Survey: Affective Clinical Evaluation Level I

Reviewer: Clinical Instructors (BIRCH, Susan)

Reviewee: Students (Robinson, Jamie)
Survey Period: 8/18/2023
Completed: 8/17/2023 3:32:20 PM CT

1. First semester Evaluation:

3rd Evaluation

3. Communications

Explains medical dosimetry procedures to N/A

patient as appropriate to situation (e.g.
when assisting with procedures in
treatment room or simulation).

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

confidentiality. Additional Comment: Always communicates with pts]
others using proper protocol.

Acts and speaks in a respectful manner Meets Expectations [10

with staff members. pts]

Asks questions in an appropriate manner. Meets Expectations [10

Additional Comment: Jamie is constantly asking pts]
questions to try and improve the plans and her
understanding.

Accepts correction and direction in a Meets Expectations [10

professional manner. pts]

Contributes as a member of the medical Meets Expectations [10

dosimetry team. Additional Comment: Jamie has done many plans pts]
on her own with very little input. She is
competent in using the tools for contouring all
routine volumes. She communicates well with the
MDs and the therapists as well as the other
dosimetrists.

Uses effective verbal communication skills Meets Expectations [10

with physician during plan consultation Additional Comment: Her communication with the pts]
and review. physicians is appropriate.

Uses effective written communication Meets Expectations [10

skills for chart, plan, and dosimetry note Additional Comment: Complete pts]
documentation.

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

4. Accuracy

Follows through instructions with attention Meets Expectations [10

to detail. Additional Comment: Very Detail oriented. pts]

Accurately enters information into chart or Meets Expectations [10

R & V system. 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: While working with her, the pts]
dosimetrist/physicist. steps are checked and reviewed, and then a
formal check is done usually by another
dosimetrist as well as physicist.

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

6. Dependability

Arrives promptly as scheduled. Meets Expectations [10

Additional Comment: always on time pts]

Schedules breaks, lunches, and other Meets Expectations [10

time needs with clinical instructors. pts]

Adheres to attendance standards of the Meets Expectations [10

program. pts]

Uses clinical time wisely. Meets Expectations [10

pts]

Follows school and hospital policies and Meets Expectations [10

procedures. pts]

Takes initiative in observing and assisting Meets Expectations [10

in dosimetry activities. Additional Comment: very enthusiastic pts]

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. pts]

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

bring into patient file. Additional Comment: Is able to also fuse images. pts]

Is able to identify anatomy and contour Meets Expectations [10

appropriate structures. Additional Comment: very competent pts]

Understands the use of the computer for Meets Expectations [10

treatment planning. pts]

Is able to enter information into the Meets Expectations [10

computer and design a basic treatment Additional Comment: Has done many 3d plans on pts]
plan in accordance with prescription. areas to include larynx, breast and pelvis as well
as bony mets.

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 Meets Expectations [10

databooks to perform hand calculations. pts]

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

efficiently complete requirements. pts]

Exhibits a basic knowledge of anatomy, Meets Expectations [10

tissue dose tolerance, definitive tumor pts]
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:

Jamie is doing great. She is mastering the use of 3d planning using wedges, different energies, and
Fin F techniques. She seems to enjoy what she is doing and is very enthusiastic.

Total points for all rating scale questions: 250 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 8/17/2023 3:42:45 PM CT