Survey: 1st Semester Affective Clinical Evaluation

Reviewer: Clinical Instructors(CREBO, Donald) Reviewee: Students (Yiga, Tenzin)

Survey Period: 4/1/2020 Completed: 4/1/2020 7:44:42 AM CT

1. First semester Evaluation:

1st Evaluation
3. Communications

Explains medical dosimetry procedures to Meets Expectations

patient as appropriate to situation (e.g. Additional Comment: Is getting better in
when assisting with procedures in using the correct vocabulary when [10 pts]
treatment room or simulation). explaining a plan to either Dosimetrist or
MD.
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: Has the ability to
help out in busy clinic. Knows workflow [10 pts]
enough to tackle basic palliative plans
and breast plans.
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

Follows through instructions with Meets Expectations [10 pts]

attention to detail.
Accurately enters information into chart Meets Expectations [10 pts]
or R & V system.
 Mean: 10.00 of 10 Points: 20 Score: 100.00%
5. Safety

Double checks all student work to include Meets Expectations

calculations and treatment plans with Additional Comment: Reviews all plans
dosimetrist/physicist. [10 pts]
before showing with Dosimetry and
Physics staff
Mean: 10.00 of 10 Points: 10 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 [10 pts]
Follows school and hospital policies and Meets Expectations
procedures. Additional Comment: Currently under
Covid-19 restrictions established by NW [10 pts]
that prohibits clinical rotations with
students in class
Takes initiative in observing and assisting Meets Expectations [10 pts]
in dosimetry activities.
Mean: 10.00 of 10 Points: 60 Score: 100.00%
7. Application of Knowledge

Demonstrates a basic understanding of Meets Expectations [10 pts]

physics concepts and principles.
Is able to retrieve imaging study (CT) and Meets Expectations [10 pts]
bring into patient file.
Is able to identify anatomy and contour Meets Expectations [10 pts]
appropriate structures.
Understands the use of the computer for Meets Expectations [10 pts]
treatment planning.
Is able to enter information into the
computer and design a basic treatment Meets Expectations [10 pts]
plan in accordance with prescription.
Mean: 10.00 of 10 Points: 50 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 prioritize and organize duties to Meets Expectations [10 pts]
efficiently complete requirements.
Exhibits a basic knowledge of anatomy,
tissue dose tolerance, definitive tumor Meets Expectations [10 pts]
dose, and typical field arrangement.
Mean: 10.00 of 10 Points: 30 Score: 100.00%
9. I have reviewed this evaluation with the student.
No
Additional Comment: Student is currently prohibited from doing her clinical rotation due to Covid-19
10. Additional Comments:

Tenzin has come along way from her first month in clinic. I feel she has a grasp for planning and will
continue to get stronger once we get past this Covid-19 setback. I look forward to seeing her when the
restrictions have been lifted.
Total points: 250 (Each main question equally weighted)
Mean percentage score: 100.0% Responses as of 5/8/2020 5:21:45 PM CT