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Survey: 3D- CRT Photon Planning Competency Evaluation

Reviewer: Clinical Instructors(CREBO, Donald) Reviewee: Students (Yiga, Tenzin)


Survey Period: 5/18/2020 Completed: 5/18/2020 3:28:38 PM CT

1. Select the external beam photon planning competency from the drop down menu below:

Pelvis (GYN or other)


2. If Other competency, please specify the type here:

Prone 3fld Rectum


3. Please assign each task a score of Satisfactory or Unsatisfactory.
Unsatisfactory in any essential task constitutes competency failure.
The student will repeat the competency at a later date.

Discusses the plan prescription with the N/A


physician. Additional Comments: discussed plan
with Dosimetrist
Loads the patient imaging studies into the Satisfactory [2 pts]
planning computer.
Contours the appropriate anatomy on the Satisfactory [2 pts]
image data set.
Successfully places the isocenter using Satisfactory [2 pts]
simulation data.
Correctly generates plan using blocks, Satisfactory [2 pts]
wedges, segmented fields.
Generates plan with appropriate Satisfactory [2 pts]
weighting.
Generates plan with appropriate Satisfactory [2 pts]
energies.
Accurately generates/evaluates plan DVH
or composite DVH (for correct # of Satisfactory [2 pts]
fractions).
Communicates effectively with physician
for plan review and makes changes as Satisfactory [2 pts]
requested.
Exports/Prints appropriate plan data. Satisfactory [2 pts]
Performs a verification calculation for Satisfactory [2 pts]
plan MU settings.
Enters correct parameters for the patient Satisfactory [2 pts]
chart.

Performs pretreatment Satisfactory [2 pts]


checks/calculations.
Utilizes respiratory gating information to N/A
determine field parameters. Additional Comments: N/A
Observes patient treatment. N/A
Additional Comments: Covid-19 - working
from home
Mean: 2.00 of 2 Points: 24 Score: 100.00%
4. Overall rating:

Pass [2 pts]
Mean: 2.00 of 2 Points: 2 Score: 100.00%
Total points: 26 (Each main question equally weighted)
Mean percentage score: 100.0% Responses as of 5/27/2020 9:37:32 AM CT

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