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Dosimetrist Checklist

COMMUNICATION *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Openly collaborate and communicate with: allied health personnel for radiation treatment planning and radiation dose delivery.
Openly collaborate and communicate with: Radiation Oncologist (RO) and to ensure accurate radiation dose to each patient.
Openly collaborate and communicate with: Qualified Medical Physicists (QMP) regarding quality assurance and quality management.
Openly collaborate and communicate with: QMPs regarding radiation safety for patients, staff, and the general public.
Openly collaborate and communicate with: Research and development scientists, RO, and equipment manufacturers involved in the development and advancement of products and procedures designed for patient care.
Provide accurate explanations and instructions at an appropriate time and level of understanding to patients and their care providers.
COMMUNICATION *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Openly collaborate and communicate with: allied health personnel for radiation treatment planning and radiation dose delivery.
Openly collaborate and communicate with: Radiation Oncologist (RO) and to ensure accurate radiation dose to each patient.
Openly collaborate and communicate with: Qualified Medical Physicists (QMP) regarding quality assurance and quality management.
Openly collaborate and communicate with: QMPs regarding radiation safety for patients, staff, and the general public.
Openly collaborate and communicate with: Research and development scientists, RO, and equipment manufacturers involved in the development and advancement of products and procedures designed for patient care.
Provide accurate explanations and instructions at an appropriate time and level of understanding to patients and their care providers.
DOCUMENTATION *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Patient data acquisition: Computer generated data sets from medical imaging devices such as CT, PET, MR, etc.
Patient data acquisition: Manual methods such as physical measurements and wire contours.
Patient data acquisition: Incorporation of data into radiation treatment plans, calculations, and treatment devices.
Accurate transfer and documenting of treatment parameters either manually or electronically according to departmental policies.
DOCUMENTATION *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Patient data acquisition: Computer generated data sets from medical imaging devices such as CT, PET, MR, etc.
Patient data acquisition: Manual methods such as physical measurements and wire contours.
Patient data acquisition: Incorporation of data into radiation treatment plans, calculations, and treatment devices.
Accurate transfer and documenting of treatment parameters either manually or electronically according to departmental policies.
CALCULATIONS AND PERFORMANCE * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Accurate dose calculations for treatment delivery: manual
Accurate dose calculations for treatment delivery: computer generated
Accurate calculations pertaining to, but not limited to: Beam modifying devices
Accurate calculations pertaining to, but not limited to: Irregular fields
Accurate calculations pertaining to, but not limited to: Gaps for adjacent fields
Accurate calculations pertaining to, but not limited to: Off-axis calculations
Accurate performance or assist with quality assurance procedures as directed
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Diodes
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Optically stimulated luminescent dosimeters (OSLD)
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Ion chambers, thermo-luminescent dosimeters (TLD)
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Film measurements
CALCULATIONS AND PERFORMANCE *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Accurate dose calculations for treatment delivery: manual
Accurate dose calculations for treatment delivery: computer generated
Accurate calculations pertaining to, but not limited to: Beam modifying devices
Accurate calculations pertaining to, but not limited to: Irregular fields
Accurate calculations pertaining to, but not limited to: Gaps for adjacent fields
Accurate calculations pertaining to, but not limited to: Off-axis calculations
Accurate performance or assist with quality assurance procedures as directed
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Diodes
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Optically stimulated luminescent dosimeters (OSLD)
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Ion chambers, thermo-luminescent dosimeters (TLD)
Perform or assist with the application of specific methods of radiation measurement as directed by a QMP: Film measurements
PROFESSIONAL KNOWLEDGE AND SKILLS * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
National Patient Safety Goals
