LATI Home

MLT 231: Practicum II Evaluation

Clinical Information
Student's Name:
 Exceeded maximum number of characters.
Date of Rotation:
 Exceeded maximum number of characters.
Clinical Evaluator:
 Exceeded maximum number of characters.
Supervisor Email:
 Exceeded maximum number of characters.
Date of Evaluation:
 Exceeded maximum number of characters. (MM/DD/YYYY)
Affective Domain Grading Scale
E=Excellent 96%
S=Satisfactory 87%
I=Improvement Needed 70%
U=Unsatisfactory 0%
Time Management
The Student:
E = Demonstrates time management skills that exceed the expected level (comes early, demonstrates initiative and efficiency in performing laboratory testing).
S = Is punctual; begins work in a timely manner; completes assignments within assigned time frame.
I = Is occasionally late; occasionally has problems beginning work in a timely manner; some assignments not completed within assigned time frames.
U = Is often late; has difficulty "getting started" on work; consistently fails to meet assignment deadlines.
Workload Management
The Student:
E = Show more organizational skills than most entry-level bench technicians.
S = Can organize work and produce required quantity of work with accuracy within the allotted time frame.
I = Occasionally has trouble organizing work; usually produces required quantity of work with accuracy within the allotted time.
U = Consistently requires help with organization; cannot complete required quantity of work with accuracy within allotted time; must always ask questions in order to complete the task.
Facilities Management
The Student:
E = Demonstrates initiative by cleaning, restocking, and adhering to regulation without directive to do so at all times.
S = Leaves work area clean and restocked; properly uses and maintains equipment; adheres to all published safety regulations in the laboratory.
I = Often leaves the work area dirty and unstocked; usually properly uses and maintains equipment and is not willfully negligent; occasionally violates published safety guidelines.
U = Does not leave work area clean and restocked even with reminding; willfully damages equipment; willfully violates published laboratory safety regulations.
Professionalism
The Student:
E = Is an exemplary professional at all times, in all circumstances.
S = Willingly follows instructions and accepts professional constructive criticism regarding work; interacts with faculty and students in a professional manner, e.g., is polite, considerate, pleasant, unhurried.
I = Occasionally fails to follow instructions and/or accept professional constructive criticism with little resistance; occasionally interacts with faculty and other students in an unprofessional manner.
U = Is willfully disobedient and insubordinate; acts unprofessionally, e.g., is abusive toward faculty members or other students.
Professionalism Part 2
The Student:
E = Handles work in logical sequence; is fully aware of own limitations; seeks help when needed.
S = Generally handles work in a logical sequence; is aware of own limitations; seeks help when needed.
I = Occasionally handles work in illogical sequence; is somewhat aware of own limitations; often seeks help before thinking the situation through. Asks many questions as a result of insecurity.
U = Has difficulty handling work in logical sequence, even after direction; does not recognize limitations even after limitations are pointed out; refuses to seek help or requires constant supervision/help.
Please comment on any I or U responses for the Affective Section: (400 Letters Max)
  CharactersExceeded maximum number of characters.

Technical Objective Grading Scale
E=Excellent 96% Student is capable of performing tests without supervision after adequate training in the procedure.
S=Satisfactory 87% Student is capable of performing tests with minimal supervision after adequate training in the procedure.
I=Improvement Needed 70% Student is capable of performing tests with moderate supervision after adequate training in the procedure.
U=Unsatisfactory 0% Student is incapable of performing tests with direct supervision after adequate training in the procedure.
NP=Demonstrated but Not
Performed		 Procedure demonstrated and student understands the principle and purpose of the test.
NA=Not Applicable Procedure not available (not demonstrated or performed).

