Massachusetts college of pharmacy & health sciences radiation therapy program school of Medical Imaging & Therapeutics Contact Information


Radiation Safety - Clinical Competency Evaluation



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Radiation Safety - Clinical Competency Evaluation


Student Name:_________________________ Date:__________________________


Evaluated by:__________________________ Evaluation period:________________

Please use the space provided for comments and suggestions for improvement.


GOAL:

The student will gain clinical experience in the practice of radiation protection and brachytherapy procedures through a rotation in the radiation safety office of an affiliated clinical education center. This experience will be gained through observation of and providing assistance to the RSO team.


The student will demonstrate PROFESSIONAL BEHAVIOR by:




S

US

Report to clinical assignment and assumed clinical duties at assigned time







Observing all aspects of RSO’s role







Utilizing clinical time to complete clinical objectives







Demonstrating self-direction in completing clinical objectives







The student will demonstrate KNOWLEDGE of radiation safety procedures by:






S

US

Describe requirements and responsibilities for a radiation protection officer







List objectives of a radiation protection program and demonstrate ability to document same







Interpret personnel monitoring reports







State examples of personnel and area radiation monitors







Describe the theory and operation and demonstrate use of the following personnel and area monitors:

ring badges, film badges, pocket ionization

GM counter, cutie pie








Identify the applications, advantages and limitations of each of the above devices







Identify controlled/ uncontrolled areas and acceptable exposure limits for each







National/ state radiation limits in controlled/ uncontrolled areas







State when a radiation survey should be done







Identify who should conduct the survey







List conditions and locations evaluated in an area survey







Identify personnel to be notified in case of isotope loss or damage







Describe “RADIATION AREA” signs






The student will observe and assist with/in:






S

US

Determining the presence of radiation in controlled or uncontrolled areas







Area and room surveys during and following brachytherapy procedures







Appropriate placement of “RADIATION AREA” signs







Appropriate storage methods for brachytherapy sources







Source inventory procedures







Maintenance, use and cleaning of brachytherapy applicators







Leak testing of brachytherapy sources








Overall assessment of clinical performance:

______satisfactory

______acceptable with reservation (see notes for improvement)

______satisfactory (documentation of efforts to correct deficiencies attached)


Areas of Strength:

Areas Needing Improvement:

Preceptor/Instructor:__________________________________________________


Student:_________________________________________

(Signature indicates only that evaluation has been reviewed.)



Student comments: (Please attach additional sheet if necessary)

Massachusetts College of Pharmacy and Health Sciences

School of Medical Imaging & Therapeutics

Radiation Therapy Program






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