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Oliveira C, Barbosa B, Couto JG, Bravo I, Hughes C, McFadden S, Khine R, McNair HA. Advanced practice roles amongst therapeutic radiographers/radiation therapists: A European survey. Radiography (Lond) 2023; 29:261-273. [PMID: 36608396 DOI: 10.1016/j.radi.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/24/2022] [Accepted: 12/04/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Advanced Practice (AP) roles in Radiotherapy (RT) over time are variable, often locally developed and not underpinned by professional standards which leads to conceptual and practical gaps. This study aimed to assess AP roles amongst Therapeutic Radiographers/Radiation Therapists (TR/RTTs) and identify educational gaps for this level across Europe. METHODS An anonymous online survey was designed, validated, and distributed across Europe. Convenience sampling was used to recruit advanced TR/RTTs practitioners or TR/RTTs working in AP roles. Descriptive analysis from closed questions and thematic analyses from open questions are reported. RESULTS A total of 272 responses were obtained, of which 189 eligible participations were from 21 European countries. 42% of respondents acknowledged additional education required to perform AP, and 25% reported a minimum of five years of RT practice to perform AP roles/tasks. There is a trend to work more on the clinical practice domain with a low percentage of working time allocated to research. Inconsistency was found in job titles, scopes of practice, and educational backgrounds across and even within countries. Education needs regarding knowledge about image-guided and adaptive RT, multimodal imaging and technologies, and advanced treatment planning were found. Training needs on leadership and management skills and clinical site-specific expertise were identified. CONCLUSION This study clearly shows a gap in education support, a need for standardisation in job titles and scopes of practice across Europe. IMPLICATIONS FOR PRACTICE As the first large-scale assessment of current AP roles and educational support amongst TR/RTTs across Europe, this study recommends the establishment of governance structure and role regulation. It also informs the curricula for master programmes to align the education with current and future practice.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - C Hughes
- School of Health Sciences, Ulster University, Shore Road Newtownabbey Co, Antrim, BT37 0QB, United Kingdom.
| | - S McFadden
- School of Health Sciences, Ulster University, Shore Road Newtownabbey Co, Antrim, BT37 0QB, United Kingdom.
| | - R Khine
- European Federation of Radiographer Societies, Utrecht, Netherlands; School of Health Care and Social Work, Buckinghamshire New University, Buckinghamshire, United Kingdom.
| | - H A McNair
- European Federation of Radiographer Societies, Utrecht, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, SM2 5PT, United Kingdom.
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Joyce E, Jackson M, Skok J, Peet B, McNair HA. Images and images: Current roles of therapeutic radiographers. Radiography (Lond) 2022; 28:1093-1100. [PMID: 36054937 DOI: 10.1016/j.radi.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Therapeutic radiography is a small profession and has adapted in response to advanced techniques. An increase in on-line adaptive MRI-guided radiotherapy (MRIgRT) will require role extension for therapeutic radiographers (TRs). This study will investigate the current role description for TRs and the activities they currently undertake with regards to MRIgRT. METHOD A training needs analysis was used to ask TRs about their current roles and responsibilities and essential skills required for MRIgRT. For the purposes of this paper, the authors present the results from the demographics of the individual, their current job title with roles and responsibilities, and experience with decision making and image assessment. Descriptive statistics was used to analyse the data. RESULTS 261 responses were received (n = 261). Only 28% of job titles listed contained the protected title of 'therapeutic radiographer'. Advanced clinical practice roles were expressed by participants indicating that if a service need is presented, emerging roles will be created. Variation existed across the standardised roles of TRs and this discrepancy could present challenges when training for MRIgRT. TRs are pivotal in image verification and recognition on a standard linac, and skills developed there can be transferred to MRIgRT. Decision making is crucial for adaptive techniques and there are many skills within their current scope of practice that are indispensable for the MRIgRT. CONCLUSION It has been demonstrated that TRs have a range of roles that cover vast areas of the oncology pathway and so it is important that TRs are recognised so the pivotal role they play is understood by all. TRs have extensive soft-tissue IGRT knowledge and experience, aiding the evolution of decision-making skills and application of off-protocol judgments, the basis of MRIgRT. IMPLICATIONS FOR PRACTICE Role development and changes in education for therapeutic radiographers.
