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Survey: "3D- CRT Photon Planning Competency Evaluation"

Reviewer: Clinical Instructors (MICHEL, Ann) Reviewee: Students (McKane, Brittni)
Survey Period: 4/18/2022 Completed: 4/18/2022 11:31:18 AM 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:

3 field pelvis

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 physician. Satisfactory [2 pts]

Loads the patient imaging studies into the planning computer. Satisfactory [2 pts]

Contours the appropriate anatomy on the image data set. Satisfactory [2 pts]

Successfully places the isocenter using simulation data. Satisfactory [2 pts]

Correctly generates plan using blocks, wedges, segmented fields. Satisfactory [2 pts]

Generates plan with appropriate weighting. Satisfactory [2 pts]

Generates plan with appropriate energies. Satisfactory [2 pts]

Accurately generates/evaluates plan DVH or composite DVH (for Satisfactory [2 pts]

correct # of fractions).

Communicates effectively with physician for plan review and makes Satisfactory [2 pts]
changes as requested.

Exports/Prints appropriate plan data. Satisfactory [2 pts]

Performs a verification calculation for plan MU settings. Satisfactory [2 pts]

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

Performs pretreatment checks/calculations. Satisfactory [2 pts]

Utilizes respiratory gating information to determine field N/A

parameters.

Observes patient treatment. N/A

Mean: 2.00 of 2  Points: 26  Score: 100.0%

4. Overall rating:

Pass [2 pts]
If applicable, please specify reason for failure:  Brittni did a wonderful job of planning this case. She has a
great understanding of field weighting and use of wedges. The physician was very pleased with her plan.
Great job!

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

Total points for all rating scale questions: 28

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

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Responses as of 4/18/2022 11:31:21 AM CT

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