Survey: 3D- CRT Photon Planning Competency Evaluation

Reviewer: Clinical Instructors (TYBURSKI, Laura)

Reviewee: Students (Ilic, Milica)
Survey Period: 10/26/2023
Completed: 10/26/2023 10:26:37 AM CT

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

ReTreat avoiding or matching old port (any area)

2. If Other competency, please specify the type here:

Retreat Hip
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 Satisfactory [2 pts]

physician.

Loads the patient imaging studies into the Satisfactory [2 pts]

planning computer.

Contours the appropriate anatomy on the Satisfactory [2 pts]

image data set.

Successfully places the isocenter using Satisfactory [2 pts]

simulation data.

Correctly generates plan using blocks, Satisfactory [2 pts]

wedges, segmented fields.

Generates plan with appropriate Satisfactory [2 pts]

weighting.

Generates plan with appropriate energies. Satisfactory [2 pts]

Accurately generates/evaluates plan DVH Satisfactory [2 pts]

or composite DVH (for correct # of
fractions).

Communicates effectively with physician Satisfactory [2 pts]

for plan review and makes changes as
requested.

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

Performs a verification calculation for plan Satisfactory [2 pts]

MU settings.

Enters correct parameters for the patient Satisfactory [2 pts]

chart.

Performs pretreatment Satisfactory [2 pts]

checks/calculations.

Utilizes respiratory gating information to N/A

determine field parameters.

Observes patient treatment. N/A

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

 4. Overall rating:

Pass [2 pts]

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

Total points for all rating scale questions: 28 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 10/30/2023 8:01:48 PM CT