THE OHIO STATE UNIVERSITY

RADIATION THERAPY
CT SIMULATION COMPETENCY EVALUATIONS
Class of 2017-2019
Students are required to complete 13 simulation competencies. Students must complete:
2 competencies the 2nd rotation, 4 on the 3rd and 4th rotations, and 3 on the 5th rotation.
(The student will demonstrate their skill on the patients of their choice.) Students must perform the competency with the Clinical
Supervisor, Clinical Instructor (having greater than 2 yrs. experience as a therapist), Clinical Coordinator or the Program Director.
The front of the competency form must be completed prior to performing a clinical competency.

Required Simulation Sites Date Completed Score Verified By

Breast

Breast

Head and Neck

Head and Neck

Chest

Chest

Pelvis

Pelvis

Abdomen (Pancreas, Para Aortic, Lymphoma etc)

Brain

Brain

Spinal Field (Prone or Supine)

Extremity Field (Long bones, shoulders or hips)

Treatment Accessory Devices

Vac Bag – Thorax

Vac Bag – Pelvis

Aquaplast mask

Encompass Mask
R:Admin/Clin Therapist/Word as of 6/12