Anesthesia Questionnaire short version

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RESOURCES (B4)
1
2014
PRE-SURVEY QUESTIONNAIRE
STANDARD B4: RESOURCES
"There must be sufficient resources including teaching faculty, the number and variety of
patients, physical and technical resources, as well as the supporting facilities and services
necessary to provide the opportunity for all residents in the program to achieve the educational
objectives and receive full training as defined by the Royal College specialty training
requirements."
Program
Radiation Oncology
University
Date of Review (month/year)
Sites Participating in this Program:
Where the resources to provide "full training" are not available at the sponsoring university, several
different types of interuniversity affiliations may be negotiated. It should be noted that the exchange of
residents between two fully accredited programs does not require an interuniversity affiliation.
RESOURCES (B4)
2
2012
1. Teaching Faculty
List by teaching site the members of the teaching faculty who have a major role in this program, including members from other
departments. In indicating a subspecialty, use as a criterion whether he or she is considered by colleagues as a subspecialist and
functions academically and professionally as one.
Teaching Site
Name
University Rank
Specialty
Qualifications
Subspecialty
(If any)
What percentage of faculty listed above have been practising in the specialty/subspecialty:
< 15 years
%
> 25 years
%
Nature of Interaction with Resident
(e.g. clinical, teaching, research)
RESOURCES (B4)
2.
3
2014
Physical Facilities for Radiation Oncology
Is there sufficient physical space and facilities at all of your participating institutions for teaching
Radiation Oncology?
Yes
No
If no, please provide details.
NAME OF INSTITUTION:
3.
Equipment and Support Facilities (to be completed for each participating institution)
a)
Therapy Equipment or Capabilities
Number of Units
Total units of all types
Orthovoltage
Megavoltage
High Dose Rate Brachytherapy
Yes
No
Pulsed Dose Rate Brachytherapy
Yes
No
Low Dose Rate Brachytherapy
Yes
No
Manually Loaded Permanent Implants
Yes
No
Intensity Modulated Radiation Therapy (Inverse Planned IMRT)
Yes
No
Stereotactic Radiation Treatment) (intracranial)
Yes
No
Stereotactic Radiation Treatment (Body)
Yes
No
Others (describe):
b)
i)
ii)
Infrastructure
Operating Room Facilities
Yes
No
Brachytherapy Facilities
Yes
No
Patient Immobilisation Facilities
Yes
No
Treatment Planning Workstations
Number:
Are treatment planning workstations readily accessible to
residents?
Explain:
Do residents have adequate time on their workstations
for contouring and treatment planning?
Do residents have adequate involvement in treatment
plan evaluation?
Explain:
Explain:
RESOURCES (B4)
4.
4
Specialized Support Staff
2014
(to be completed for each participating institution)
Is there sufficient access to support staff for teaching? If no, please specify.
5.
a) Therapeutic Nuclear Medicine
Yes
No
b) Physicists
Yes
No
c) Radiobiologists and/or molecular oncology
basic scientists
Yes
No
d) Diagnostic Imaging
Yes
No
e) Pathology
Yes
No
f)
Yes
No
Other staff (specify)
Patient Load, Consultations, and Clinics (to be completed for each participating institution)
Number
a) Total number of consultations by radiation oncologists in your program annually
b) Total number of courses of radiation administered annually
c) Total number of cases planned for Brachytherapy
d) Total number of cases planned for IMRT with inverse planning
e) Total number of cases planned for SRT
f)
Total number of cases treated with radioisotopes annually
g) Average number of in-patients cared for by Radiation Oncology daily
h) Percentage of radical treatment cases reviewed in formal peer review process
6.
Radiation Oncology new patient consults seen (in the last 12 months)
Tumour site
Central nervous system
Breast
Head and neck
Lung
Gastrointestinal
Genitourinary
Gynecologic
Hematologic
Skin
Sarcoma
Pediatric
Symptom control (if seen
in specialized consult service)
7.
Clinical Oncology
Number
RESOURCES (B4)
5
2014
Does the program provide rotational or other arrangements whereby the individual resident gains
experience in the following?
Surgery
Systemic Therapy
Diagnostic Imaging
Anatomical Pathology
Palliative Care
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Pediatric Oncology
Yes
No
If no, describe how this standard is met.
8.
Community Oncology Experience
Describe the opportunities for the residents to gain exposure to radiation oncology practice outside of
large training centres. Please indicate the site(s) where community experience was undertaken (over
the past 3 years).
9.
Information/Space Resources
a) Do residents have free 24/7 access to on-line libraries, journals and other educational resources?
Yes
No
Partially
If “No” or “Partially”, please explain.
b) Do residents have adequate work space with access to electronic imaging and treatment planning
to carry out their daily work? Yes
No
Partially
If “No” or “Partially”, please explain.
c) Are technical resources required for patient care duties located in the work setting?
Yes
No
Partially
If “No” or “Partially”, please explain.
d) Do facilities allow resident skills to be observed?
Yes
No
Partially
If “No” or “Partially”, please explain.
e) Do facilities allow for confidential feedback/discussions?
Yes
No
Partially
If “No” or “Partially”, please explain.
10. Summary of Adequacy of Resources
Comment on the adequacy of the resources in the overall residency program, with particular
reference to the relationship between such resources and the number of residents dependent upon
RESOURCES (B4)
6
them. Include consideration of the following questions:
Are there significant areas where the workload of the teachers (clinical care, undergraduate
teaching, etc.) is such as to affect adversely the continuous supervision and instruction of
residents in Radiation Oncology?
Are the numbers of patients and examinations available for teaching sufficient to provide
for the training of residents rotating from other programs and services, without adverse
effects on the training of residents in Radiation Oncology?
Are the diagnostic and basic science facilities available to the program sufficient to provide
adequate teaching for residents in Radiation Oncology in addition to other residents sharing
the same facilities?
Revised November 2011
Editorial revisions - February 2012
Revised June 2014
2014
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