5/6/24, 11:23 AM Typhon Group - EASI System

Survey: "3D- CRT Photon Planning Competency Evaluation"

Reviewer: Clinical Instructors (LAW, Camille)
Reviewee: Students (Ahmed, Muna)
Survey Period: 4/19/2024
Completed: 4/19/2024 12:54:15 PM CT

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

Palliative (Spine, Hip, Ribs, etc)

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

400 cGy x 5 fx, T8 to L2, no prior Rt, no cardiac devices

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5/6/24, 11:23 AM Typhon Group - EASI System
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 physician. Satisfactory [2 pts]

Additional Comments: Typical RX for spine, saw that the
bottom of the field wasn't fully encompassing L2. The
confirmed sim order stated spinal cord compression and
disease. MD confirmed margin is ok

Loads the patient imaging studies into the planning computer. Satisfactory [2 pts]
Additional Comments: Confirmed

Contours the appropriate anatomy on the image data set. Satisfactory [2 pts]
Additional Comments: Body, Carina for setup, couch --
>reminder to Muna that the Carina needs to be called "xCarina"
for setup

Successfully places the isocenter using simulation data. Satisfactory [2 pts]

Additional Comments: Confirmed - placed at T11

Correctly generates plan using blocks, wedges, segmented Satisfactory [2 pts]

fields. Additional Comments: AP/PA 0 and 180

Generates plan with appropriate weighting. Satisfactory [2 pts]

Additional Comments: 50%/50%, reference point was placed at
midline at 13.2 cm

Generates plan with appropriate energies. Satisfactory [2 pts]

Additional Comments: Separation at the central axis was 26.4
cm so she designed a 15x plan with max dose 113.9%. She
created a 6x plan as an alternative with max dose around 123%,
but 100% was very broken.

Accurately generates/evaluates plan DVH or composite DVH Satisfactory [2 pts]

(for correct # of fractions).

Communicates effectively with physician for plan review and Satisfactory [2 pts]
makes changes as requested.

Exports/Prints appropriate plan data. Satisfactory [2 pts]

Performs a verification calculation for plan MU settings. Satisfactory [2 pts]

Enters correct parameters for the patient chart. Satisfactory [2 pts]

Additional Comments: Muna was correct in adding the AP/LAT
with obliques due to arm positioning but discussed that for
triology machines we should add all 4 cardinal angles for
setup.

Performs pretreatment checks/calculations. Satisfactory [2 pts]

Utilizes respiratory gating information to determine field N/A

parameters.

Observes patient treatment. Satisfactory [2 pts]

Additional Comments: Reviewed OLR

Mean: 2.00 of 2 Points: 28 Score: 100.0%

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5/6/24, 11:23 AM Typhon Group - EASI System
4. Overall rating:

Pass [2 pts]
If applicable, please specify reason for failure: Feedback from senior: Nice work, everything looks good.
I would just read up on when the extra kV angles are needed since it doesn’t come up often. Also, make
sure you are comfortable when to ask MD’s to confirm their field parameters. You did the right thing in
this case by doing so, but the MD’s response also implied that we could move the jaws to include all of
L2 which is not what they intended originally, so we may have confused them. But more often
situations arose where planners missed the issue or didn’t ask MD’s to confirm and they turn out to be
wrong or not optimal, so again, always best to confirm. For purely cosmetic reasons, I’ve added the
95% IDL line to show MD that at least 95% is covering since the 100% IDL had a large hole near the
spine. We could also manipulate the calc pt position to improve coverage if the hotspots allow, but in
this case it wasn’t necessary and it’s good you went with 15MV. Overall, Muna did a great job on the
calc. Her confidence in speaking with the MD will come with more practice.

Mean: 2.00 of 2 Points: 2 Score: 100.0%

Total points for all rating scale questions: 30

Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/6/2024 11:22:52 AM CT

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