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Affiliation(s)
- E Joyce
- Royal Marsden NHS Foundation Trust, UK
| | - M Jackson
- St George's University of London, UK
| | - J Skok
- St George's University of London, UK
| | - B Peet
- Royal Marsden NHS Foundation Trust, UK
| | - H A McNair
- Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, UK.
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Barbosa B, Bravo I, Oliveira C, Antunes L, Couto JG, McFadden S, Hughes C, McClure P, Dias AG. Digital skills of therapeutic radiographers/radiation therapists - Document analysis for a European educational curriculum. Radiography (Lond) 2022; 28:955-963. [PMID: 35842952 DOI: 10.1016/j.radi.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION It is estimated that around 50% of cancer patients require Radiotherapy (RT) at some point during their treatment, hence Therapeutic Radiographers/Radiation Therapists (TR/RTTs) have a key role to play in patient management. It is essential for TR/RTTs to keep abreast with new technologies and continuously develop the digital skills necessary for safe RT practice. The RT profession and education is not regulated at European Union level, which leads to heterogeneity in the skills developed and practised among countries. This study aimed to explore the white and grey literature to collate data on the relevant digital skills required for TR/RTTs practice. METHODS An exhaustive systematic search was conducted to identify literature discussing digital skills of TR/RTTs; relevant grey literature was also identified. A thematic analysis was performed to identify and organise these skills into themes and sub-themes. RESULTS 195 digital skills were identified, organised in 35 sub-themes and grouped into six main themes: (i) Transversal Digital Skills, (ii) RT Planning Image, (iii) RT Treatment Planning, (iv) RT Treatment Administration, (v) Quality, Safety and Risk Management, and (vi) Management, Education and Research. CONCLUSION This list can be used as a reference to close current gaps in knowledge or skills of TR/RTTs while anticipating future needs regarding the rapid development of new technologies (such as Artificial Intelligence or Big Data). IMPLICATIONS FOR PRACTICE It is imperative to align education with current and future RT practice to ensure that all RT patients receive the best care. Filling the gaps in TR/RTTs skill sets will improve current practice and provide TR/RTTs with the support needed to develop more advanced skills.
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Affiliation(s)
- B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain; Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - I Bravo
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain.
| | - L Antunes
- School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida MSD2080, Malta.
| | - S McFadden
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - C Hughes
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - P McClure
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - A G Dias
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Medical Physics Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
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Oliveira C, Barbosa B, Couto JG, Bravo I, Khine R, McNair H. Advanced practice roles of therapeutic radiographers/radiation therapists: A systematic literature review. Radiography (Lond) 2022; 28:605-619. [PMID: 35550932 DOI: 10.1016/j.radi.2022.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/06/2022] [Accepted: 04/19/2022] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación Ao Campus Universitario, 36310, Vigo, Pontevedra, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación Ao Campus Universitario, 36310, Vigo, Pontevedra, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2080, Malta.
| | - I Bravo
- Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072, Porto, Portugal.
| | - R Khine
- European Federation of Radiographer Societies, PO Box 30511, Utrecht, 3503, AH, Netherlands; School of Health Care and Social Work, Buckinghamshire New University, Buckinghamshire, United Kingdom.
| | - H McNair
- European Federation of Radiographer Societies, PO Box 30511, Utrecht, 3503, AH, Netherlands; The Royal Marsden NHS Foundation Trust, Radiotherapy and the Institute of Cancer Research, Surrey, SM2 5PT, United Kingdom.
