THE OHIO STATE UNIVERSITY

RADIATION SCIENCES AND THERAPY PROGRAM

ROOM CLINICAL COMPETENCY OBJECTIVES

During clinical procedures, the student must demonstrate competency of the following:
1. Manually sets gantry angle.
- Enter correct gantry angle on pendant
- Define gantry angles according to Lt. and Rt. Lat.
- Assure equipment is clear of obstruction

2. Manually sets collimator angle.

- Enter correct collimator angle on pendant
- Rotate collimator CCW & CW without specific angle

3. Manually sets field size.

- Set symmetrical field size

4. Manually sets independent jaws.

- Set independent Y jaws
- Set independent X jaws

5. Smoothly manipulates couch movements in all directions.

6. Identifies the purpose for each of the lasers in treatment room.

- Define use of lateral lasers and when they would be used
- Define use of sagittal lasers and when they would be used
- Define use of overhead laser and when it would be used.

7. Identifies correct location to place reticle, BB Tray, electron cones and blocks.

8. Explains purpose and locations for circuit breaker, emergency offs, and motion stops.
- Identify the location for circuit breaker and explain when it would be used.
- Identify the location of all emergency off buttons and explain when they would be used.
- Identify the location of the motion stops and explain when they would be used.

9. Defines the use of door interlock and Rad off.

10. Identifies the ODI and can set the table to 100 SSD.
 THE OHIO STATE UNIVERSITY
RADIATION THERAPY PROGRAM
CLINICAL COMPETENCY OBJECTIVES

During clinical procedures, the student must demonstrate competency of the following:

1. Review chart, and DRR’s or simulation films prior to preparing patient for
treatment

-review patient set up and assures understanding

-utilize DRR’s or simulation films for set-up on initial treatment
-recognize need for port films

2. Checks prescription with total dose currently delivered.

-read prescription daily

-check daily prescribed dose against daily treatment dose
-check total prescribed dose against current total delivered
-check addition of total dose

3. Prepare treatment room with appropriate equipment

-utilize set-up information in chart

-set out appropriate positioning aids, custom blocks and wedges

4. Greet and assist patient to and from the treatment area

-greet patient
-confirm patient identity
-introduce self and other pertinent personnel to patient
-ask as to patient's general condition

5. Explain procedure if new to the patient and confirm patient's understanding

-explain purpose and procedure to be done

-use language that is non-technical and appropriate to patient understanding
-confirm patient understanding

6. Assist patient into treatment position

__ Ambulatory, ___ Wheel Chair ___ Cart

-assist patient to treatment table from wheelchair

-assist in safely lifting patient from cart
-assist patient by supporting back/neck and lifting legs while reclining
-position headrest and other devices for proper function and patient comfort

7. Position patient to reproduce set-up indicated in treatment chart

-utilize any and all appropriate positioning aids

-position extremities as indicated in chart
-correct for any misalignment before proceeding with treatment
Clinical Competency Objectives Cont.

8. Immobilize patient

-use all appropriate immobilization devices as indicated in

chart
-utilize safety belts as needed if patient is not secure on table
-assure patient comfort within guidelines of immobilization device use

9. Aligns Tx field & Set treatment parameters to reproduce set-up as indicated in

chart or EMR

-assure correct field size is set

-use correct patient markings
-accurately align radiation light field with accurate markings
-set correct SSD/SAD
- assure correct table/couch angle is set
- assure correct gantry angle is set
- assure correct collimator angle is set

10. Select and place correct blocks, wedges, compensators, bolus, etc.

-check chart/simulation sheet or prescription for required beam modifying devices

-check films for correct placement of MLC’s or custom blocks
-check treatment plan for correct wedges and the orientation of wedges
-place and secure blocks and wedges into proper orientation and location
-place bolus as indicated
-double check for correctness of devices before administering treatment

11. Recheck set-up with set-up indicated in electronic chart and films

-recheck prescription, films, set-up instructions, and compare to actual patient

set-up
-resolve any discrepancies if field alignment does not match
-call for assistance from technical supervisor, dosimetrist, or physician if
discrepancies are not resolved

12. Indicate to patient that treatment is to begin

-instruct patient to remain still during treatment

-inform patient that treatment is to begin
-close door to treatment room

13. Set appropriate controls on treatment machine console treating through the record
and verify system.

-set timer/monitor units as indicated in chart if paper chart

-assure back-up timer allows adequate time for treatment
-set accurate rad/degree for rotational treatment
-select correct electron/photon energy
Clinical Competency Objectives Cont.

14. Performs verbal “timeout”.

-state patient name, treatment site, treatment fraction, and/or any other
information required by the institution prior to activating machine for treatment
or localization.

15. Performs IGRT and aligns the patient appropriately. ____Conebeam _____OBI
_____Exact Trac _____Vision RT

-use appropriate equipment to obtain adequate imaging prior to treatment.

-view images and adjust table parameters to align fudicials or
bony landmarks as indicated.
-patient alignment should be within approximately 3mm of where the therapist or
physician approves.

16. Activate machine to deliver prescribed dose

-perform appropriate procedures in proper sequence to beam on

17. Monitor patient during treatment

-assure clear view of camera during treatment

-communicate to patient via audio monitors if necessary
-turn off treatment unit if patient moves or appears to be in distress

18. Monitor treatment unit function during treatment delivery

-check for rad on

-check for operating lights
-check treatment unit for output

19. Verifies (EMR) or records (paper chart) technical data was documented in patient
chart

-verify correct MU’s and dose were recorded if EMR

-write appropriate figures in required spaces
-add columns correctly
-note wedge checks
-note port films taken
-check co-workers charting

20. Records patient data in treatment chart

-write appropriate technical notes

-documents bolus, SSD’s, etc.
-create patient checklists if applicable
Clinical Competency Objectives Cont.

