Trajecsys is the clinical record-keeping database used by Cape Fear Community College. Trajecsys allows students to track their clinical hours, the scans they have completed, and clinical evaluation grades. When my sister began the sonography program, clinical instructors would complete an evaluation of the student and the grade that was produced from their evaluation was inputted into the gradebook, as it was the student’s accurate score. After Angela Meeker lowered my sister’s end evaluation grade from Novant Health Medical Plaza, this practice changed. My sister’s CFCC instructors contacted my sister’s clinical instructors after they had completed evaluations of my sister to ask what letter/number grade they would give my sister. Instead of my sister’s abilities being graded (as her classmates were being graded), my sister’s instructors at CFCC were determining what her grades would be.

When my sister began the program, clinical evaluations were split into a few different categories: patient care, professionalism, communication, initiative, performance, and critical thinking. Clinical instructors were given the option to choose always, often, sometimes, or never on prompts given to them about the student. Always represented a student was performing a given task 100% of the time. Often represented a student was performing a given task roughly 75% of the time. Sometimes represented a student was performing a given task roughly 50% of the time. Of course, never represented a student was performing a given task 0% of the time.

If a clinical instructor selected sometimes on any of the prompts, the student would receive a flag on their evaluation. Flags are further broken down into green flags and red flags. If a student received a green flag, their evaluation had a few sometimes selected, but not enough that it was impeding the student’s ability to move forward with the program. If a student received a red flag, their evaluation had many sometimes selected, and that student was placed on a plan of action (academic probation). If any category represented an 84 or above on a student’s evaluation, the student was good to go. If any category represented below an 84 on a student’s evaluation, the student would be placed on a plan of action. If the student received a subsequent clinical evaluation with a red flag (less than an 84 in any category), the medical sonography program handbook stated that the student would be dismissed from the program.

My sister’s CFCC instructors made contact with her clinical instructors to ask them what grade they would give my sister after her clinical instructors had already given her a grade through Trajecsys. After they contacted my sister’s clinical instructors, my sister’s clinical evaluation grades were lowered to fit the narrative that my sister couldn’t scan.

Comps—or competencies—are scans required for medical sonography students to perform during their time in the program. Medical sonography students are required to perform a certain number of exams before they receive a “comp.” For example, medical sonography students were required to complete at least 2 aorta ultrasounds unassisted before they received their “comp” in aorta.

The medical sonography students were given a clinical education progress chart at the beginning of the program that laid out which exams students should be competent in by which semester, and how many they were required to have by the end of each semester. My sister exceeded this amount each semester, as she was competent in various subjects of scanning.

While written exam scores cannot be altered, every scan test that medical sonography students complete are graded subjectively by the CFCC medical sonography faculty and lab instructors. This leaves plenty of room for personal opinion, disdain, or distaste to factor into a student’s grade. When my sister was enrolled in the sonography program, her sonography handbook stated that clinical evaluations would be graded through Trajecsys and that, “clinical grading will be based on verbal and written assessments received from the clinical instructors. Some information may come from verbal communication with clinical instructors and may be added to the student evaluation or record. These verbal or written assessments may alter the grade on the evaluation after it has been submitted.” Right here, CFCC medical sonography is admitting that they change student grades!