‘Survey: ‘Affective Clinical Evaluation Level I" Reviewer: ca nstretcs SH, Temluwa (te) Reviewee: Stueats Tran Hu) ‘Survey Period: vanay2008 Completed: ‘a/13/2028 4-06 PM CT 1. Eaton: ‘dof Fall Semester 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 crection na profesional manet Most Expectations Contos a8 a member ofthe medical dosmety 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 Performs dose caeulatoneaceratey, Meets Expectations (69,TLO Diodes Fin on Chamber Accutaey designs pny computer or manuslcompstaton Meets Expectations ingecrdance with pescption Accurately ott information it chart or R&Veytem, Moet 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 appropriate precautions in Ration Safey, Double checks al caleations ang weatmen plans wih 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 speck ealoulton methods ts able to denttyenatomy and contour appropriate st Lites te! hinkngoroblem song sks in aproaching Lnderstands how neal oncology formato is use ‘uestmen pling (eye ord stage of ance) izes rtcal inking ils when evaluating dose vokime Uses problem sing sil when comparing various treat plans fora specif eaten Is ableto desig optimal restmnt plan base on cautions, ose volume histograms, prescription, 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 Most 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 calulation databooks to perfom hand ‘alatons In able to dose out (complete) char per eesripton ar pn Exhbts knowledge of antomy, sue dose tolerance deintne ‘umer dose an ype field atengemer Ie able to independent produce treatment plans a equeed by competency It forthe semeste: In able to pote an organize duties to eet 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 leas been an awesome student, We have enjoyed bis tie here. Total points for all ratings se questions: 360, ‘Mean percentage score for all ating scale questions: 100.0% man sccton ual wets) opt} nop) nope) nop) nope) opt