THE OHIO STATE UNIVERSITY

RADIATION THERAPY PROGRAM

CLINICAL COMPETENCY OBJECTIVES
During clinical procedures, the student must demonstrate competency of the following:
1.

Review chart, and DRRs or simulation films prior to preparing patient for
treatment
-review patient set up and assures understanding
-utilize DRRs or simulation films for set-up on initial treatment
-recognize need for port films

2.

Checks prescription with total dose currently delivered.

-read prescription daily
-check daily prescribed dose against daily treatment dose
-check total prescribed dose against current total delivered
-check addition of total dose

3.

Prepare treatment room with appropriate equipment

-utilize set-up information in chart
-set out appropriate positioning aids, custom blocks and wedges

4.

Greet and assist patient to and from the treatment area

-greet patient
-confirm patient identity
-introduce self and other pertinent personnel to patient
-ask as to patient's general condition

5.

Explain procedure if new to the patient and confirm patient's understanding

-explain purpose and procedure to be done
-use language that is non-technical and appropriate to patient understanding
-confirm patient understanding

6.

Assist patient into treatment position

__ Ambulatory, ___ Wheel Chair

___ Cart

-assist patient to treatment table from wheelchair

-assist in safely lifting patient from cart
-assist patient by supporting back/neck and lifting legs while reclining
-position headrest and other devices for proper function and patient comfort
7.

Position patient to reproduce set-up indicated in treatment chart

-utilize any and all appropriate positioning aids
-position extremities as indicated in chart
-correct for any misalignment before proceeding with treatment

Clinical Competency Objectives Cont.

8.

Immobilize patient
-use all appropriate immobilization devices as indicated in
chart
-utilize safety belts as needed if patient is not secure on table
-assure patient comfort within guidelines of immobilization device use

9.

Aligns Tx field & Set treatment parameters to reproduce set-up as indicated in

chart or EMR
-assure correct field size is set
-use correct patient markings
-accurately align radiation light field with accurate markings
-set correct SSD/SAD
- assure correct table/couch angle is set
- assure correct gantry angle is set
- assure correct collimator angle is set

10.

Select and place correct blocks, wedges, compensators, bolus, etc.

-check chart/simulation sheet or prescription for required beam modifying devices
-check films for correct placement of MLCs or custom blocks
-check treatment plan for correct wedges and the orientation of wedges
-place and secure blocks and wedges into proper orientation and location
-place bolus as indicated
-double check for correctness of devices before administering treatment

11.

Recheck set-up with set-up indicated in electronic chart and films

-recheck prescription, films, set-up instructions, and compare to actual patient
set-up
-resolve any discrepancies if field alignment does not match
-call for assistance from technical supervisor, dosimetrist, or physician if
discrepancies are not resolved

12.

Indicate to patient that treatment is to begin

-instruct patient to remain still during treatment
-inform patient that treatment is to begin
-close door to treatment room

13.

Set appropriate controls on treatment machine console treating through the record
and verify system.
-set timer/monitor units as indicated in chart if paper chart
-assure back-up timer allows adequate time for treatment
-set accurate rad/degree for rotational treatment
-select correct electron/photon energy

Clinical Competency Objectives Cont.

14.

Performs verbal timeout.

-state patient name, treatment site, treatment fraction, and/or any other
information required by the institution prior to activating machine for treatment
or localization.

15.

Performs IGRT and aligns the patient appropriately.

_____Exact Trac _____Vision RT

____Conebeam

_____OBI

-use appropriate equipment to obtain adequate imaging prior to treatment.

-view images and adjust table parameters to align fudicials or
bony landmarks as indicated.
-patient alignment should be within approximately 3mm of where the therapist or
physician approves.
16.

Activate machine to deliver prescribed dose

-perform appropriate procedures in proper sequence to beam on

17.

Monitor patient during treatment

-assure clear view of camera during treatment
-communicate to patient via audio monitors if necessary
-turn off treatment unit if patient moves or appears to be in distress

18.

Monitor treatment unit function during treatment delivery

-check for rad on
-check for operating lights
-check treatment unit for output

19.

Verifies (EMR) or records (paper chart) technical data was documented in patient
chart
-verify correct MUs and dose were recorded if EMR
-write appropriate figures in required spaces
-add columns correctly
-note wedge checks
-note port films taken
-check co-workers charting

20.

Records patient data in treatment chart

-write appropriate technical notes
-documents bolus, SSDs, etc.
-create patient checklists if applicable

Clinical Competency Objectives Cont.

21.

Set up opposing/additional portals correctly

-follow all previously listed behaviors to set-up additional ports

22.

Utilize all treatment equipment safely

-move gantry and table with care
-lift blocks and wedges so as not to drop them
-place and secure equipment safely
-use equipment so as not to frighten or harm the patient
-utilize the equipment so as not to incur equipment damage

23.

Assist patient from treatment table

-help patient sit up, supporting patient's back and neck
-help patient move legs off table
-assure patient is standing steadily before leaving them
unattended
-help patient into wheelchair
-assist in securely lifting patient from table to stretcher

24.

Answer patient questions

-attempt to answer questions from patients and families
-direct questions to others if unable to answer

25.

Answer therapist questions relevant to the procedure

-set-up and/or treatment delivery questions asked by a therapist to verify the
students understanding of concepts relevant to the procedure performed are
answered appropriately.

26.

Attend to additional patient care details

-send patient for laboratory tests when needed
-send patient to be weighed when needed
-keep patient for physician examination when necessary
-schedule simulation when necessary
-inform patient of upcoming scheduled events

27.

Display ethical standards and maintain a level of professionalism

-speak in manner appropriate to the situation
-refer to patients, physicians, co-workers with respect
-refrain from discussion of inappropriate topics in the
treatment area
-treat patients and families with respect and dignity
-demonstrate a confident and competent manner