Survey: Affective Clinical Evaluation Level I
Reviewer: Clinical Instructors (LAW, Camille)
Reviewee: Students (Peck, Fiona)
Survey Period: 5/1/2024
Completed: 4/24/2024 3:48:19 PM CT
1. First semester Evaluation:
3rd Evaluation
3. Communications
Explains medical dosimetry procedures to N/A
patient as appropriate to situation (e.g.
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: 70 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 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
Additional Comment: Fiona feels that she is progressing well and understanding concepts. She knows that its
repetition and practice that will get her to the point of excelling. She will organize her notes better to find things
more quickly.
10. Additional Comments:
Fiona has completed 4 comps as of today (fusion, mantle, 3F wedge, 4F pelvis). We've discussed the
agenda (pick up more clinical cases, aim to complete the electron beam planning comp) for the
remaining semester and she feels confident in completing it. We will have her focus on really gaining
confidence in everything she has learned and aim to complete things as if they were second nature.
Fiona has completed 4 finalizations, 6 fusions, and 2 rectum cases in the clinic.
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 5/9/2024 2:08:52 PM CT
