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TOTAL RESPONSES: 4

Instructional Text

Evaluation month:
(Open Ended - Comments Box) Total Respondents: 4 Skipped this question: 0

Communications
(Rating Scale Matrix) Statistical Mode in BOLD Explains medical dosimetry procedures to patient as appropriate to situation. Respects patient's rights to privacy and confidentiality. Acts and speaks in a respectful manner with staff members. Asks questions in an appropriate manner. Accepts correction and direction in a professional manner. Contributes as a member of the medical dosimetry team. Uses effective verbal 1 Does Not Meet Expectation s 2 Partially Meets Expectation s 3 Meets Expectation s Additiona N/A l Comment Mea n [13] Percentag e Score

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communication skills with physician during plan consultation and review. Uses effective written communication skills for chart, plan, and dosimetry note documentation. OVERALL COUNTS/MEANS :

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Accuracy
(Rating Scale Matrix) Statistical Mode in BOLD Performs dose calculations accurately. Reads radiation measurement devices accurately and carefully. (eg, TLD, Diodes. Film, Ion Chamber) Accurately designs plans by computer or manual computation in accordance with prescription. Accurately enters information into chart or R & V system. OVERALL COUNTS/MEANS: 1 2 3 Does Not Partially Meets Meet Meets Expectations Expectations Expectations 0.0% (0) 0.0% (0) 100.0% (4) N/A Mean Percentage [1-3] Score

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Total Respondents: Skipped this question:

Safety
(Rating Scale 1 2 3 N/A Mean Percentage

Matrix) Statistical Mode in BOLD Takes appropriate precautions in Radiation Safety. Double checks all calculations and treatment plans with dosimetrist/physicist. Performs Quality Assurance per recommended guidelines and reviews with dosimetrist/physicist. Uses time, distance, shielding practices & principles. OVERALL COUNTS/MEANS:

Does Not Partially Meets Meet Meets Expectations Expectations Expectations 0.0% (0) 0.0% (0) 100.0% (4) 0.0% (0)

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Dependability
(Rating Scale Matrix) Statistical Mode in BOLD Arrives promptly as scheduled. Schedules breaks, lunches, and other time needs with clinical instructors. Adheres to attendance standards of the program. Uses clinical time wisely. Follows school and hospital policies and procedures. Takes initiative in observing and assisting in dosimetry activities. OVERALL 1 2 3 Does Not Partially Meets Meet Meets Expectations Expectations Expectations 0.0% (0) 0.0% (0) 100.0% (4) N/A Mean Percentage [1-3] Score 3.00 100.0%

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COUNTS/MEANS: Total Respondents: Skipped this question: 4 0

Application of Knowledge
(Rating Scale Matrix) Statistical Mode in BOLD Understands the technique and use of special calculation methods. Is able to retrieve imaging study (CT) and bring into patient file. Is able to identify anatomy and contour appropriate structures. Understands the use of the computer for treatment planning. Is able to enter information into the computer and design treatment plan in accordance with prescription. Utilizes critical thinking/problem solving skills in approaching treatment planning. Demonstrates a basic understanding of physics concepts and principles. Understands how clinical oncology information is used in treatment planning. Utilizes critical thinking skills when evaluating dose volume histograms. Uses problem solving skills when comparing 1 2 3 Does Not Partially Meets Meet Meets Expectations Expectations Expectations 0.0% (0) 0.0% (0) 100.0% (4) N/A Mean Percentage [1-3] Score

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various treatment plans for a specific treatment case. Is able to design optimal treatment plans based on calculations, dose volume histograms, prescription, and treatment implementation. OVERALL COUNTS/MEANS:

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Total Respondents: Skipped this question:

General Dosimetry Skills


(Rating Scale Matrix) Statistical Mode in BOLD Performs calculations in a timely manner. Accurately uses dose calculation databooks to perform hand calculations. Is able to dose out chart per prescription and plan. Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical field arrangement. Is able to independently produce treatment plans as required by competency list for the semester. Is able to prioritize and organize duties to efficiently complete requirements. OVERALL COUNTS/MEANS: 1 2 3 Does Not Partially Meets Meet Meets Expectations Expectations Expectations 0.0% (0) 0.0% (0) 100.0% (4) N/A Mean Percentage [1-3] Score 3.00 100.0%

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Total Respondents:

Skipped this question:

I have reviewed this evaluation with the student.


(Yes or No) Yes No Response Response Percent Total 100.0% 0.0% 4 0

Additional Comment

25.0%

Total Respondents: Skipped this question:

4 0

Additional Comments:
(Open Ended - Comments Box) Total Respondents: 3 Skipped this question: 1

Mean percentage score for all rating scale questions: 100.0% (Each main question equally weighted)

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