Survey: 3D- CRT Photon Planning Competency Evaluation
Reviewer: Clinical Instructors (PIOTROWSKI, Nick)
Reviewee: Students (Head, Peyton)
Survey Period: 2/29/2024
Completed: 2/29/2024 1:22:23 PM CT
1. Select the external beam photon planning competency from the drop down menu below:
Intact Breast Tangents
2. If Other competency, please specify the type here:
NR
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. Additional Comments: Wishlist obtained
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]
Additional Comments: Mixed energy
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. Additional Comments: Sure calc
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. Satisfactory [2 pts]
Mean: 2.00 of 2 Points: 28 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: 30 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 5/6/2024 3:12:58 PM CT
Survey: 3D- CRT Photon Planning Competency Evaluation
Reviewer: Clinical Instructors (PIOTROWSKI, Nick)
Reviewee: Students (Head, Peyton)
Survey Period: 3/21/2024
Completed: 3/21/2024 9:49:42 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:
Pelvis 4 field
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 Satisfactory [2 pts]
determine field parameters.
Observes patient treatment. Satisfactory [2 pts]
Mean: 2.00 of 2 Points: 30 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: 32 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 5/6/2024 3:12:49 PM CT
Survey: 3D- CRT Photon Planning Competency Evaluation
Reviewer: Clinical Instructors (PIOTROWSKI, Nick)
Reviewee: Students (Head, Peyton)
Survey Period: 4/4/2024
Completed: 4/4/2024 10:53:12 AM CT
1. Select the external beam photon planning competency from the drop down menu below:
Emergent case: Sim and Treat same day
2. If Other competency, please specify the type here:
NR
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. Satisfactory [2 pts]
Mean: 2.00 of 2 Points: 28 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: 30 (Each main question equally weighted)
Mean percentage score for all rating scale questions: 100.0% Response as of 5/6/2024 3:12:41 PM CT
Survey: 3D- CRT Photon Planning Competency Evaluation
Reviewer: Clinical Instructors (PIOTROWSKI, Nick)
Reviewee: Students (Head, Peyton)
Survey Period: 5/6/2024
Completed: 5/6/2024 1:19:11 PM CT
1. Select the external beam photon planning competency from the drop down menu below:
Palliative (Spine, Hip, Ribs, etc)
2. If Other competency, please specify the type here:
NR
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 N/A
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. Satisfactory [2 pts]
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 5/6/2024 3:12:15 PM CT
