STUDENT CLINICAL SELF EVALUATION
NAME:
Clinic
course completed:
INSTRUCTIONS: Please read each statement carefully
and select the response which, in your judgment, best
describes YOU in clinic. Mark only one response
for each statement.
Use the
following for your responses
A = strongly agree
B = agree
C = somewhat agree
D = disagree
E = strongly disagree
1. I access and utilize the instructor’s webpage to supplement my course of
study.
2. I am rarely absent from clinic.
3. I expect a high grade in clinic this
semester.
4. I am always prepared for clinical
rotations.
5. I work independently in the clinical
site.
6. I need encouragement to perform an exam
in clinic for the first time.
7. I like to do patients without a
technologist in the room with me.
8. I remain in my assigned room and help with exams even if I have not been
taught in class.
9. I check the room for supplies, technique charts, shields, sponges, linen, etc.
and
keep my room stocked.
10. I always use "standard
precautions."
11. I critique my own radiographs for
radiographic quality and positioning.
12. I have all my radiographs reviewed by an
R.T.
13. I feel comfortable with the
technologists.
14. I ask questions to learn (not to
impress).
15. I keep a notebook to write down techniques,
etc., and use it.
16. I'm reluctant to do an exam without my
notes.
17. I operate equipment safely and
efficiently.
18. I fluoroscopy patients to position for
BE and UGI exams.
19. I fluoroscopy patients to verify that
the equipment is operating correctly.
20. I stand behind the radiologist during
fluoroscopy.
21. I hold patients during exposures.
22. I wear a lead apron when doing or
assisting with fluoroscopy.
23. A technologist is always with me when I
repeat a film.
24. I routinely shield patients.
25. I wear a lead apron when doing or
assisting with portable examinations.
26. I clean the table and
change sheets/pillowcases between patients.
27. I wash my hands in between patients.
28. I assist in patient transportation.
29. I introduce myself to my patients and
verify their identification.
30. I check all in-patients’ charts to verify
orders.
31. I accept advice and criticism with a
positive attitude.
32. I dress professionally and am neat and
clean.
33. I have no difficulty using Automatic
Exposure Controls (AEC).
34. I have no difficulty selecting manual
techniques.
35. I do more than is expected of me by the
technologists.
36. Clinical assignments should be more
educational.
37. I discourage gossip.
38. I do not violate patient confidentiality.
39. I perform procedures with other students without a competency in the
procedure.
40. I follow ALARA in selecting exposure
factors.