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McNair HA, Joyce E, O'Gara G, Jackson M, Peet B, Huddart RA, Wiseman T. Radiographer-led online image guided adaptive radiotherapy: A qualitative investigation of the therapeutic radiographer role. Radiography (Lond) 2021; 27:1085-1093. [PMID: 34006442 PMCID: PMC8497277 DOI: 10.1016/j.radi.2021.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/06/2021] [Accepted: 04/25/2021] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Online MRI guided adaptive radiotherapy (MRIgRT) is resource intensive. To maintain and increase uptake traditional roles and responsibilities may need refining. This novel study aims to provide an in-depth understanding and subsequent impact of the roles required to deliver on-line adaptive MRIgRT by exploring the current skills and knowledge of radiographers. METHOD A purposive sampling approach was used to invite radiographers, clinicians and physicists from centres with experience of MRIgRT to participate. Focus Group Interviews were conducted with two facilitators using a semi-structure interview guide (Appendix 1). Four researchers independently familiarised themselves and coded the data using framework analysis. A consensus thematic framework of ptive Radiotherapy codes and categories was agreed and systematically applied. RESULTS Thirty participants took part (Radiographers: N = 18, Physicists: N = 9 and Clinicians: N = 3). Three key themes were identified: 'Current MRIgRT', 'Training' and 'Future Practice'. Current MRIgRT identified a variation in radiographers' roles and responsibilities with pathways ranging from radiographer-led, clinician-light-led and MDT-led. The consensus was to move towards radiographer-led with the need to have a robust on-call service heavily emphasised. Training highlighted the breadth of knowledge required by radiographers including MRI, contouring, planning and dosimetry, and treatment experience. Debate was presented over timing and length of training required. Future Practice identified the need to have radiographers solely deliver MRIgRT, to reduce staff present which was seen as a main driver, and time and resources to train radiographers seen as the main barriers. CONCLUSION Radiographer-led MRIgRT is an exciting development because of the potential radiographer role development. A national training framework created collaboratively with all stakeholders and professions involved would ensure consistency in skills and knowledge. IMPLICATIONS FOR PRACTICE Role development and changes in education for therapeutic radiographers.
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Affiliation(s)
- H A McNair
- Royal Marsden NHS Foundation Trust, United Kingdom; Institute of Cancer Research, United Kingdom.
| | - E Joyce
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - G O'Gara
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - M Jackson
- St George's University of London, United Kingdom
| | - B Peet
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - R A Huddart
- Institute of Cancer Research, United Kingdom
| | - T Wiseman
- Royal Marsden NHS Foundation Trust, United Kingdom
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Motshweneng OS, Mdletshe S. Preparing for advanced practice radiation therapy in South Africa: Conceptual and curricular considerations. Health SA 2021; 26:1587. [PMID: 34522393 PMCID: PMC8424728 DOI: 10.4102/hsag.v26i0.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/15/2021] [Indexed: 11/29/2022] Open
Abstract
The higher education landscape in South Africa has recently changed with the new National Qualifications Framework, leading to the introduction of four-year degrees in all four radiography disciplines. Additionally, there have been developments in the extension of roles in radiography, while the need for interdisciplinary practice has also been emphasised. The Professional Board for Radiography and Clinical Technology (PBRCT) of the Health Professions Council of South Africa is currently revising the scope of the profession which will now include extended roles. However, the extended role concept in radiation therapy has not received the attention similar to Diagnostic/Medical Imaging. The aim of this paper is, therefore, to provide concept clarification and key considerations for developing a postgraduate curricular framework for training radiation therapists to practise in the envisaged extended roles. For this narrative review, a Boolean search for advanced practice and role extension in radiation therapy was done on all databases (43) available on EbscoHost to source for peer-reviewed articles published between January 1950 and September 2020. A total of 17 articles met the inclusion criteria and were used to frame the discussion. Advanced practice emerged as the more suitable concept as it goes beyond an extension of tasks to include critical characteristics that are necessary to drive transformation in the local social, professional and educational arenas. It is envisaged that some of the key points discussed in this paper could assist the PBRCT in thinking about the implementation of the proposed extended roles for radiation therapists in South Africa.
