Survey: "Affective Clinical Evaluation Level I"

Reviewer: Clinical Instructors (MULLINS, Carolyn)

Reviewee: Students (Ilic, Milica)
Survey Period: 4/6/2023
Completed: 4/6/2023 9:58:05 AM CT

1. First semester Evaluation:

1st Evaluation

3. Communications

Explains medical dosimetry procedures to patient as N/A

appropriate to situation (e.g. when assisting with procedures in Additional Comment:  Milica has not had any patient contact
treatment room or simulation). during this rotation with me.

Respects patient's rights to privacy and confidentiality. Meets Expectations [10 pts]
Additional Comment:  Milica always takes into account the
patient's privacy.

Acts and speaks in a respectful manner with staff members. Meets Expectations [10 pts]
Additional Comment:  Milica is always respectful and pleasant
to work with.

Asks questions in an appropriate manner. Meets Expectations [10 pts]

Additional Comment:  Milica asks appropriate questions.

Accepts correction and direction in a professional manner. Meets Expectations [10 pts]
Additional Comment:  Milica is always professional and glad to
receive any direction.

Contributes as a member of the medical dosimetry team. Meets Expectations [10 pts]

Uses effective verbal communication skills with physician Meets Expectations [10 pts]
during plan consultation and review. Additional Comment:  Milica communicates well with the
physician's

Uses effective written communication skills for chart, plan, and Meets Expectations [10 pts]
dosimetry note documentation. Additional Comment:  Milica understands what is need for
documentation in the patient's chart.

Mean: 10.00 of 10  Points: 70  Score: 100.0%

4. Accuracy

Follows through instructions with attention to detail. Meets Expectations [10 pts]
Additional Comment:  Milica is good at following instructions
and completes the project.

Accurately enters information into chart or R & V system. Meets Expectations [10 pts]
Additional Comment:  Milica is understanding of what
information is needed in chart.

Mean: 10.00 of 10  Points: 20  Score: 100.0%

5. Safety

Double checks all student work to include calculations and Meets Expectations [10 pts]
treatment plans with dosimetrist/physicist. Additional Comment:  Milica always has her work checked by
dosimetrist.

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

6. Dependability

Arrives promptly as scheduled. Meets Expectations [10 pts]

Additional Comment:  Milica is very dependable. Always arrives
on time.

Schedules breaks, lunches, and other time needs with clinical Meets Expectations [10 pts]
instructors. Additional Comment:  Takes lunch breaks at reasonable time.
She Makes sure her work is completed before leaving.

Adheres to attendance standards of the program. Meets Expectations [10 pts]

Additional Comment:  Milica goes above and beyond.

Uses clinical time wisely. Meets Expectations [10 pts]

Follows school and hospital policies and procedures. Meets Expectations [10 pts]

Takes initiative in observing and assisting in dosimetry Meets Expectations [10 pts]
activities. Additional Comment:  Milica is always ready to observe and
learn new activities.

Mean: 10.00 of 10  Points: 60  Score: 100.0%

7. Application of Knowledge

Demonstrates a basic understanding of physics concepts and Meets Expectations [10 pts]
principles. Additional Comment:  Milica is understanding of concepts.

Is able to retrieve imaging study (CT) and bring into patient file. Meets Expectations [10 pts]

Is able to identify anatomy and contour appropriate structures. Meets Expectations [10 pts]
Additional Comment:  Milica knows her anatomy and is able to
contour correctly.

Understands the use of the computer for treatment planning. Meets Expectations [10 pts]
Additional Comment:  Milica understands how our planning
computer works and is able to perform planning.

Is able to enter information into the computer and design a Meets Expectations [10 pts]
basic treatment plan in accordance with prescription. Additional Comment:  Milica is able to perform planning as
expected at her level.

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 databooks to perform hand Meets Expectations [10 pts]
calculations. Additional Comment:  Milica understands the calc book and
how to perform hand calculations.

Is able to prioritize and organize duties to efficiently complete Meets Expectations [10 pts]
requirements.

Exhibits a basic knowledge of anatomy, tissue dose tolerance, Meets Expectations [10 pts]
definitive tumor 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
10. Additional Comments:

I am very pleased with Milica's progress. I feel she is going to be a very good dosimetrist.

Total points for all rating scale questions: 250

Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/12/2023 5:33:34 PM CT