Utilizing Treatment Plans with Simulated Errors for Resident Training on Physics Plan and Chart Review
Abstract
Purpose
Physics plan and chart review is one of the most effective QA processes to identify high-severity errors in radiotherapy treatments; mastering it is crucial for our residents. However, exposure to such errors during training is limited, making it challenging for trainees to practice and develop these skills without intention. In this study, we developed a curriculum where residents utilize simulated plans to train and assess their ability to catch potential errors during plan review.
Methods
We developed the curriculum utilizing a simulation-based training module from the AAPM WGPE. The module contains anonymized treatment plans from different oncology information systems (OIS) and treatment planning systems (TPS). Plans are embedded with errors based on high-priority failure modes identified in TG-275. Faculty mentors in participating institutions train residents with simulated plans after getting familiar with their in-house chart-checking process, and assess the residents’ ability to catch potential errors using a standardized performance assessment form. Residents are scored based on the percentage of simulated errors caught.
Results
A training scheme is developed with 23 Linac-based simulated plans divided into training and assessment sets. Each set contains multiple 3D conformal, IMRT/VMAT, SBRT and electron plans of different tumor sites, with corresponding errors to expose residents to different types of potential high priority failure modes. The assessment dataset is combined with an assessment form and an evaluation form to help faculty mentors assess the residents’ performance at the end of the training.
Conclusion
Physics plan and chart review is an essential responsibility of clinical medical physicists. Training residents with simulated plans generated from multiple OIS/TPS with embedded errors can strengthen their training. Additionally, this curated set of plans is a valuable resource to training programs nationwide and can help standardize training to ensure adequate exposure to rare but severe errors regardless of training institution.