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Affiliation(s)
- Oupa S Motshweneng
- Department of Health Sciences Education, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sibusiso Mdletshe
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Le Tallec P, Corbin S, Ahado S, Boisbouvier S. [Cooperation protocol and advanced practice, an evolutionary perspective for the French radiation therapist]. Cancer Radiother 2021; 25:638-641. [PMID: 34284967 DOI: 10.1016/j.canrad.2021.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Abstract
For several years, the profession of radiographer has been unattractive and is in search of professional recognition. Increasingly complex therapeutic and diagnostic evolutions forces professionals to develop their skills to ensure quality and safe care for all patients. The primary role of the radiographer is to support patients and to accompany them during their examination or treatment, combining caregiver and technician's roles. Transversal missions and delegation of tasks are inherent to the profession but are not widely recognized. Cooperation between radiotherapy professionals is a response to offer the therapeutic radiographer/radiation therapist (RTT) opportunities in terms of attractiveness, career prospects, and increased skills. In radiotherapy, advanced practice activities already exist in some departments but require regulatory adjustments, in particular regarding the redistribution of the roles of RTT but also the status of these professionals. The formalization of these practices can be largely inspired by the many feedbacks around the world. This article aims to reflect the evolution's perspectives in the career of an RTT and on the valorisation of this profession in the current context.
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Affiliation(s)
- P Le Tallec
- Département de Radiothérapie, Centre Henri Becquerel, Rouen, France.
| | - S Corbin
- Département d'oncologie radiothérapie Gustave-Roussy, 94805 Villejuif, France; Université Paris-Saclay, 94805 Villejuif, France
| | - S Ahado
- Département de Radiothérapie, Institut Bergonié, Bordeaux, France
| | - S Boisbouvier
- Département de Radiothérapie, Centre Léon Bérard, Lyon, France
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Hilder B, VanDam P, Doherty K. Investigating opinions of, and perceptions to, advanced practice radiation therapist roles. J Med Imaging Radiat Sci 2021; 52:198-206. [PMID: 33685844 DOI: 10.1016/j.jmir.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The demand for cancer services is growing due to increased incidence and the number of people who survive their initial diagnosis but require ongoing therapy. One method of increasing capacity in radiation oncology is to delegate tasks from one professional group to another. In the last ten years there has been increasing interest in advanced practice radiation therapist (APRT) roles. The majority of the Australian literature relates to metropolitan radiation oncology centres with a paucity of information from regional or rural settings. This study sought to explore the knowledge of, and attitudes to APRT roles of members of three professional groups in public radiation oncology centres in Tasmania. METHOD Data was collected through a self-reported online survey from radiation oncologists (RO), radiation oncology medical physicists (ROMP) and radiation therapists (RT) working in Tasmanian public radiation oncology services regarding their knowledge and understanding of APRT roles, acceptance and support for the roles and where APRTs could contribute to improving patient care. The survey incorporated a combination of five point Likert scale, Yes/No/Don't know and Yes/No/Not Applicable choices. The survey was reviewed by a professional panel of RT, RO and ROMP from mainland Australian radiation oncology centres. RESULTS At the time of survey invitation, there were 52 RTs, 7 ROs, and 7 ROMPs working in the identified departments. The survey had an overall response rate of 48.5%with profession specific response rates of 48.1% (RT), 42.9% (RO) and 57.1% (ROMP). General agreement was found amongst survey respondents with regards to understanding of APRT roles having themes of clinical expertise, leadership, communication, collaboration and teaching. Where participants were offered a list of tasks to choose those appropriate to APRT roles, the highest agreement was with "Contour organs at risk per protocol", "Image review - soft tissue online decision making/adaptive RT" and "Principal investigator in clinical research. The notion of establishing ARPT roles was well supported, as strong agreement was found with the statements related to improvement in job satisfaction, opportunities, recruitment and retention for RTs, and that APRTs could be used to relieve workload of other professionals. CONCLUSION This exploratory study found that the respondents were generally in favour of APRT roles, but that they were not clear about the tasks to be performed by APRTs. It was identified that patients, ROs, ROMPs, RTs and the department would benefit from the implementation of APRT roles. Sseveral areas of practice were identified by respondents which they perceived would improve the quality of patient care.
