Survey: 1st Semester Affective Clinical Evaluation

Reviewer: Clinical Instructors (DOZLER, Cheryl)

Reviewee: Students (Goffic, Tara)
Survey Period: 3/30/2022
Completed: 4/4/2022 1:13:26 PM CT

1. First semester Evaluation:

1st Evaluation

3. Communications

Explains medical dosimetry procedures to Meets Expectations [10

patient as appropriate to situation (e.g. Additional Comment: Tara is great at explaining to pts]
when assisting with procedures in our HDR Patient of what to expect during the
treatment room or simulation). treatment and what we are doing.

Respects patient's rights to privacy and Meets Expectations [10

confidentiality. Additional Comment: Tara is very conscientious pts]
about patient privacy

Acts and speaks in a respectful manner Meets Expectations [10

with staff members. Additional Comment: Tara always interacts pts]
appropriately with staff.

Asks questions in an appropriate manner. Meets Expectations [10

Additional Comment: Tara asks questions pts]
appropriately when procedures and processes
are shown to her.

Accepts correction and direction in a Meets Expectations [10

professional manner. Additional Comment: Tara accepts direction and pts]
follows through in professional manor.

Contributes as a member of the medical Meets Expectations [10

dosimetry team. Additional Comment: Tara contributes to the pts]
medical dosimetry team. She is great at offering
to do things before asked.

Uses effective verbal communication skills Meets Expectations [10

with physician during plan consultation Additional Comment: Tara does a great job pts]
and review. communicating with the doctors.

Uses effective written communication Meets Expectations [10

skills for chart, plan, and dosimetry note Additional Comment: Tara completes competent pts]
documentation. documentation in the chart.

Mean: 10.00 of 10 Points: 80 Score: 100.0%

4. Accuracy

Follows through instructions with attention Meets Expectations [10

to detail. Additional Comment: Tara does excellent job pts]
following instruction.

Accurately enters information into chart or Meets Expectations [10

R & V system. Additional Comment: Tara meet expectations. 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 Additional Comment: Tara always asked for review pts]
dosimetrist/physicist. of her work.

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

6. Dependability

Arrives promptly as scheduled. Meets Expectations [10

Additional Comment: Tara is always here on time pts]
and spends the extra time when needed.

Schedules breaks, lunches, and other Meets Expectations [10

time needs with clinical instructors. Additional Comment: Tara meets expectations. pts]

Adheres to attendance standards of the Meets Expectations [10

program. Additional Comment: Tara complies with program pts]
standard.

Uses clinical time wisely. Meets Expectations [10

Additional Comment: Tara spends time efficiently. pts]

Follows school and hospital policies and Meets Expectations [10

procedures. Additional Comment: Tara follows policy and pts]
procedures.

Takes initiative in observing and assisting Meets Expectations [10

in dosimetry activities. Additional Comment: Tara is great about stepping pts]
in and assisting or observing procedures and
planning.

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. Additional Comment: Tara is doing a great job pts]
picking up on physics concepts and asking
appropriate questions.

Is able to retrieve imaging study (CT) and Meets Expectations [10

bring into patient file. Additional Comment: Tara does an excellent job. pts]

Is able to identify anatomy and contour Meets Expectations [10

appropriate structures. Additional Comment: Tara is becoming more pts]
efficient at contouring.

Understands the use of the computer for Meets Expectations [10

treatment planning. Additional Comment: Tara's skills on the planning pts]
system have improved.

Is able to enter information into the Meets Expectations [10

computer and design a basic treatment Additional Comment: Tara's skills at basic planning pts]
plan in accordance with prescription. have improved.

Mean: 10.00 of 10 Points: 50 Score: 100.0%

8. General Dosimetry Skills

Performs calculations in a timely manner. Meets Expectations [10

Additional Comment: Tara does a great job with pts]
calculations.

Accurately uses dose calculation Meets Expectations [10

databooks to perform hand calculations. Additional Comment: Tara can perform dose pts]
calculations by hand.

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

efficiently complete requirements. Additional Comment: Tara is getting faster at pts]
completing requirements.

Exhibits a basic knowledge of anatomy, Meets Expectations [10

tissue dose tolerance, definitive tumor Additional Comment: Tara has improved her pts]
dose, and typical field arrangement. knowledge of treatment planning in regards to
anatomy, dose tolerances , tumor doses and field
arrangement.

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

9. I have reviewed this evaluation with the student.

Yes

Additional Comment: Tara is becoming more knowledgeable, but understands that she has to become a little
quicker with her contouring.
 10. Additional Comments:

Overall, I am pleased with the progress that Tara has made so far and feel that she is retaining the
knowledge she needs to become a great dosimetrist.

Total points for all rating scale questions: 260 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 4/4/2022 1:45:19 PM CT