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Development of Treatment Plan Evaluation Competencies: Design and Implementation of a Simulation Environment

J Winter*, J Adleman , T Purdie , J Croke , A McNiven , The Princess Margaret Cancer Centre - UHN, Toronto, ON


(Monday, 7/30/2018) 1:45 PM - 3:45 PM

Room: Karl Dean Ballroom A2

Purpose: To create an innovative platform for simulation-based training of treatment plan evaluation competencies for both medical physics and radiation oncology residents designed to meet learner needs, as identified by trainees and faculty.

Methods: To inform development of our case bank and simulation platform, we conducted a needs assessment by asking current residents and junior faculty to assess plan evaluation confidence using a 10-point Likert scale (1=least confident, 10=most confident) as well as provide suggestions to inform software design. To create the case bank, we reviewed and characterized unacceptable plans. To interact with the unacceptable and corrected case bank plans, we employed an interactive web-based DICOM-RT tool that includes the ability to identify technical errors via beam information, such as segments in a beam’s-eye-view. We also developed an interactive simulation platform for user interaction with the database and DICOM-RT tool.

Results: Needs assessment results from 30 participants indicated confidence values of 7 ± 2 for target coverage, 6 ± 2 for organs-at-risk dose, 6 ± 2 for conformity, 5 ± 2 for overall acceptability and 5 ± 2 for ability to suggest improvements. We reviewed 75 plans and classified each based on error type. Simulation platform provides ability to search for cases, review the case in the DICOM-RT tool and record assessment, error classification and potential corrective action. After plan review is complete, the simulation platform will provide immediate feedback, including error description, correction strategy and link to the corrected clinically-approved plan for comparison.

Conclusion: We created a simulation platform for treatment plan evaluation linked to a curated and classified case bank. Our platform enables full 3D interaction with the plan, provides immediate feedback to learners and links to a final clinically acceptable plan. We plan to assess our simulation framework and its efficacy and in future implement it widely.


Treatment Planning


TH- External beam- photons: General (most aspects)

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