Survey: "External Beam ELECTRON Planning Competency"

Reviewer: Clinical Instructors (LAW, Camille)

Reviewee: Students (Ceselka, Veronica)
Survey Period: 4/24/2024
Completed: 4/24/2024 10:28:17 AM CT
1. 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 physician.
Loads the patient imaging studies into the planning computer.
Contours the appropriate anatomy on the image data set.
Successfully places field/SSD using simulation data.
Correctly generates plan using appropriate cone/cutout size.
Generates plan with correct reference depth.
Generates plan with appropriate energy.
Correctly adds the appropriate thickness of bolus.
Generates bolus to adequately cover treatment field borders.
Accurately calculates daily dose for treatment field using
prescription % and weighting.
Accurately generates a single fraction DVH or composite DVH (for
correct # of fractions).
Communicates effectively with physician for plan review and makes
changes as requested.
Exports/Prints appropriate plan data.
Performs hand verification calculations for plan MU settings using
data/calc books
Enters in correct parameters for patient chart.
Satisfactory
Additional Comment: Veronica completed the electron beam plan
as prescribed. Assessed that the lung dose was very high with ≤
90% reaching the lung. She created two alternative plans for 9e at
90% and 9e at 85%. Presented 3 plans to the senior and further
offered that the MD could add bolus to the 12e plan to draw the
dose away from the lung. I've advised Veronica to take the next step
in offering her professional assessment and propose 2 options
instead (MD prescribed vs. best alternative). Also could have had
the conversation earlier to save time.
Satisfactory
Additional Comment: Verified user origin using the sim RTT scan
doc that was set to the breast. Reviewed the concepts of user origin
vs origin; encouraged her to review these items again.
Satisfactory
Additional Comment: The body, x setup stuctures, nipple contours
looked good. Asked to fix the lung and liver contour bc they were
slightly under-contoured.
Satisfactory
Additional Comment: Veronica tried to get the c/o to fit in a 10x10
cone, but it had to be 15x15. She then verified the cone clearance
for 100 SSD. She compared it against 103 SSD since it was a bit
close to the arm (under 1 cm clearance). Reminded her to keep her
photon clearance for someone to be able to check.
Satisfactory
Additional Comment: As described above. She tried to get the c/o
to fit in a 10x10 but still didn't fit even when using 100 or 103 SSD.
Satisfactory
Additional Comment: Measured the cavity to have an average depth
of 2.6 cm to the GTV and 2.8 cm to the CTV.
Satisfactory
Additional Comment: As described above
Satisfactory
Additional Comment: Veronica made an alternative 12e plan with
0.5 cm bolus.
Satisfactory
Additional Comment: Covered the entire field correctly. discussed it
doesn't need to be from medial to lateral tattoo.
Satisfactory
Satisfactory
Unsatisfactory
Additional Comment: As discussed, Veronica needs to work on her
professional presentation and decision for the treatment plan based
on what she has learned instead of just offering multiple copies to
choose from.
Satisfactory
Additional Comment: Is confident in the finalization portion of the
process
Satisfactory
Satisfactory
Additional Comment: Reminder to re-check L workflow bc things
can be more difficult with you're picking up the process after
someone else has done things.
 Performs pretreatment checks/calculations. Satisfactory

Observes patient treatment. Satisfactory

Additional Comment: Will see setup in person and review OLR

2. Overall rating:

Pass

3. Additional Comments:

Veronica has completed 3 development cases, 1 clinical case, and 2 finalizations before the competency. Feeling more comfortable reaching out to planners
to work on cases. She has done a fine job learning how to perform electron beam planning. As stated above, we want her to get to the point of giving her final
professional opinion on the plans. We discussed her reaching out earlier to start the discussion with the MD when needed to save her time down the line
when the case is not straightforward.

Responses as of 5/6/2024 8:01:25 AM CT