DOS 772: Clinical Practicum II
Course Description
Students continue to gain clinical experience through the guidance of their mentors at their affiliated clinical internship site. They start advancing to more advanced treatment planning techniques while still maintaining the basic concepts of clinical oncology specific to patient treatment.
ProKnow Contouring Assignments
Students were assigned 3 organs, rectum, sigmoid, and large bowel, to contour in the Proknow contouring accuracy scoring system. ProKnow has organs that have been contoured by experts and allows dosimetrists to check their contouring skills and accuracy by contouring on a data set and submitting it for scoring. The website then shows you the areas of the contour that are in agreement, areas that are missing and the areas that are contoured in as extra. The website also allows one to retry and practice to try and achieve what the experts perceive as the correct contouring for the organ.
Proknow Prostate Fossa Plan Study
A Prostate fossa data set and contours were given to students to upload into their treatment planning system. Students were given a set of treatment planning instructions and a prescription to follow and they were to plan a prostate fossa treatment plan. Once the optimal plan was achieved it was to be deposited into ProKnow where the website graded the plan based on their planning criteria and critical organ constraints. Once all students submitted their plans, they were able to see what other students had achieved and compare their treatment plan against other students.
Case Study
Last semester there was a written case study. This semester case studies were presented in video format with PowerPoint slides. Patients disease presentation and background was still discussed but the main topic of the case study this semester was comparing two different treatment plans against each other for this patient. Due to the complexity of explaining some treatment planning techniques in writing the presentations were presented orally.
My presentation compared a 2 arc VMAT plan to a 4-field conformal plan for an adenocarcinoma of the right upper lung that need radiotherapy for residual disease of the lymph nodes in the mediastinum post chemotherapy and surgery. My presentation can be viewed as a MyMedia presentation in the link below.
Plan comparison of 3D and VMAT for Lung Cancer
Clinical Affective Evaluations
Each month, our clinical preceptors were asked to complete an evaluation of our performance in the clinic based on various factors including communication, accuracy, safety, dependability, application of knowledge and general dosimetry skills. My three evaluations from the summer semester can be found below.
May-June
June-July
July-August
Clinical Competencies
Each semester, we are required to complete clinical competencies. This semester we were required to complete 6 new competencies in addition to our 4 required competencies from spring semester. Below are the competencies I completed this summer semester:
Limb Sarcoma
Chest Wall Tangents with Supraclav and PAB
Abdominal IMRT
Prostate IMRT
Prostate with nodes IMRT
Thoracic IMRT
Brachytherapy Intracavitary Implant Plan
To view the clinical competencies documentation, select the procedures above.
Service Project Journal
I had the opportunity to complete two service projects this semester. One was an employer service project in which I helped with our hospital’s Relay-for-Life team and the other was a community service project where I volunteered for the Greater Clermont Cancer Foundation at a 5k in which part of the proceeds benefited the foundation. My journal entries can be found below.
Relay-for-Life
Bra Run 5k
Case Logs
Our time spent in the clinic is documented in case log entries. These entries are generated into a report that can be viewed to show the types of cases I was able to work on this semester
Case Logs From Spring and Summer Semesters
Case Logs From Summer Semester
Self-reflection
After each course students are asked to take a moment and self-reflect on what they gained during the course and how it affected their education and growth.
The new knowledge and skills I gained during this course were a better understanding of setting up optimization constraints and weights of IMRT plans per the area of treatment and the prescription to that area. Also, I gained a better grasp of how to perform simultaneous integrated boosts with IMRT and how to achieve the optimal dose distribution to both PTVs at each of their desired doses.
The skills I hope to learn more about and use next semester are using the simultaneous integrated boost technique to conquer the advanced treatment planning of head and neck treatments.
What I enjoyed most about this clinical rotation was that my preceptor made me plan my IMRT plans with rings first then I was able to use Pinnacle’s auto plan feature to plan the same thing, I got to see how close, or better, I could get my IMRT plans with rings to that of the auto plan feature. I also truly enjoyed my brachytherapy rotation and going to the operating room and getting to plan the treatments.
What I enjoyed least about this clinical rotation and how I intend to change in the upcoming semester is how fast this seemed to move. Everyone said this program would go by fast but I could not imagine that as a possibility. After this semester, I have come to the realization how soon December will be here and all of the things I still have left to do and how important it is that I stay focused and organized so that I stay on track.
Other reflective thoughts. I tried to make my focus this semester on finding the challenging plans. Even if I did not get to plan them for the patient’s treatment I would copy them after the planning process was finished and clear everything I could out and plan them for myself so I could push myself. I want to make sure I continue that throughout next semester and continue to expand my knowledge.
