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Evaluation by: Clinical Instructors (DALTON, Paige)
Evaluation of: Students (Rocque, Michelle)
Evaluation Period: 11/19/2015
Survey Completed: 11/19/2015 10:11:02 AM CT
Select the brachytherapy planning competency from the drop down menu below:
z Intracavitary
physician) [0 pts]
z Loads the patient imaging studies into the planning computer. - Satisfactory
z Contours the appropriate anatomy on the image data set. - Satisfactory
z Identifies appropriate dose points on the image data set. - Satisfactory
z Successfully identifies source positions. - Satisfactory
[2 pts]
[2 pts]
[2 pts]
[2 pts]
z Identifies available isotope and activity for date and time of treatment. - Satisfactory
[2 pts]
z Correctly generates plan using appropriate isotope and activity to achieve treatment objective. - Satisfactory
[2
pts]
z Accurately generates DVH/Dose point summary for implant. - Satisfactory [2 pts]
z Communicates effectively with physician for plan review and makes changes as requested. - N/A (Additional
[2 pts]
z Performs hand verification calculations for dwell time. - N/A (Additional Comment: used secondary verification
program) [0 pts]
z Assembles necessary equipment for source loading. - N/A (Additional Comment: HDR)
[0 pts]
z Makes appropriate entries in source log and fills out necessary paperwork for appropriate room posting. -
[0 pts]
[2 pts]
[2 pts]
z Uses appropriate radiation measuring devices for brachytherapy procedures and source inventory. -
Satisfactory [2 pts]
z Uses time, distance and shielding principles during brachytherapy procedures. - Satisfactory
[2 pts]
https://www.typhongroup.net/eval/analyze/studentdetails.asp?r=0&facility=9094&survey=... 12/7/2015
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Overall rating:
z Pass
[2 pts]
MEAN: 2.00 (out of possible 2), % SCORE: 100.0%
Additional Comments:
z Michelle did a great job planning brachytherapy which required her learning a new TPS.
https://www.typhongroup.net/eval/analyze/studentdetails.asp?r=0&facility=9094&survey=... 12/7/2015