A new graduate education program in radiation therapy (original) (raw)
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Transition to practice in radiation oncology: Mind the gap
Radiotherapy and Oncology, 2019
Introduction: Physicians entering independent practice often express apprehension in managing the nonclinical aspects of practice. This study examined the perceived preparedness of radiation oncology (RO) residents for independent practice, identified education gaps, and discussed how these deficiencies could be addressed. Materials and methods: Focus groups with senior RO residents, fellows, new-to-practice radiation oncologists (ROs), and residency program directors were conducted. Data were coded using the Canadian Medical Education Directives for Specialists (CanMEDS) competencies using thematic analysis. Results: Commonly reported gaps in the transition to practice (TtP) for ROs were lack of experience with: practice management, understanding the structure and function of the health care system and how it varies by jurisdiction, financial planning, effective communication and collaboration with other health care team members, creation of accurate and timely documentation, and radiotherapy problem-solving related to treatment planning and evaluation. Suggestions to address these challenges included use of mentorship, educational resources, courses, simulation-based medical education, improved graded responsibility, resident longitudinal clinics, and formal curricula in radiation therapy planning and evaluation. Conclusion: There are gaps in TtP education for RO trainees with opportunities for enrichment through the forthcoming implementation of a competency-based medical education framework in 2019. The gap in perceived competency in physician-related radiotherapy tasks may be caused by the complex interaction of clinical workflow processes, people and technology that has led to ineffective integration of trainees. The data are informative to medical education leaders for the development of comprehensive TtP curricula.
Implementation of the first Australian graduate entry masters degree in radiation therapy
Journal of Radiotherapy in Practice, 2004
This lecture will compare the UK and USA radiation therapy delivery models. This comparison will demonstrate how the UK advance practice model for therapy radiographers may not be applicable in the framework of the USA healthcare system. A brief overview of the development of the Radiologist Assistant will be provided to demonstrate the process for development of a successful advance practice model in the USA. A potential advanced practice model for the USA will be presented and discussed.
2013
Introduction: Undergraduate students studying the Bachelor of Radiation Therapy at Queensland University of Technology (QUT) attend clinical placements in a number of department sites across Queensland. To ensure that the curriculum prepares students for the most common treatments and current techniques in use in these departments, a curriculum matching exercise was performed. Methods: A cross-sectional census was performed on a predetermined "Snapshot" date in 2012. This was undertaken by the clinical education staff in each department who used a standardized proforma to count the number of patients as well as prescription, equipment, and technique data for a list of tumour site categories. This information was combined into aggregate anonymized data. Results: All 12 Queensland radiation therapy clinical sites participated in the Snapshot data collection exercise to produce a comprehensive overview of clinical practice on the chosen day. A total of 59 different tumour sites were treated on the chosen day and as expected the most common treatment sites were prostate and breast, comprising 46% of patients treated. Data analysis also indicated that intensity-modulated radiotherapy (IMRT) use is relatively high with 19.6% of patients receiving IMRT treatment on the chosen day. Both IMRT and image-guided radiotherapy (IGRT) indications matched recommendations from the evidence. Conclusion: The Snapshot method proved to be a feasible and efficient method of gathering useful data to inform curriculum matching. Frequency of IMRT use in Queensland matches or possibly exceeds that indicated in the literature. It is recommended that future repetition of the study be undertaken in order to monitor trends in referral patterns and new technology implementation.
Radiography, 2014
Background: There is a lack of clarity as to what factors affect practitioners' fitness to practise (FTP). Purpose: The purpose of this study was to identify what radiation therapists perceived to be the key determinants of FTP and to establish the importance that they place on each determinant. Methods: A mixed methods approach using focus groups with a brainstorming activity was used for data collection. Qualitative analysis was informed by grounded theory, where the data was coded and assigned themes. Findings: Three focus groups were conducted with 21 participants. Twenty-one unique determinants of FTP were identified. Professional development, communication, competence, qualifications, ethics and professionalism were common themes in all focus groups. Knowledge, technical and professional skills were most frequently cited by participants as the three most important determinants. Self-awareness, values and ethics featured last on the list. Participants of higher seniority identified a greater variety of determinants with lesser emphasis on technical skills, when compared with junior participants. Nine determinant themes were identified initially and these were spliced to form three primary categories; Impairment, Competence, and Values/Ethics. Conclusion: The most important issues to radiation therapists were associated with technical and clinical competence. This indicates a need to further educate practitioners on the other determinants of FTP, such as values, ethics, probity, trust and criminal activity. Further investigation is required to assess practitioner behavioural responses to deviations from accepted practice and the socio-cultural context of FTP.
