Fillable Radiologic Technology Mid Term Clinical Evaluation (Indian Hills Community College)

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Radiologic Technology Mid Term Clinical Evaluation (Indian Hills Community College)

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Mid-Term Clinical Evaluation
Radiologic Technology Program
Student’s Name: Date:
Clinical Facility:
Clinical: 1 2 3 4 5 6 7
Fill out and return each mid-term. Comments are required to support mid-term rating.
Clinical Instructor Mid-Term Evaluation
1
Does Not Meet
Expectations
2
Below Average
Expectations
3
Average
Expectations
4
Above Average
Expectations
5
Exceeds
Expectations
Comments:
Clinical Instructor’s Signature: Date:
Clinical Coordinator Mid-Term Evaluation
1
Does Not Meet
Expectations
2
Below Average
Expectations
3
Average
Expectations
4
Above Average
Expectations
5
Exceeds
Expectations
Comments:
Clinical Coordinator’s Signature: Date:
Students must have completed at least 50% of their competencies to be considered passing at Mid-Term.
PASS FAIL
Student’s Signature: Date:
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Radiologic Technology Mid Term Clinical Evaluation (Indian Hills Community College)

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Completed 18 July 2020

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