‘Survey: ‘Affective Clinical Evaluation Level I" Reviewer: ca nstretcs SH, Temluwa (te) Reviewee: ‘Stueats (Tran Heu) ‘Survey Period: swnaz008 Completed: rinay2028 95:54 AM CT 1. Eaton: 2nd of 3 Fall Samestr Explains mesial dosimetry procedures to patient as Meets Expectations ‘ppropsatetostuston (eg wien paripating in procedures n ‘he weetmert oom o sult. Respects patents rahtstprivacy and confidential Moots Expectations ‘Acta and speak ine epectfl mans wth taf embers. Meets Expectations ‘Asks questions in an approprct manne. Meets Expectations Accepts comesion and drection na profesional manner Most Expectations Contos a8 a member ofthe medical dosimety team, Meets Expectations Uses effective vertal communication skis wih physician Most Expectations ung ple consultation an review Uses effective writen communication sia fr char pla, abs Meet Expectations Mean: 10.00 of 10 Points: €0 Score: 100.0% 4. Aecuraey Perfor dose cseulatoneaccratey, Meets Expectations (69,TLO Diodes Fin on Chamber Accurately designs plnsby computer rmanuslcompstaton Meets Expectations ingecrdance with pescption Accurately ott information it chart or R&Veytem, Most Expectations Mean: 10.00 of 10 Points: 40. Score: 100.0% opt trop) hope nop) Hops) nope} tno pt) nope) no pt) hope nop) trop)‘ saley Takes aporonrate precautions in Ration Safety, Double checks al caleations ang weatment plans with osimetisuphyscist, Peto Quality Resurance pr econ:mended gules snd cevews with osetia pysicit, Uses time stance, shiingpractees& pencils. Mean: 10.00 of 10 Points: 40 Score: 100.0% Dependabity ‘Schedules breaks lunches, and other tine needs with lial Uses ena tme wily. Follows school and hosp poles and procedures. Mean: 10.00 of 10 Points: 60 Score: 100.0% Application of Krowleépe Understands the ecanique and use of special aout methods Is able to denttyenatomy and contour appropiate st Lites cite! hinkngoroblem coking sks in apeoaching Linderstands how neal oncology formato is used ‘uestmen pling (e.type oad stage of ance) ze ical inking sls when evaluating dose vokime Uses problem sing sil when comparing various teat plans fora specif eaten Is ableto desig optialrestmnt plan base on cautions, ose volume histograms, prescrip, and weatment implementation Mean: 10.00 of 10 Points: 80 Score: 100.0% Meets Expectations Moet Expectations Moet Expectations Most Expectations Moet Expectations Meets Expectations Moet Expectations Most Expectations Meets Expectations Most Expectations Meets Expectations Moots Expectations Meet Expectations Moet Expectations Moet Expectations Moet Expectations opt) trop) nope} nop) hope nop) nope) hope 109) nope nope) hope hop) Hops) hope) Hop) hope nop)8. cena Dosiaty Sle Peta eseutions nately mane ‘Accurately uses dose caulation databooks to perfom hand ‘alatons Ie able to dose out (complete) char per eesripton ar pn Exhbts knowledge of antomy, issue dose tolerance, deine ‘mer dose ané ype field atengemert Ie able to independently produce raiment plans a equeed by competency tt forthe semeste In able to protien organize duties to efit complete requverent Meets Epectatons Moot Expectations Masts Expectation Mosts Expectations Meets Expectations Mean: 10.00 of 10 Points: 60 Score: 100.0% 9. Ihave reviewed this oalaton with the student 10. Please provide a commento let the student know of any weakness they can work on anor ay strength to commen Hieuas done an awesome job at the proton centr Keep up the god work Total points for all ratings se questions: 360, ‘Mean percentage score for all ating scale questions: 100.0% man sccton ual wets) nope} nop) nope) nop) nop) opt