Microbiology E S I U NP NA
1. Determines acceptability of specimen.
2. Logs in specimen properly.
3. Selects and labels proper media for specimen.
4. Inoculates media with proper plate-streaking technique.
5. Selects proper incubation temperature and atmosphere.
6. Practices acceptable sterile technique throughout each step of the set-up.
7. Recognizes colony morphology of common bacteria.
8. Recognizes normal flora.
9. Recognizes contamination and reports appropriately.
10. Grades sputums properly.
11. Performs microbiology laboratory procedures utilizing manual and/or automated techniques and obtains results within acceptable limits of accuracy.
11a. Automated Equipment Used: (400 Letters Max)
  CharactersExceeded maximum number of characters.
12. Reads biochemicals and identifies common organisms.
13. Indicates which tests are needed to identify common pathogens.
14. Obtains organisms in pure culture.
15. Inoculates biochemicals properly.
16. Correctly identifies a series of unknown organisms.
17. Selects correct colony for identification and sensitivity testing.
18. Sets up and reads sensitivity test correctly.
19. Prepares smears (for gram staining, other) and stains properly.
20. Recognizes the morphology of various bacteria.
21. Performs and reports a Gram stain according to laboratory protocol.
22. Performs and reports a KOH preps.
23. Performs any parasitology or mycology work done by the clinical site.
23a. Please comment on any I or U responses for the Microbiology Section: (400 Letters Max)
  CharactersExceeded maximum number of characters.
Immunology/Serology E S I U NP NA
24. Performs immunology/serology laboratory procedures utilizing manual and/or automated techniques and obtains results within acceptable limits of accuracy.
24a. Tests Performed: (400 Letters Max)
  CharactersExceeded maximum number of characters.
25. Interprets the significance of a positive test for IgM versus a positive for IgG.
26. Interprets correctly the titers of acute and convalescent serums when performed.
27. Performs QC with the tests required and recognizes "out of limits" QC and does not report patient results until appropriate troubleshooting has been completed.
28. Recognizes possible erroneous patient results and completes appropriate result validation prior to reporting of results.
28a. Please comment on any I or U responses for the Immunology Section: (400 Letters Max)
  CharactersExceeded maximum number of characters.
Immunohematology E S I U NP NA
29. Washes cells and prepares a 3-5% RBC suspension.
30. Grades agglutination reaction correctly.
31. Recognizes hemolysis as a positive result.
32. Performs and interprets ABO typing (forward and reverse) with 100% accuracy.
33. Performs and interprets Rh typing to include "weak D's".
34. Performs and interprets the direct antiglobulin test.
35. Performs and interprets antibody screens.
36. Performs and interprets antibody identification panels.
37. Performs and interprets gel tests (if available).
38. Selects the appropriate type of blood for crossmatch.
39. Performs a number of crossmatches under the supervision of staff tech.
40. Performs testing to determine the need for RhIg.
41. Performs fetal screen and/or fetal stain when indicated.
42. Performs testing for and observes the issue of RHIg when indicated.
43. Tags units of blood for transfusion.
44. Observes the issuance of blood including documentation.
45. Explains and applies component usage.
46. Performs all quality control procedures in the blood bank, recognizing "out-of-limits" QC and taking appropriate action (not reporting patient results until appropriate troubleshooting has been completed and QC is within acceptable limits).
47. Recognizes patient result errors and follows up appropriately.
48. Explains emergency blood issue protocol.
49. Explains proper reissue of blood back into the bank.
49a. Please comment on any I or U responses for the Immunohematology Section: (400 Letters Max)
  CharactersExceeded maximum number of characters.
Practicum II Comments
1. Are there any tests or procedures that the student should perform or repeat prior to graduation? (400 Letters Max)
  CharactersExceeded maximum number of characters.
2. Did the student accomplish the learning experiences YOU feel he/she should have accomplished during this rotation? (400 Letters Max)
  CharactersExceeded maximum number of characters.
3. Is there anything you would like to compliment the student on? (400 Letters Max)
  CharactersExceeded maximum number of characters.
4. Are there any other comments/suggestions? (400 Letters Max)
  CharactersExceeded maximum number of characters.
A copy of this evaluation will be forwarded to the student


search

Home | Alumni | Programs | Admissions | Foundation | Student Handbook | Interactive Map | Catalog | Contact Us

Copyright ©2008 Lake Area Technical Institute
230 11th Street NE - PO Box 730 - Watertown, South Dakota - 57201
General Information: (605) 882-LATI or 1-800-657-4344
Accredited by The Higher Learning Commission