PROFESSIONAL KNOWLEDGE AND SKILLS *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
National Patient Safety Goals
CLINICAL INFECTION CONTROL PROCEDURES * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Hand Hygiene
Personal Protective Equipment (PPE)
Respiratory Hygiene/Cough Etiquette
Sterilization and Disinfection of Patient-Care Items and Devices
Environmental Infection Prevention and Control
CLINICAL INFECTION CONTROL PROCEDURES *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Hand Hygiene
Personal Protective Equipment (PPE)
Respiratory Hygiene/Cough Etiquette
Sterilization and Disinfection of Patient-Care Items and Devices
Environmental Infection Prevention and Control
WORK SETTING * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Acute Care - Adult
Acute Care - Pediatric
Outpatient - Adult
Outpatient - Pediatric
WORK SETTING *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Acute Care - Adult
Acute Care - Pediatric
Outpatient - Adult
Outpatient - Pediatric
PRETREATMENT * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
CT/iCT
MR
PET Scan
Simulation of Treatment Sites
Tumor Localization
PRETREATMENT *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
CT/iCT
MR
PET Scan
Simulation of Treatment Sites
Tumor Localization
BEAM MODIFYING/POSITIONING * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
3D Conformal Therapy
Block Cutting
B-Mode Acquisition Targeting
Compensation Filters
Custom Molds
Dynamic Wedges
Physical Wedges
Portal Cast
BEAM MODIFYING/POSITIONING *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
3D Conformal Therapy
Block Cutting
B-Mode Acquisition Targeting
Compensation Filters
Custom Molds
Dynamic Wedges
Physical Wedges
Portal Cast
TREATMENT PLANS *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Design Treatment Plans
Calculate dose of radiation
Quality Assurance
Supervise Implementation
TREATMENT PLANS *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Design Treatment Plans
Calculate dose of radiation
Quality Assurance
Supervise Implementation
TREATMENT *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Beam Data Acquisition for Small Fields
Electron Arc Therapy
External Beam Therapy
Gamma Knife
IGRT - Image Guided Radiation Therapy
IMRT - Intensity Modulated Radiotherapy
IORT - Intraoperative Radiation Therapy
Linear Accelerator
MiMiC - Multileaf Intensity Modulating Collimator
Multileaf/Dynamic Multileaf Collimator
Port Films/Electronic Portal Imaging
Respiratory Gating
Stereotactic Radiosurgery
Stereotactic Radiotherapy
Strontium 90 Treatment
Superficial Tx - Orthovoltage Radiation Treatment
Tomo Therapy
Total Body Irradiation
TSI - Total Skin Irradiation
TREATMENT *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Beam Data Acquisition for Small Fields
Electron Arc Therapy
External Beam Therapy
Gamma Knife
IGRT - Image Guided Radiation Therapy
IMRT - Intensity Modulated Radiotherapy
IORT - Intraoperative Radiation Therapy
Linear Accelerator
MiMiC - Multileaf Intensity Modulating Collimator
Multileaf/Dynamic Multileaf Collimator
Port Films/Electronic Portal Imaging
Respiratory Gating
Stereotactic Radiosurgery
Stereotactic Radiotherapy
Strontium 90 Treatment
Superficial Tx - Orthovoltage Radiation Treatment
Tomo Therapy
Total Body Irradiation
TSI - Total Skin Irradiation
INTERNAL TREATMENT *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Hyperthermia
Microwave
Ultrasound - Guided
INTERNAL TREATMENT *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Hyperthermia
Microwave
Ultrasound - Guided
BRACHYTHERAPY *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Assist with Intracavity/Interstitial Administration
Compute Dose Distribution
BRACHYTHERAPY *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Assist with Intracavity/Interstitial Administration
Compute Dose Distribution
TREATMENT PLANNING SYSTEMS *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Eclipse (Varian)
Pinnacle (Philips)
XiO Focus
TREATMENT PLANNING SYSTEMS *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Eclipse (Varian)
Pinnacle (Philips)
XiO Focus
RECORD AND VERIFY SYSTEMS * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Impac MOSAIQ
Varis-Vision/Aria
RECORD AND VERIFY SYSTEMS *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Impac MOSAIQ
Varis-Vision/Aria
TREATMENT UNITS * SKIL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
GE
Philips
Siemens
Varian
TREATMENT UNITS *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
GE
Philips
Siemens
Varian
ELECTRONIC DOCUMENTATION * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Allscripts
Care360
Cerner
CPSI
eClinicalWorks
Eclipsys
EPIC
MACLAB
McKesson/Paragon
Meditech
PACS
Quadramed
Sorian
ELECTRONIC DOCUMENTATION *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Allscripts
Care360
Cerner
CPSI
eClinicalWorks
Eclipsys
EPIC
MACLAB
McKesson/Paragon
Meditech
PACS
Quadramed
Sorian
AGE SPECIFIC COMPETENCIES *SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)
AGE SPECIFIC COMPETENCIES *FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)