Responses About You - Details - "Photon Planning Competency Evaluation (rev2015)"

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1 of 4
Evaluation by:
Evaluation of:
Evaluation Period:
Survey Completed:

Clinical Instructors (FRANCIS, Louise)

Students (Coffey, Ashley)
2/29/2016
2/29/2016 10:12:04 PM CT
Add your comments

Select the external beam photon planning competency from the drop down menu below:
Palliative (Spine, Hip, Ribs, etc)

If Other competency, please specify the type here:

Palliative Rt Arm done with Rick Lloyd, CMD and Tayisiya Polischuk RT(T).

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 (Additional Comment: Ashley
contoured scatter and adjusted its density.) [2 pts]
Successfully places the isocenter using simulation data. - Satisfactory [2 pts]
Correctly generates plan using blocks, wedges, segmented Xelds. - Satisfactory [2 pts]
Generates plan with appropriate weighting. - Satisfactory [2 pts]
Generates plan with appropriate energies. - Satisfactory [2 pts]
Accurately calculates daily isocenter dose for each treatment Xeld using prescription % and weighting. Satisfactory [2 pts]
Accurately generates a single fraction DVH or composite DVH (for correct # of fractions). - N/A (Additional
Comment: No DVH for this plan, no structures drawn by the physician.)
Communicates effectively with physician for plan review and makes changes as requested. - Satisfactory [2
pts]
Exports/Prints appropriate plan data. - Satisfactory [2 pts]
Performs a veriXcation calculation for plan MU settings. - Satisfactory (Additional Comment: Plan
successfully transferred to RadCalc for MU veriXcation by physicist.) [2 pts]
Enters correct parameters for the patient chart. - Satisfactory [2 pts]
Performs pretreatment checks/calculations. - Satisfactory [2 pts]
Observes patient treatment. - N/A (Additional Comment: Not necessary for this setup)
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%

Overall rating:
Pass [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%
Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/6/2016 3:28:50 PM CT

Responses About You - Details - "Photon Planning Competency Evaluation (rev2015)"

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2 of 4
Evaluation by:
Evaluation of:
Evaluation Period:
Survey Completed:

Clinical Instructors (FRANCIS, Louise)

Students (Coffey, Ashley)
2/29/2016
3/2/2016 8:48:28 AM CT
Add your comments

Select the external beam photon planning competency from the drop down menu below:
Intact Breast Tangents

If Other competency, please specify the type here:

Tangent breast done with Rick Lloyd, CMD 2/26/2016

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 Xelds. - Satisfactory [2 pts]
Generates plan with appropriate weighting. - Satisfactory [2 pts]
Generates plan with appropriate energies. - Satisfactory [2 pts]
Accurately calculates daily isocenter dose for each treatment Xeld using prescription % and weighting. Satisfactory [2 pts]
Accurately generates a single fraction DVH or composite DVH (for correct # of fractions). - Satisfactory [2
pts]
Communicates effectively with physician for plan review and makes changes as requested. - Satisfactory [2
pts]
Exports/Prints appropriate plan data. - Satisfactory [2 pts]
Performs a veriXcation calculation for plan MU settings. - Satisfactory (Additional Comment: Plan was
exported to RadCal program for evaluation by Physicist.) [2 pts]
Enters correct parameters for the patient chart. - Satisfactory [2 pts]
Performs pretreatment checks/calculations. - Satisfactory (Additional Comment: Ashley performed
pretreatment checks utilizing departmental dosimetry checklist.) [2 pts]
Observes patient treatment. - Satisfactory [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%

Overall rating:
Pass [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%
Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/6/2016 3:29:21 PM CT

Responses About You - Details - "Photon Planning Competency Evaluation (rev2015)"

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Evaluation by:
Evaluation of:
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Survey Completed:

Clinical Instructors (FRANCIS, Louise)

Students (Coffey, Ashley)
3/23/2016
3/23/2016 4:19:24 PM CT
Add your comments

Select the external beam photon planning competency from the drop down menu below:
Pelvis (GYN or other)

If Other competency, please specify the type here:

Competency done with Ruth Ann Good, CMD 3/23/2016

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. - N/A (Additional Comment: Ashley was on
Spring Break at time of simulation.)
Contours the appropriate anatomy on the image data set. - N/A (Additional Comment: Resident Physician put
in contours, which Ashley reviewed.)
Successfully places the isocenter using simulation data. - N/A (Additional Comment: No change from
simulation isocenter placement.)
Correctly generates plan using blocks, wedges, segmented Zelds. - Satisfactory [2 pts]
Generates plan with appropriate weighting. - Satisfactory [2 pts]
Generates plan with appropriate energies. - Satisfactory [2 pts]
Accurately calculates daily isocenter dose for each treatment Zeld using prescription % and weighting. Satisfactory [2 pts]
Accurately generates a single fraction DVH or composite DVH (for correct # of fractions). - Satisfactory [2
pts]
Communicates effectively with physician for plan review and makes changes as requested. - Satisfactory [2
pts]
Exports/Prints appropriate plan data. - Satisfactory [2 pts]
Performs a veriZcation calculation for plan MU settings. - Satisfactory (Additional Comment: Plan
appropriately exported to Rad Cal for physics to perform veriZcation calc of plan MU settings) [2 pts]
Enters correct parameters for the patient chart. - Satisfactory [2 pts]
Performs pretreatment checks/calculations. - Satisfactory [2 pts]
Observes patient treatment. - N/A
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%

Overall rating:
Pass [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%
Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/6/2016 3:29:34 PM CT

Responses About You - Details - "Photon Planning Competency Evaluation (rev2015)"

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4 of 4
Evaluation by:
Evaluation of:
Evaluation Period:
Survey Completed:

Clinical Instructors (FRANCIS, Louise)

Students (Coffey, Ashley)
4/26/2016
4/26/2016 1:11:07 PM CT
Add your comments

Select the external beam photon planning competency from the drop down menu below:
Limb Sarcoma

If Other competency, please specify the type here:

Competency done with Ruth Ann Good on Tues 3/29/2016

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. - N/A (Additional Comment: Boost (same scan
as initial))
Contours the appropriate anatomy on the image data set. - N/A
Successfully places the isocenter using simulation data. - N/A
Correctly generates plan using blocks, wedges, segmented Yelds. - Satisfactory [2 pts]
Generates plan with appropriate weighting. - Satisfactory [2 pts]
Generates plan with appropriate energies. - Satisfactory [2 pts]
Accurately calculates daily isocenter dose for each treatment Yeld using prescription % and weighting. - N/A
Accurately generates a single fraction DVH or composite DVH (for correct # of fractions). - Satisfactory [2
pts]
Communicates effectively with physician for plan review and makes changes as requested. - Satisfactory [2
pts]
Exports/Prints appropriate plan data. - Satisfactory [2 pts]
Performs a veriYcation calculation for plan MU settings. - Satisfactory (Additional Comment: Ashley exported
plan to Rad Cal for MU veriYcation by physicist.) [2 pts]
Enters correct parameters for the patient chart. - Satisfactory [2 pts]
Performs pretreatment checks/calculations. - Satisfactory (Additional Comment: Ashley performed
pretreatment checks utilizing departmental dosimetry checklist.) [2 pts]
Observes patient treatment. - Satisfactory [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%

Overall rating:
Pass [2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%
Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 5/6/2016 3:29:47 PM CT