Radiography, 2014
Advanced practice for radiation therapists has been a part of the international landscape for several years; however formal implementation into the Australian health care system is yet to happen. Despite this, three short course radiation therapy advanced practitioner programs have been established by an Australian tertiary institution in response to clinical service needs at several organisations. This paper describes the rationale for curriculum design and development of the program materials, the small-scale implementation of the programs at pilot sites, and the evolution of the curriculum to be available to registered radiation therapists nationally. Each program has been designed around a specific clinical role, where flexibility of delivery to busy practitioners was central to the decision to offer them via distance education. The curriculum comprises theoretical units of study which run in parallel to and underpin clinical practice units, where advanced competence in the specific area of practice is overseen by an experienced radiation oncologist mentor. Given the nature of the disparate clinical services requiring an advanced radiation therapy practitioner, the workplace learning component of the course is individually negotiated at a local level. Outcomes suggest that the flexible clinically based training underpinned by a distance education academic curriculum is able to support the development of advanced radiation therapy practitioners responsive to local service need, and ultimately may improve the patient experience.
Supporting Clinical Teachers: Developing Radiation Therapists’ Preceptorship Skills
Preceptorship is a valuable component of undergraduate radiation therapy education and allows students to develop clinical skills and professional attitudes under the supervision of experienced practitioners. Preceptor preparation in the form of continuing professional development is an important factor for successful preceptorship to occur. This article describes the development and evaluation of a short, flexible blended learning course by a group of Ontario educators. The course was designed to support radiation therapists teaching students from the joint University of Toronto and Michener Institute Medical Radiation Sciences (MRS) program undergoing the clinical practicum component of their 3-year program. The course comprises two workshops and a web-based component. Topics include adult education theories, orienting a student to clinic, feedback, fostering clinical reasoning, conflict resolution, formal evaluation, the MRS program structure/processes and the needs of the student with English as a second language. To date, three cohorts have completed the course (52 learners) from four Ontario radiation therapy departments. Evaluations have been positive, with high participant satisfaction and a noteworthy difference in self-perceived knowledge using the original course objectives between pre- and post-knowledge levels. It is hoped that this course will contribute to the success of the role
Journal of Cancer Education
Changes in the field of radiation oncology (RO) impacts residency training. Assessing trainee experiences is essential to inform curriculum development. We aim to explore gaps and strengths in current Canadian RO training, as we move towards competency-based medical education (CBME). An online survey was distributed to residents at all Canadian RO training programs. Surveys consisted of 66 open-ended, Likert-scale, matrix-style, and multiple-choice questions, and assessed clinical exposure, didactic teaching, professional relationships, and research experiences. Statistics were calculated from anonymized, aggregate responses. Out of 128 eligible residents, 53 responded (41% response rate). Of these, 57% were male, and 77% were Canadian medical graduates. Senior residents (PGY-4 to PGY-5) perceived insufficient exposure to lymphoma and ocular malignancies, brachytherapy for breast and esophagus malignancies, and stereotactic radiotherapy of the pancreas, prostate, and adrenal gland. Half (51%) had training on image-guided radiotherapy (IGRT) challenges, and 43% had a formal staff mentor. Most residents presented at least one research project at conferences (77%) and authored ≥ 1 publications (66%) during residency. Canadian RO residents are satisfied with their clinical training and educational experience in high-volume tumor sites and highvolume brachytherapy procedures. Areas identified for potential improvement are (1) low-volume tumor sites; (2) low-volume brachytherapy procedures; (3) low-volume stereotactic radiotherapy sites; (4) IGRT challenges; and (5) mentorship opportunities. These findings will inform future CBME curriculum revisions.
The principal goal of interprofessional education (IPE) is to cultivate collaborative practice for providing patient centered care. Introduction to Radiation Therapy (IRT) is a course designed to introduce radiation oncology residents to the radiation treatment process and the interprofessional nature of the radiation oncology environment. Each resident is paired with a radiation therapy student during the clinical portion of the IRT course. The intent behind the pairing is to facilitate opportunities for IPE and to establish a professional relationship for interprofessional collaboration in the future. The overall outcome of the IPE experience has been positive and beneficial to both groups. Results of the survey examining the residents’ and the radiation therapy students’ perception of their IPE experience within the IRT course showed that they were able to gain insight into each other’s role, as well as learn with and from each other. However, the timing of the IPE experience had some impact on the participants’ ability to reflect on their own practice and share it meaningfully.