21. Set up opposing/additional portals correctly

-follow all previously listed behaviors to set-up additional ports

22. Utilize all treatment equipment safely

-move gantry and table with care

-lift blocks and wedges so as not to drop them
-place and secure equipment safely
-use equipment so as not to frighten or harm the patient
-utilize the equipment so as not to incur equipment damage

23. Assist patient from treatment table

-help patient sit up, supporting patient's back and neck

-help patient move legs off table
-assure patient is standing steadily before leaving them
unattended
-help patient into wheelchair
-assist in securely lifting patient from table to stretcher

24. Answer patient questions

-attempt to answer questions from patients and families

-direct questions to others if unable to answer

25. Answer therapist questions relevant to the procedure

-set-up and/or treatment delivery questions asked by a therapist to verify the

student’s understanding of concept’s relevant to the procedure performed are
answered appropriately.

26. Attend to additional patient care details

-send patient for laboratory tests when needed

-send patient to be weighed when needed
-keep patient for physician examination when necessary
-schedule simulation when necessary
-inform patient of upcoming scheduled events

27. Display ethical standards and maintain a level of professionalism

-speak in manner appropriate to the situation

-refer to patients, physicians, co-workers with respect
-refrain from discussion of inappropriate topics in the
treatment area
-treat patients and families with respect and dignity
-demonstrate a confident and competent manner
 THE OHIO STATE UNIVERSITY
RADIATION THERAPY PROGRAM
CT SIM CLINICAL COMPETENCY OBJECTIVES

During clinical simulation procedures, the student must demonstrate competency of the
following:

1. Reviews chart, simulation planning sheet, and films prior to preparing patient for
simulation.

-review patients chart for pathology and diagnosis

-review simulation planning sheet to determine how patient will be set up
-review simulation plan to determine field of simulation
-utilize diagnostic imaging to help determine location of tumor

2. Prepares treatment chart, simulation sheet, and film jackets.

-fill out information in front of treatment chart

-prepare simulation sheet and/or other sim documents
-checks for a signed patient consent

3. Checks for a signed consent and follows through if not signed.

4. Prepare simulation room with appropriate equipment

-utilize treatment planning sheet

-set out appropriate positioning aids
-prepare and place linen on simulation table

5. Greet and assist patient to and from the simulation area

-confirm patient identity

-greet patient upon arrival into room
-introduce self and other pertinent personnel to patient
-ask as to patient's general condition

6. Explain procedure if new to the patient and confirm patient's understanding.

-explain purpose and procedure to be done

-use language that is non-technical and appropriate to patient understanding
-confirm patient understanding

7. Assist patient into simulation position

__ Ambulatory, ___ Wheel Chair ___ Cart
-assist patient to treatment table from wheelchair
-assist in safely lifting patient from cart
-assist patient by supporting back/neck and lifting legs while reclining
-position headrest and other devices for proper function and patient comfort
CT Sim Clinical Competency Objectives Cont.

8. Utilizes and prepares immobilization devices.

-review treatment planning sheet for anatomic site and request for a specific
immobilization device
-prepare equipment to fabricate immobilization device
-follow all safety measures while preparing immobilization device
-construct immobilization device in a smooth and timely manner
-assure patient comfort within guidelines of immobilization device use

9. Prepares contrast and/or loads the injector adequately

-properly mix or dilute oral contrast when necessary

-load iodinated IV contrast into injector or syringe

10. Administers and monitors patient for adverse reactions

-instruct oral contrast patient when and how much to drink

-inject iodinated IV contrast at the correct time and rate of speed, while
monitoring for adverse reactions

11. Obtains CT images by utilizing preset protocols

12. Adjust image parameters to obtain scan (slice level, FOV etc.)

13. Utilize all simulation equipment safely

-move gantry and table with care

-place and secure equipment safely
-use equipment so as not to frighten or harm the patient
-utilize the equipment so as not to incur equipment damage

14. Set appropriate mA and kV on console.

-make proper adjustments due to patient age and/or size (pediatrics/obesity)

15. Monitor patient during CT scan

--monitor patient during scanning process

-communicate to patient during scanning process

16. Mark patient’s isocenters during initial scan

-mark all set up and field parameters on patient

-explain care of marks to patient
Simulation Clinical Competency Objectives Cont.

17. Records data of set up and completes all paperwork

-fill out simulation sheet with correct treatment parameters

-take set up photos and place in chart (electronic or paper)
-complete any checklists and documents (i.e. whiteboard, sim notes, tx plan
requests, etc.)

18. Schedules the patient and distributes sim material to the appropriate places

-schedule appointment for patient with appropriate machine

-fill out appointment card for patient
-delivers simulation information to appropriate personnel

19. Assist patient from treatment table

-help patient sit up, supporting patient's back and neck

-help patient move legs off table
-assure patient is standing steadily before leaving them unattended
-help patient into wheelchair
-assist in securely lifting patient from table to stretcher

20. Answer patient questions or directs questions to appropriate personnel.

21. Display ethical standards and maintain a level of professionalism

-speak in manner appropriate to the situation

-refer to patients, physicians, co-workers with respect
-refrain from discussion of inappropriate topics in the
simulation area
-treat patients and families with respect and dignity
-demonstrate a confident and competent manner

22. Follows radiation protection principles to assure safety of therapist and patient.