Course Description
Students continue to gain clinical experience through the guidance of their mentors at their affiliated clinical internship site. They start advancing to more advanced treatment planning techniques while still maintaining the basic concepts of clinical oncology specific to patient treatment.
ProKnow Contouring Assignments
Students were assigned 3 organs, rectum, sigmoid, and large bowel, to contour in the Proknow contouring accuracy scoring system. ProKnow has organs that have been contoured by experts and allows dosimetrists to check their contouring skills and accuracy by contouring on a data set and submitting it for scoring. The website then shows you the areas of the contour that are in agreement, areas that are missing and the areas that are contoured in as extra. The website also allows one to retry and practice to try and achieve what the experts perceive as the correct contouring for the organ.
Proknow Prostate Fossa Plan Study
A Prostate fossa data set and contours were given to students to upload into their treatment planning system. Students were given a set of treatment planning instructions and a prescription to follow and they were to plan a prostate fossa treatment plan. Once the optimal plan was achieved it was to be deposited into ProKnow where the website graded the plan based on their planning criteria and critical organ constraints. Once all students submitted their plans, they were able to see what other students had achieved and compare their treatment plan against other students.
Case Study
Last semester there was a written case study. This semester case studies were presented in video format with PowerPoint slides. Patients disease presentation and background was still discussed but the main topic of the case study this semester was comparing two different treatment plans against each other for this patient. Due to the complexity of explaining some treatment planning techniques in writing the presentations were presented orally.
My presentation compared a 2 arc VMAT plan to a 4-field conformal plan for an adenocarcinoma of the right upper lung that need radiotherapy for residual disease of the lymph nodes in the mediastinum post chemotherapy and surgery. My presentation can be viewed as a MyMedia presentation in the link below.
Plan comparison of 3D and VMAT for Lung Cancer
Clinical Affective Evaluations
Each month, our clinical preceptors were asked to complete an evaluation of our performance in the clinic based on various factors including communication, accuracy, safety, dependability, application of knowledge and general dosimetry skills. My three evaluations from the summer semester can be found below.
May-June
June-July
July-August
Clinical Competencies
Each semester, we are required to complete clinical competencies. This semester we were required to complete 6 new competencies in addition to our 4 required competencies from spring semester. Below are the competencies I completed this summer semester:
Limb Sarcoma
Chest Wall Tangents with Supraclav and PAB
Abdominal IMRT
Prostate IMRT
Prostate with nodes IMRT
Thoracic IMRT
Brachytherapy Intracavitary Implant Plan
To view the clinical competencies documentation, select the procedures above.
Service Project Journal
I had the opportunity to complete two service projects this semester. One was an employer service project in which I helped with our hospital’s Relay-for-Life team and the other was a community service project where I volunteered for the Greater Clermont Cancer Foundation at a 5k in which part of the proceeds benefited the foundation. My journal entries can be found below.
Relay-for-Life
Bra Run 5k
Case Logs
Our time spent in the clinic is documented in case log entries. These entries are generated into a report that can be viewed to show the types of cases I was able to work on this semester
Case Logs From Spring and Summer Semesters
Case Logs From Summer Semester
Self-reflection
After each course students are asked to take a moment and self-reflect on what they gained during the course and how it affected their education and growth.
The new knowledge and skills I gained during this course were a better understanding of setting up optimization constraints and weights of IMRT plans per the area of treatment and the prescription to that area. Also, I gained a better grasp of how to perform simultaneous integrated boosts with IMRT and how to achieve the optimal dose distribution to both PTVs at each of their desired doses.
The skills I hope to learn more about and use next semester are using the simultaneous integrated boost technique to conquer the advanced treatment planning of head and neck treatments.
What I enjoyed most about this clinical rotation was that my preceptor made me plan my IMRT plans with rings first then I was able to use Pinnacle’s auto plan feature to plan the same thing, I got to see how close, or better, I could get my IMRT plans with rings to that of the auto plan feature. I also truly enjoyed my brachytherapy rotation and going to the operating room and getting to plan the treatments.
What I enjoyed least about this clinical rotation and how I intend to change in the upcoming semester is how fast this seemed to move. Everyone said this program would go by fast but I could not imagine that as a possibility. After this semester, I have come to the realization how soon December will be here and all of the things I still have left to do and how important it is that I stay focused and organized so that I stay on track.
Other reflective thoughts. I tried to make my focus this semester on finding the challenging plans. Even if I did not get to plan them for the patient’s treatment I would copy them after the planning process was finished and clear everything I could out and plan them for myself so I could push myself. I want to make sure I continue that throughout next semester and continue to expand my knowledge.