Evaluation month:

JANUARY 2014

Communications
Explains medical dosimetry procedures to patient as appropriate to
situation. - N/A
Respects patient's rights to privacy and confidentiality. - Meets
Expectations [3 pts]
Acts and speaks in a respectful manner with staff members. - Meets
Expectations [3 pts]
Asks questions in an appropriate manner. - Meets Expectations [3 pts]
Accepts correction and direction in a professional manner. - Meets
Expectations [3 pts]
Contributes as a member of the medical dosimetry team. - Partially Meets
Expectations [2 pts]
Uses effective verbal communication skills with physician during plan
consultation and review. - N/A (Additional Comment: Too early in the
process)
Uses effective written communication skills for chart, plan, and dosimetry
note documentation. - N/A (Additional Comment: Too early in the process)
MEAN: 2.80 (out of possible 3), % SCORE: 93.3%

Accuracy
Performs dose calculations accurately. - N/A
Reads radiation measurement devices accurately and carefully. (eg, TLD,
Diodes. Film, Ion Chamber) - N/A
Accurately designs plans by computer or manual computation in accordance
with prescription. - N/A
Accurately enters information into chart or R & V system. - N/A

Safety
Takes appropriate precautions in Radiation Safety. - Meets Expectations [3
pts]
Double checks all calculations and treatment plans with
dosimetrist/physicist. - N/A
Performs Quality Assurance per recommended guidelines and reviews with
dosimetrist/physicist. - N/A
Uses time, distance, shielding practices & principles. - Partially Meets
Expectations [2 pts]
MEAN: 2.50 (out of possible 3), % SCORE: 83.3%






Dependability
Arrives promptly as scheduled. - Meets Expectations [3 pts]
Schedules breaks, lunches, and other time needs with clinical instructors. -
Meets Expectations [3 pts]
Adheres to attendance standards of the program. - Meets Expectations [3
pts]
Uses clinical time wisely. - Meets Expectations [3 pts]
Follows school and hospital policies and procedures. - Meets
Expectations [3 pts]
Takes initiative in observing and assisting in dosimetry activities. - Partially
Meets Expectations [2 pts]
MEAN: 2.83 (out of possible 3), % SCORE: 94.4%

Application of Knowledge
Understands the technique and use of special calculation methods. - N/A
Is able to retrieve imaging study (CT) and bring into patient file. - N/A
Is able to identify anatomy and contour appropriate structures. - Partially
Meets Expectations [2 pts]
Understands the use of the computer for treatment planning. - N/A
Is able to enter information into the computer and design treatment plan in
accordance with prescription. - N/A
Utilizes critical thinking/problem solving skills in approaching treatment
planning. - N/A
Demonstrates a basic understanding of physics concepts and principles. -
Meets Expectations [3 pts]
Understands how clinical oncology information is used in treatment
planning. - N/A
Utilizes critical thinking skills when evaluating dose volume histograms. -
N/A
Uses problem solving skills when comparing various treatment plans for a
specific treatment case. - N/A
Is able to design optimal treatment plans based on calculations, dose volume
histograms, prescription, and treatment implementation. - N/A
MEAN: 2.50 (out of possible 3), % SCORE: 83.3%

General Dosimetry Skills
Performs calculations in a timely manner. - N/A
Accurately uses dose calculation databooks to perform hand calculations. -
N/A
Is able to dose out chart per prescription and plan. - Meets Expectations [3
pts]
Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose,
and typical field arrangement. - N/A
Is able to independently produce treatment plans as required by competency
list for the semester. - N/A
Is able to prioritize and organize duties to efficiently complete requirements.
- N/A
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%

Additional Comments:
Some of the questions are too early in the process. I have tried to check these
not applicable at this time, or temporary does not meet expectation yet.

Mean percentage score for all rating scale questions: 90.9%
(Each main question equally weighted)
NOTE: Question #4 is not included in this score due to no responses