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Affiliation(s)
- Bronwyn Hilder
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia; Royal Hobart Hospital, Hobart, Tasmania, Australia.
| | - Pieter VanDam
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Kathleen Doherty
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, Tasmania, Australia
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Wong SM, Sin S, Lim L, Nurul Tassha B, Lin J, Melissa K, Koh W, Ho F, Quah DS, Sommat K, Tuan JK, Wong F, Ng W, Yeo RM, Soong Y, Wang ML. The implementation of an advanced practice radiation therapy (APRT) program in Singapore. Tech Innov Patient Support Radiat Oncol 2021; 17:63-70. [PMID: 34007909 PMCID: PMC8111035 DOI: 10.1016/j.tipsro.2021.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The exploration of Advanced Practiced Radiation Therapists (APRTs) development in Singapore started in 2011. This study aims to provide an overview of the development of the APRT roles, and to discuss the approaches used to develop and implement these roles in Singapore. MATERIALS AND METHODS A mixed methods approach was used in the development of the APRT program. A literature review was carried out to define the APRT scope of practice and core responsibilities. A competency and assessment framework were setup to assess the core competency areas. With this framework, a structured 1-year residency training program was developed. RESULTS The scope of practice and core responsibilities of APRTs were defined with five proposed advanced practice profiles being successfully validated. A competency framework was set up to assess the core competency domains: clinical, technical and professional competencies, research, education and leadership. A 4-point scoring system was developed for the competency assessment based on two criteria; the frequency with which RTTs would demonstrate competency, and the ability of performing the task competently. A 1-year structured APRT residency program was developed and implemented. The programme consisted of structured lectures, and clinical practice-based modules where APRT residents receive structured mentoring under a mentorship program. CONCLUSION The APRT program in Singapore employed an evidence-based implementation process that tested the feasibility of a new practice model. Multidisciplinary involvements, mentorship and clinical training were important factors for the success of the APRT program.
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Affiliation(s)
- Sharon M.M. Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- College of Allied Health-SingHealth Academy, Singapore
- Singapore Institute of Technology, Singapore
| | - S.Y. Sin
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - L.H. Lim
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | | | - Jeannie Lin
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - K. Melissa
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - W.Y. Koh
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - Francis Ho
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - Daniel S.C. Quah
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - Kiatissa Sommat
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - Jeffrey K.L. Tuan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - F.Y. Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - W.L. Ng
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - Richard M.C. Yeo
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - Y.L. Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
| | - Michael L.C. Wang
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-National University of Singapore, Graduate Medical School, Singapore
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Bader LR, Bates I, Galbraith K. Trends in advanced practice and specialisation in the global pharmacy workforce: a synthesis of country case studies. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:182-190. [PMID: 32176413 DOI: 10.1111/ijpp.12612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aims to gain a better understanding of the drivers and barriers to the development of advanced practice and specialised systems around the world. Through the synthesis of in-depth country case studies, this paper aims to identify current models of advanced practice and specialisation in pharmacy and illustrate trends, drivers and barriers in policy development. This is the first analysis of its kind to examine pharmacy specialisation and advanced practice in this depth from a global perspective. METHODS A synthesis of country case studies was carried out. The country case study template was reviewed and approved by an expert working group drawn from a cross section of International Pharmaceutical Federations (FIP) experts and special-interest groups. FIP member organisations and country-level contacts from regulatory, professional and government agencies and universities were approached to contribute to the case study database. The data were collected between January and May 2015. Descriptive comparative analysis and qualitative thematic analysis were both used to analyse the data. KEY FINDINGS Case study submissions were received from 17 countries. The findings demonstrate that the pace and depth of change in advanced practice and specialisation are occurring at different rates across countries and regions, although many countries appear to be moving towards recognising advanced and specialised practice of pharmacists and developing frameworks and/or formalised recognition systems. CONCLUSIONS Country-specific examples are useful in identifying factors that may contribute to the rate at which developments in advanced practice and specialisation in pharmacy are taking place and enable progress in around the world.
