurately. Meets Expectations [10 pts]

Reads radiation measurement devices
accurately and carefully. (eg, TLD, Diodes, N/A
Film, Ion Chamber)
 Accurately designs plans by computer or
manual computation in accordance with Meets Expectations [10 pts]
prescription.
Accurately enters information into chart Meets Expectations [10 pts]
or R & V system.
Mean: 10.00 of 10 Points: 30 Score: 100.00%
5. Safety

Takes appropriate precautions in Meets Expectations [10 pts]

Radiation Safety.
Double checks all calculations and
treatment plans with Meets Expectations [10 pts]
dosimetrist/physicist.
Performs Quality Assurance per
recommended guidelines and reviews Meets Expectations [10 pts]
with dosimetrist/physicist.
Uses time, distance, shielding practices & Meets Expectations [10 pts]
principles.
Mean: 10.00 of 10 Points: 40 Score: 100.00%
6. Dependability

Arrives promptly as scheduled. Meets Expectations [10 pts]

Schedules breaks, lunches, and other time Meets Expectations [10 pts]
needs with clinical instructors.
Adheres to attendance standards of the Meets Expectations [10 pts]
program.
Uses clinical time wisely. Meets Expectations
Additional Comment: Use the slow time [10 pts]
to practice the rapid arc techniques that
Heather taught you
Follows school and hospital policies and Meets Expectations [10 pts]
procedures.
Takes initiative in observing and assisting Meets Expectations
in dosimetry activities. Additional Comment: Look at the [10 pts]
schedule and start taking things before
being assigned
Mean: 10.00 of 10 Points: 60 Score: 100.00%
7. Application of Knowledge
 Understands the technique and use of Meets Expectations [10 pts]
special calculation methods.
Is able to enter information into the
computer and design treatment plan in Meets Expectations [10 pts]
accordance with prescription.
Is able to identify anatomy and contour Meets Expectations [10 pts]
appropriate structures.
Utilizes critical thinking/problem solving Meets Expectations
skills in approaching treatment planning. Additional Comment: able to identify [10 pts]
problems but not confident in
answering/correcting the problems
Understands how clinical oncology
information is used in treatment planning Meets Expectations [10 pts]
(e.g. type, grade, stage of cancer).
Utilizes critical thinking skills when Meets Expectations [10 pts]
evaluating dose volume histograms.
Uses problem solving skills when
comparing various treatment plans for a Meets Expectations [10 pts]
specific treatment case.
Is able to design optimal treatment plans
based on calculations, dose volume Meets Expectations [10 pts]
histograms, prescription, and treatment
implementation.
Mean: 10.00 of 10 Points: 80 Score: 100.00%
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 dose out (complete) chart per Meets Expectations [10 pts]
prescription and plan.
Exhibits knowledge of anatomy, tissue
dose tolerance, definitive tumor dose, Meets Expectations [10 pts]
and typical field arrangement.
Is able to independently produce Meets Expectations
treatment plans as required by [10 pts]
competency list for the semester. Additional Comment: Work in progress

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

efficiently complete requirements.
 Mean: 10.00 of 10 Points: 50 Score: 100.00%
9. I have reviewed this evaluation with the student.
Yes
Additional Comment: Need to have more confidence in your planning abilities
10. Please provide a comment to let the student know of any weakness they can work on, and/or any strength to
commend:

Same as 9

Total points: 340 (Each main question equally weighted)

Mean percentage score: 100.0% Responses as of 11/7/2019 1:27:07 PM CT