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

(Choice - One Answer Drop Down) First Rotation Palliative Para-aortic or Nodal Irradiation Pelvis - 4 field Abdomen - 3 or 4 field Off-Axis Prescription Point Pelvis - 3 field with wedges Second Rotation Palliative Intact Breast Tangentials Chestwall Tangentials (Bolus:NonBolus Weighting) Breast or Chestwall with SC and PAB Thoracic (Conformal ) Limb Sarcoma Lymphoma Prostate (Conformal) True Vocal Cord Third Rotation Respons e Percent 50.0% Respons e Total 1

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Palliative H&N (Conformal) Brain (Fusion Required) Esophagus Other 0.0% 0.0% 0.0% 0.0% 0 0 0 0 2 0

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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 the isocenter using simulation data. Correctly generates plan using blocks, wedges, fields, segmented fields. Generates plan with appropriate weighting. Generates plan with appropriate energies. Accurately calculates daily isocenter dose for each treatment field using prescription % and weighting. 1 2 Unsatisfactory Satisfactory 0 N/A Additional Comment Mean Percentage [0-2] Score

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Accurately generates an individual 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. Performs pretreatment checks/calculations. Observes patient treatment. OVERALL COUNTS/MEANS:

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

Additional Comments:
(Open Ended - Comments Box)

[If "Other" Competency, please specify type here]

Total Respondents: 2 Skipped this question: 0

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