Survey: "Affective Clinical Evaluation Level I"

Reviewer: Clinical Instructors (GEHRIG, Chelsea)

Reviewee: Students (Ilic, Milica)
Survey Period: 2/24/2023
Completed: 2/23/2023 1:15:39 PM 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: We have not yet had the opportunity to
treatment room or simulation). work in-person with a patient in planning or in simulation.

Respects patient's rights to privacy and confidentiality. Meets Expectations [10 pts]

Acts and speaks in a respectful manner with staff members. Meets Expectations [10 pts]

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

Additional Comment: Doing a great job with asking questions
and taking notes.

Accepts correction and direction in a professional manner. Meets Expectations [10 pts]

Contributes as a member of the medical dosimetry team. Meets Expectations [10 pts]
Additional Comment: Milica is doing a good job with learning
the basics of treatment planning. She is at the level that I
expect her to be in the first semester.

Uses effective verbal communication skills with physician Meets Expectations [10 pts]
during plan consultation and review.

Uses effective written communication skills for chart, plan, and Meets Expectations [10 pts]
dosimetry note documentation.

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

4. Accuracy

Follows through instructions with attention to detail. Meets Expectations [10 pts]

Accurately enters information into chart or R & V system. Meets Expectations [10 pts]

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.

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 time needs with clinical Meets Expectations [10 pts]
instructors.

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

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.

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.

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]

Understands the use of the computer for treatment planning. Meets Expectations [10 pts]

Is able to enter information into the computer and design a Meets Expectations [10 pts]
basic treatment 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. N/A

Accurately uses dose calculation databooks to perform hand N/A

calculations. Additional Comment: Have not yet had the opportunity to work
on 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: 20 Score: 100.0%

9. I have reviewed this evaluation with the student.

Yes

10. Additional Comments:

Milica is doing well and asking great questions. She takes initiative in her learning and keeps busy with planning on her own or with observing.

Total points for all rating scale questions: 230

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