Competency-based simulation and evaluation in medical education: clinical decision making and reference dosimetry
Recommended Citation
Roumeliotis M, Warkentin H, Buckley L, Babic S, Becker N, Cherpak A, Ranganathan V, Thind K, McNiven A, Alexander A, Popovic M, Quirk S. Competency-based simulation and evaluation in medical education: clinical decision making and reference dosimetry. Int J Radiat Oncol Biol Phys. 2026.
Document Type
Article
Publication Date
2-11-2026
Publication Title
International journal of radiation oncology, biology, physics
Keywords
competency by design; competency-based; education; education program; evaluation; learning; simulation; structured learning
Abstract
PURPOSE: To develop a competency-based simulation program to evaluate medical physics residents in radiation output measurements and clinical decision making.
METHODS: A national working group developed methodology to assess competency of residents performing the measurement of radiation output for photon beams on a linear accelerator. The program included (i) pre- and post-task self-assessment, (ii) qualitative task evaluation, (iii) quantitative task evaluation, (iv) evaluator directed discussion and debrief, and (v) evaluator feedback. Eligible study participants were CAMPEP-accredited residents in medical physics. Evaluation was performed by a certified medical physicist directly observing the participant perform the simulation. Study outcomes included time-to-complete as well as qualitative scoring using a 30-point global rating scale (GRS) and quantitative measures including a procedural checklist for simulation accuracy and completeness. All statistical evaluations used an alpha of 0.05 to indicate significance.
RESULTS: Over the study period, 39 residents participated from centers in Canada (n = 9) and the US (n = 2). The median (range) time-to-complete the simulation task for a single photon beam energy is 50 (24 to 139) minutes. In the self-assessment questionnaire with nine questions, the difference in pre- and post-task score was statistically significant (p < 0.001). On multivariable linear regression, residents earliest in their residency program (0 to 6 months) reported the largest improvement in preand post-assessment scores (p = 0.02). In the qualitative evaluation, the average (± standard deviation) global rating scores for the entire cohort were 26.1 (± 2.6). On multivariable linear regression, residents with prior hands-on experience in performing dosimetry measurements yielded a significantly improved GRS score (p < 0.01).
CONCLUSIONS: A competency-based simulation program was applied to medical physics residents in a structured, multi-institutional setting. These findings support the role of simulation-based environments in consolidating foundational dosimetry knowledge and clinical reasoning within medical physics residency training.
PubMed ID
41688028
ePublication
ePub ahead of print
