University of Vermont Nuclear Medicine Technology Program
NMT164 Clinical Report Form - Spring 2008
Start Time End Time e-mail address: --Assigned Clinic Work Area-- CT CVCA Forte Hot Lab MRI PET PharmaLogic Sopha I Sopha II XL I Ultrasound I also spent time in: CT CVCA Forte Lab MRI PET Pharmalogic Sopha I Sopha II Ultrasound XL I and: CT CVCA Forte Hot Lab MRI PET PharmaLogic Sopha I Sopha II Ultrasound XL I
--My Supervising Technologist was-- Rocel Aguillon Christy Bowman Chelsea Bullard Emily Crook Tom DeFranco (Pharmalogic) David Gervais (CVCA) Jesse Guterres Richard Lew Steve Relation Jennifer Simpson Smith Ed Tumielewicz Jillian Turner Christin Young I also worked with: Rocel Aguillon Christy Bowman Chelsea Bullard Emily Crook Tom DeFranco (Pharmalogic) David Gervais (CVCA) Jesse Guterres Richard Lew Steve Relation Jennifer Simpson Smith Ed Tumielewicz Jillian Turner Christin Young and: Rocel Aguillon Christy Bowman Chelsea Bullard Emily Crook Tom DeFranco (Pharmalogic) David Gervais (CVCA) Jesse Guterres Richard Lew Steve Relation Jennifer Simpson Smith Ed Tumielewicz Jillian Turner Christin Young
Give a general summary of what you actually did during this clinic session, including a list of the procedures you observed and how many of each.
SELF APPRAISAL: --During this session, I was:-- mostly observing 3/4 observing, 1/4 hands-on 1/2 observing, 1/2 hands-on 1/4 observing, 3/4 hands-on mostly hands-on --Did I arrive in clinic on time?-- YES NO --Was I prepared for this clinic session?-- YES NO --Did I adhere to the dress code?-- YES NO --Did I refrain from inappropriate conversation in front of the patient?-- YES NO N/A --Did I remain calm in a stressful situation?-- YES NO N/A --Did I accept constructive criticism from the technologist?-- YES NO N/A
--Did I communicate with patients?-- YES NO N/A --Did I make any entries in my notebook?-- YES NO --Est'd downtime during this clinic session-- 0% 25% 50% 75% 100%
If there was any downtime, list what you did:
CLINICAL COMPETENCY - --am I ready to take clinical competency exam?-- YES NO
GENERAL COMMENTS: If you have any general comments about the clinic session, or wish to comment on any of your selections above, please write them below:
OR