Results of the 2014 Survey of the Association of Directors of Radiation Oncology Programs (ADROP)

Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors

Background

Physicians and physicists are expected to contribute to patient safety and quality improvement (QI) in Radiation Oncology (RO), but prior studies suggest that training for this may be inadequate. RO and medical physics (MP) program directors (PDs) were surveyed to better understand the current patient safety/QI training in their residency programs.

Methods

PDs were surveyed via email in January 2017. Survey questions inquired about current training, curriculum elements, and barriers to development and/or improvement of safety and QI training.

Results

Eighty-nine RO PDs and 84 MP PDs were surveyed, and 21 RO PDs (28%) and 31 MP PDs (37%) responded. Both RO and MP PDs had favorable opinions of current safety and QI training, and used a range of resources for program development, especially safety and QI publications. Various curriculum elements were reported. Curriculum elements used by RO and MP PDs were similar, except RO were more likely than MP PDs to implement morbidity and mortality (M&M) conference (72% vs. 45%, p < 0.05). RO and MP PDs similarly cited various barriers, but RO PDs were more likely to cite lack of experience than MP PDs (40% vs. 16%, p < 0.05). PDs responded similarly independent of whether they reported using a departmental incident learning system (ILS) or not.

Conclusions

PDs view patient safety/QI as an important part of resident education. Most PDs agreed that residents are adequately exposed to patient safety/QI and prepared to meet the patient safety/QI expectations of clinical practice. This conflicts with other independent studies that indicate a majority of residents feel their patient safety/QI training is inadequate and lacks formal exposure to QI tools.

Electronic supplementary material

The online version of this article (10.1186/s13014-018-1128-5) contains supplementary material, which is available to authorized users.

Radiation oncology directors of training survey 2016: Perspectives and challenges

INTRODUCTION

This paper reports the key findings of the first survey of Australian and New Zealand Radiation Oncology Directors of Training (DoTs) dealing with their perspectives, experiences and challenges.

METHODS

The survey was conducted in September 2016 using a 34-question instrument. It was emailed to all radiation oncology DoTs listed on the Royal Australian and New Zealand College of Radiologists (RANZCR) database. The questions related to demographics, protected time, weekly activities, support, the value of curriculum assessments, challenges and suggested improvements. Respondents were assured that their responses were anonymous.

RESULTS

The response rate was 59.6% (31/52). The median age of respondents was in the 41 to 45 age bracket, but nearly one quarter were over 45 years of age. The median time respondents had been in the role was three to five years (range <0.5 to >10) with the median number of trainees supervised being four (range 1-8). Thirty-five percent had a co DoT. DoTs spent a median of three hours per week on the role (range <1 to >8) with most respondents (67.7%) requiring time during and out of work performing the role, but ten percent claimed it was done out of hours only. Nearly all DoTs were aware they should have protected time, but only just half received it. The educational aspects of training dominated weekly activities, but rostering, specific trainee issues and administration were also featured. Time issues were the greatest challenge for respondents with clinical assignments the most challenging assessment. However, more emphasis on contouring and planning was thought to be required. All DoTs found the dedicated DoT workshops useful, but felt future discussions on trainees in difficulty could be emphasized. The vast majority felt supported by their training site and the College. All respondents believed in the role with most having an interest in educational activities. The majority of respondents (85%) intended to continue in the role for the next 1 to 2 years, but this dropped to 45% when asked about continuing for 5 years.

CONCLUSIONS

This survey of predominantly experienced DoTs, indicated that the role was deemed to be of value in delivering optimal training. The most significant challenges faced by DoTs were finding sufficient time to deal with the responsibilities of the role and dealing with underperforming trainees. Feedback on the currently employed work based assessments will be considered as FRO transitions into programmatic assessment. Furthermore, a desire for training in how to deal with trainees in difficulty, underperforming or unsuitable trainees is noted. Future work is planned following refinements of the survey instrument; and, will also explore stress and burnout in the DoT cohort.