Investigating opinions of, and perceptions to, advanced practice radiation therapist roles

Advanced practice among diagnostic radiographers - An international survey

INTRODUCTION

As the global healthcare system evolves, diagnostic radiographers (DRs) are taking on advanced roles, constituting advanced radiography practice. This study explored the definition of ARP tasks among DRs, radiology department managers (RDMs), and National Society Officers (NSOs) on a global scale.

METHODS

Data collection was obtained via a self-developed online survey administered via email and social media to DRs, RDMs, and NSOs. The survey sought to collect demographic data, insights into definition of ARP tasks, and perceptions regarding global practice.

RESULTS

206 respondents from 25 countries participated, predominantly from Norway (n = 77), Australia (n = 34), and Portugal (n = 20). 71.7 % of DR respondents defined teaching as ARP task, while RDMs (74.2) and NSOs (88.8 %) identified approving image quality independently as ARP. 53.4 % of DRs perceived their practice as ARP-aligned, with awareness reported by 44.8 % of DRs, 66.7 % of RDMs, and 77.8 % of NSOs.

CONCLUSION

This study provides a clearer understanding of the task respondents consider ARP and the extent to which it is practiced, whereas DRs are increasingly performing advanced tasks globally. Clarifying ARP tasks in the workplace will promote a common understanding of the role and foster support for its establishment in diagnostic radiography. Further research is required to gather a more comprehensive international perspective on ARP tasks, especially given the limitations of this study, as well as the limited responses from the Americas and African regions.

IMPLICATIONS FOR PRACTICE

Clear definitions of ARP tasks are necessary for seamless integration of ARP into current practices. Additionally, advocating for official recognition, and global acknowledgement by the profession and key stakeholders are imperative for DRs to fully develop in these areas.

Automation and artificial intelligence in radiation therapy treatment planning

Automation and artificial intelligence (AI) is already possible for many radiation therapy planning and treatment processes with the aim of improving workflows and increasing efficiency in radiation oncology departments. Currently, AI technology is advancing at an exponential rate, as are its applications in radiation oncology. This commentary highlights the way AI has begun to impact radiation therapy treatment planning and looks ahead to potential future developments in this space. Historically, radiation therapist's (RT's) role has evolved alongside the adoption of new technology. In Australia, RTs have key clinical roles in both planning and treatment delivery and have been integral in the implementation of automated solutions for both areas. They will need to continue to be informed, to adapt and to transform with AI technologies implemented into clinical practice in radiation oncology departments. RTs will play an important role in how AI-based automation is implemented into practice in Australia, ensuring its application can truly enable personalised and higher-quality treatment for patients. To inform and optimise utilisation of AI, research should not only focus on clinical outcomes but also AI's impact on professional roles, responsibilities and service delivery. Increased efficiencies in the radiation therapy workflow and workforce need to maintain safe improvements in practice and should not come at the cost of creativity, innovation, oversight and safety.

Established advanced practice roles in radiation therapy: A scoping review

Advanced practitioners are healthcare professionals that are highly skilled with a particular area of expertise. These roles have been successfully implemented in many healthcare settings, improving efficiency of the service, as well as enhancing the standard of care received by patients. Although advanced practice roles have been implemented in some radiation therapy departments, their implementation have yet to be facilitated in the majority of countries. The purpose of this review is to scope the literature available regarding established advanced practice roles in radiation therapy. The PRISMA strategy for the identification of relevant literature was adhered to. Two data bases, EMBASE and PubMed, were searched using combinations of the key words 'Advanced', 'Practice', 'APRT', 'Radiation', 'Therapy' and 'Radiotherapy'. Exclusion criteria were applied, and citation lists were also screened for additional relevant sources, including grey literature sources. A total of 35 relevant sources were identified that discussed advanced practice radiation therapy roles in the United Kingdom, Singapore, Canada, Australia and the USA. Means of role establishment and scope of practice were defined, and a number of advantages and challenges for advanced practice radiation therapist roles were identified. There are many benefits of implementing advanced practice roles in radiation therapy departments. Though the implementation of these roles can be challenging, the existing evidence indicates that it would be beneficial for the patient, the radiation therapist and the department as a whole. A more systematic approach, including reporting of quantitative outcomes may assist in the more widespread implementation of these roles.

Advanced practice roles of therapeutic radiographers/radiation therapists: A systematic literature review

INTRODUCTION

Advances in Radiotherapy (RT) technology and increase of complexity in cancer care have enabled the implementation of new treatment techniques. Subsequently, a greater level of autonomy, responsibility, and accountability in the practice of Therapeutic Radiographers/Radiation Therapists (TR/RTTs) has led to Advanced Practice (AP) roles. The published evidence of this role is scattered with confusing terminology and divergence regarding the perception of whether a specific role represents AP internationally. This study aims to establish an international baseline of evidence on AP roles in RT to identify roles and activities performed by TR/RTTs at advanced level practice and to summarise the impact.

METHODS

A systematic PRISMA review of the literature was undertaken. Thematic analysis was used to synthesise the roles and associated activities. Six RT external experts validated the list. The impact was scrutinised in terms of clinical, organisational, and professional outcomes.

RESULTS

Studies (n = 87) were included and categorised into four groups. AP roles were listed by clinical area, site-specific, and scope of practice, and advanced activities were organised into seven dimensions and 27 sub-dimensions. Three most-reported outcomes were: enhanced service capacity, higher patient satisfaction, and safety maintenance.

CONCLUSION

Evidence-based AP amongst TR/RTTs show how AP roles were conceptualised, implemented, and evaluated. Congruence studies have shown that TR/RTTs are at par with the gold-standard across the various AP roles.

IMPLICATIONS FOR PRACTICE

This is the first systematic literature review synthetisising AP roles and activities of TR/RTTs. This study also identified the main areas of AP that can be used to develop professional frameworks and education guiding policy by professional bodies, educators and other stakeholders.