Competency-Based Simulation and Evaluation in Medical Education: Clinical Decision Making and Reference Dosimetry

Area of Science:

• Medical Physics
• Radiation Oncology
• Medical Education

Background:

• Medical physics residency programs require robust evaluation methods for essential clinical skills.
• Traditional assessment methods may not fully capture competency in radiation output measurements and clinical decision-making.

Purpose of the Study:

• To develop and evaluate a competency-based simulation program for medical physics residents.
• The program aims to assess radiation output measurements and clinical decision-making skills.

Main Methods:

• A national working group designed a simulation methodology for assessing radiation output measurements on linear accelerators.
• The program incorporated pre- and post-task self-assessments, qualitative and quantitative task evaluations, and structured debriefing.
• Certified medical physicists evaluated CAMPEP-accredited residents using a 30-point global rating scale and procedural checklist.

Main Results:

• 39 residents from Canada and the US participated; the median simulation completion time was 50 minutes.
• Statistically significant improvement in self-assessment scores was observed post-simulation (p < 0.001), with earlier residents showing the largest gains.
• The average global rating score was 26.1 (± 2.6), and prior dosimetry experience correlated with improved scores (p < 0.01).

Conclusions:

• A competency-based simulation program was successfully implemented in a multi-institutional medical physics residency setting.
• Simulation-based training effectively consolidates foundational dosimetry knowledge and clinical reasoning skills.
• This program provides a structured framework for evaluating and enhancing resident competency in critical clinical tasks.