Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE OF PATIENTS CARED FOR

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Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64 years to 79 years)
Elderly Adults (over 79+ years)

GENERAL SKILLS

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Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Crash Carts
Defibrillators

RADIATION THERAPY PHYSICS

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Physical Property of Atoms and Nuclei
Basic Nuclear Transformations
Medical Linear Accelerations

Interaction of High Energy Electrons & X-Rays with Matter

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Photoelectric Effect
Campton Scatter
Pair Production
Physical Properties of Dose and Exposure

Dosimetry Equipment

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Ion Chambers
Thermoluminescent Dosimetry
TG-51 (Calibration Protocol)
Radioactive Isotopes
Electron Beam Therapy
IMRT (Intensity Modulated Radiation Therapy)

Beam Modifiers

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Physical Wedges
Dynamic Wedges
Blocks
3-D Conformal Radiation Therapy

Basic Principles and Applications

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CT Scan
MRI Machine
PET Scan

BRACHYTHERAPY PROCEDURES

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Systemic Errors
Random Errors
Treatment Documentation, Procedure Checklists, & Forms
Application Preparation
Application Insertion
Implant Localization and Stimulation
Treatment Prescription

Implant Design and Evaluations

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Localization
Computer Treatment Planning
Manual Verification of Computer
Patient Preparation, Setup, and Treatment
Post Treatment Quality Assurance

Emergency Procedures for HDR

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Routine Emergency Equipment
Physical Plant Emergencies
Minor and Major Emergencies
Intravascular Brachytherapy

Prostate Seed Implants:

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I-125 Seeds
P-103 Seeds
Ommaya Reservoir

TREATMENT PLANNING

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Auxiliary Devices (Digitizer, Plotter)
Software
Quality Assurance

SPECIAL TECHNIQUES

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TBI (Total body Irradiation)
Electron Arc Therapy
Interoperative Electron Therapy
TSI (Total Skin Irradiation)
SRS (Stereotactic Radiosurgery)
Beam Data Acquisition for Small Fields
Treatment Planning Computer Data Input
SRT (Stereotactic Radiotherapy)

STANDARDS FOR TREATMENT PLANS/PROTOCOLS

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Ensures Accurate Dose
Ensures Proper Patient Positioning
Ensures Proper Machine Settings
Deviation of Normal Parameters for Equipment

Field Shaping

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Custom Blocking
Multileaf Collimators
Half-Value Thick Blocks
Gonadal Shields
Eye Shields
Internal Shields
In Vivo Dosimetry
TLD (Thermoluminescent Dosimeters) Chips

Patient Positioning

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Immobilization Devices
Anatomic Landmarks

Certifications

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Medical Dosimetrist Certification Board

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - Dosimetrist