Jeremy Marshall

DOS 772 Clinical Practicum II

Service-Learning Journal
Service-Learning Journal II – Employer

For the employer portion of my service-learning journal, I chose to volunteer my time

within the radiation oncology department. In order to best serve the department, I asked my

clinical preceptor, other dosimetrist, and physics staff what they would like to see changed. They

thought the current treatment request guides and DVH forms were behind the times, so I worked

on editing those. Our facility had recently gone through a name change so the first thing I did

was update the headers for all of the documents to reflect the new name.

Figure 1 Outdated header

Figure 2 Updated header

Changing the headers went fast; the majority of my time was spent looking at our clinical

protocols such as 3 and 5 fraction SRS treatments. For these clinical protocols, structure names
are defined along with dose constraints. Each protocol was different depending on the

prescription, fractionation, and area treated, however they all defined the constraints per the

protocol and the variation acceptable dose constraints. In our current state, for any treatment, we

have a treatment request guide with all the dose constraints and a DVH form where we record

dose values and mark whether they met the dose constraints or not. As my preceptor pointed out,

it makes little sense to convert digital information to analog and then back to digital. Instead, it

makes more sense to create and utilize the clinical protocol templates within Eclipse.

Figure 3 Example of DVH form;

 By creating these clinical protocol templates, the DVH forms would be eliminated,

effectively minimizing the possibility for human data entry error. With the clinical protocol

templates, assuming all structures were defined according to the protocol, a DVH analysis would

be printed out on the report. This would also allow the template to be pulled in when treatment

planning, with defined arcs, normalization, and treatment technique. By utilizing these templates,

the dosimetrists could save time and ensure that treatments and record keeping were precise and

accurate. Below are examples of the 3 fraction SRS protocol with dose constraints from TG-101.

Figure 4 Portion of the 3 fraction SRS protocol template

Figure 5 Manually setting up 3 fraction SRS constraints

I believe that this service project for my department was a mutually beneficial one. By

streamlining the clinical protocols, the medical dosimetrists and myself can save time when

treatment planning and analyzing the results. The minimization of data entry error is also a great

benefit stemming from these clinical protocol templates. Finally, the project allowed me to have

extended periods of time with dose constraints. Rather than simply looking at flash cards and

memorizing dose constraints for different parts of the body, I feel that I had a much more

engaging and meaningful interaction with the constraints, one that I will be able to reflect back

on during job interviews or when sitting for the boards.