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.

(Rating Scale Matrix) Statistical Mode in BOLD 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 1 2 Unsatisfactory Satisfactory 0 N/A Additional Comment Mean Percentage [0-2] Score

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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. Performs pretreatment checks/calculations. Observes patient treatment. OVERALL COUNTS/MEANS: 0.0% (0) 100.0% (1) 0.0% (0) 2.00 100.0%

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0.0% (0) 0.0% (0) 0 Total Respondents: Skipped this question:

2.00 2.00 2.00

100.0% 100.0% 100.0% 1 0

Overall rating:
(Rating Scale - One Answer Horizontal) Statistical Mode in BOLD 1 Fail 0.0% (0) 2 Pass 100.0% (1) Total Respondents: Skipped this question: If applicable, Mean Percentage please specify [1-2] Score reason for failure 2.00 100.0% 1 0

Additional Comments:
(Open Ended - Comments Box) Total Respondents: 1 Skipped this question: 0

Mean percentage score for all rating scale questions: 100.0% (Each main question equally weighted)