Survey: 3D- CRT Photon Planning Competency Evaluation

Reviewer: Clinical Instructors (LAW, Camille)

Reviewee: Students (Peck, Fiona)
Survey Period: 4/23/2024
Completed: 4/23/2024 3:04:47 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:

Rectum (4500 cGy in 25 fx) with Cone down (5400 cGy 180x5), 3D
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 Satisfactory [2 pts]

physician. Additional Comments: The original emails were
clear. It became a little messy as the planning
process continued.

Loads the patient imaging studies into the Satisfactory [2 pts]

planning computer.

Contours the appropriate anatomy on the Satisfactory [2 pts]

image data set. Additional Comments: Swapped the laterality on
the femurs

Successfully places the isocenter using Satisfactory [2 pts]

simulation data. Additional Comments: correct

Correctly generates plan using blocks, Satisfactory [2 pts]

wedges, segmented fields.
Additional Comments: Fiona created a nice
standard 3-field EDW case for the first phase and
2-field lat cone down. I asked her to make a FiF
comparison for the first phase and 3 field cone
down as alternatives. Final plans used for
treatment were the FiF and 3F cone down.

Generates plan with appropriate Satisfactory [2 pts]

weighting. Additional Comments: The balance of the plans
looked nice.

Generates plan with appropriate energies. Satisfactory [2 pts]

Additional Comments: Ultimately used 15x due to
patient size/thickness. She tried to use the 6x in
the PA field to reduce the bowel dose but
coverage wasn't as good. 15x had better
coverage and reduced the max dose.

Accurately generates/evaluates plan DVH Unsatisfactory [1 pts]

or composite DVH (for correct # of Additional Comments: Initially, in the first phase
fractions). plan: 95% of the target is covered by 104% of the
RX. Advised Fiona to renormalize for more
appropriate coverage. She had to adjust the
weightings of the beams after renormalizing to
maintain 100% coverage.

Communicates effectively with physician Satisfactory [2 pts]

for plan review and makes changes as
requested.

Exports/Prints appropriate plan data. Unsatisfactory [1 pts]

Additional Comments: Missed the extended CBCT
and setup ins

Performs a verification calculation for plan Satisfactory [2 pts]

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

Performs pretreatment Unsatisfactory [1 pts]

checks/calculations. Additional Comments: The kV fields should be set
to 29 x22, the APkV should have been called PA
since the patient is prone, beam time was not
defined, all tol tables were set to 8 obi keyed, the
imager was missing the position, femurs should
only be fem heads only

Utilizes respiratory gating information to N/A

determine field parameters.

Observes patient treatment. Satisfactory [2 pts]

Additional Comments: Will review OLR

Mean: 1.79 of 2 Points: 25 Score: 89.3%

4. Overall rating:

Pass [2 pts]
If applicable, please specify reason for failure: Fiona has completed 6 development cases
and 1 clinical case before her competency. She has gotten herself to a good point
with designing EDW plans with a balanced dose distribution. She can create a nice
FiF plan but with more practice, she will be more confident in the pre-planning steps
and dose evaluation and normalization. Advised to take on another 3d rectum case if
there is time and one comes through the clinic. She was happy to take on the case
from start to end as she only did 1 case before her competency (she has finalized 4
clinical cases in the past but there are not many 3D rectum cases in the clinic). She
learned a lot about problem-solving and handling clinical cases.

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

Total points for all rating scale questions: 27 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 94.7% Response as of 5/9/2024 2:08:17 PM CT