Manual for ESTRO Teachers

Evaluation Form for an ESTRO Course on

Title

City, Country

Date

ESTRO hopes that you have found this course to be useful, but since nothing is perfect, we need your input to continue to develop this course to meet participants’ needs. We therefore ask you to fill this evaluation form during the course and return it at the end of the course. Your evaluation will be anonymous. Thank you for your comments.

I.

Background Information

1.

Gender:

Male

Female

2.

Specialty:

Radiation Oncologist Radiation Physicist

Specialist Specialist Specialist Specialist

Trainee Trainee Trainee Trainee

Radiobiologist

RTT

Other, please specify:______________________________________

Number of years worked in the field of speciality:___________

3.

I heard about the course from:

ESTRO publications Department director

Radiotherapy & Oncology journal

National Organizations

Colleagues

Internet

IAEA

Other____________________

4. I have previously attended the following ESTRO courses (please cross the corresponding number) :

1 Basic Clinical Radiobiology 16 Advanced Skills in Modern Radiotherapy 2 Dose Modeling and Verification for External Beam Radiotherapy 17 MultidisciplinaryManagement of Lung Cancer 3 Modern Brachytherapy Techniques 18 MultidisciplicaryManagement of Head and Necl Cancer 4 Particle Therapy 19 Hematological Malignancies 5 IMRT and Other Conformal Techniques in Practice 20 Palliative Care and Radiotherapy 6 Image-Guided Cerviox Cancer Radiotherapy 21 Physics for Modern Radiotherapy 7 Target Volume Determination 22 Basic Treatment Planning 8 Molecular Imaging and Radiation Oncology 23 Advanced Treatment Planning 9 MultidisciplinaryManagement of Breast Cancer 24 Imaging for Physicists 10 MutidisciplinaryManagement of Prostate Cancer 25 Comprehensive QualityManagement in Radiotherapy 11 Lower GI 26 Biological Basis of Personalised Radiation Oncology 12 Upper GI 27 Image-Guided and Adaptive Radiotherapy 13 Advanced Brachytherapy Physcis 28 Multiodisciplinary Approach of Cancer Imaging 14 Image-Guided Stereotactic Body Radioatherapy 29 Accelerated Partial Breast Course 15 Evidence Based Radiation Oncology 30 Pediatric Radiation Oncology

5. Did you have any training in treatment planning before?

Not at all Some training at the department

Attended a local course: __________hours I attended a national course: _______hours Other: ________________________