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Affiliation(s)
- Lina R Bader
- Lead for Workforce Transformation & Development, International Pharmaceutical Federation, The Hague, The Netherlands
| | - Ian Bates
- UCL-FIP Collaborating Centre, School of Pharmacy, University College London, London, UK
| | - Kirsten Galbraith
- Experiential Development & Graduate Education (EDGE), Monash Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Vic., Australia
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Duffton A, Devlin L, Tsang Y, Mast M, Leech M. Advanced practice: An ESTRO RTTC position paper. Tech Innov Patient Support Radiat Oncol 2019; 10:16-19. [PMID: 32095543 PMCID: PMC7033776 DOI: 10.1016/j.tipsro.2019.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Aileen Duffton
- Radiotherapy Department, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Lynsey Devlin
- Radiotherapy Department, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Yatman Tsang
- Radiotherapy Department, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Mirjam Mast
- Radiation Therapy Department, Haaglanden Medical Center, Burg Banninglaan 1, 2262 BA Leidschendam, the Netherlands
| | - Michelle Leech
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College, Dublin 2, Ireland
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Job M, Holt T, Bernard A. An evaluation of an advanced practice role in palliative radiation therapy. J Med Radiat Sci 2019; 66:96-102. [PMID: 30809974 PMCID: PMC6545471 DOI: 10.1002/jmrs.318] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/06/2018] [Accepted: 12/08/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The purpose of the study was to evaluate the palliative advanced practice radiation therapy (APRT) role with respect to the impact on waiting times for patients from referral to radiation treatment delivery, the ability of the APRT to define palliative radiation therapy fields and patient satisfaction. The evaluation of the impact of the APRT role and referral pathway on patient waiting times has been previously published. Methods Patients were allocated to two different pathways; APRT and standard. Patients in the APRT pathway had their radiotherapy treatment managed by the APRT including defining their palliative fields blinded to the radiation oncologist (RO). Results Of the 150 palliative patients, 94 had their radiation therapy managed by the APRT and 56 were managed through the standard pathway. 82/92 APRT defined fields were accepted by the RO. Conclusions Inter‐observer variability between the APRT and the RO in defining palliative radiation therapy fields is similar to that reported in the literature between clinicians. With previously published reduced wait times from referral to treatment for palliative patients, the establishment of the APRT role is justified.
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Affiliation(s)
- Mary Job
- Radiation Oncology Mater Centre, Princess Alexandra Hospital, Raymond Terrace, South Brisbane, Brisbane, Australia
| | - Tanya Holt
- Radiation Oncology Mater Centre, Princess Alexandra Hospital, Raymond Terrace, South Brisbane, Brisbane, Australia.,University of Queensland, Brisbane, Australia
| | - Anne Bernard
- QFAB Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
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Internationalising Research Methods Teaching of Undergraduate Health Professionals. J Med Imaging Radiat Sci 2018; 49:97-105. [PMID: 30479296 DOI: 10.1016/j.jmir.2017.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/07/2017] [Accepted: 11/20/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The project aims were: (1) identifying the pedagogical impact of collaborative student experience on student understanding of research methods and (2) evaluating the perceived value of providing students with an international perspective on their professional practice. METHODS Student cohorts from year 1 of the University of Liverpool (UoL) (n = 80) and year 2 of the Royal Melbourne Institute of Technology University (RMIT) (n = 128) undergraduate Medical Radiation Science degree programmes participated in the intervention as part of their teaching. Students were tasked with designing, deploying, and analysing data from survey-based research projects and invited to provide feedback via an anonymous and voluntary online survey (UoL students) or an equivalent paper-based survey (RMIT students), comprising both quantitative (Likert) and qualitative (open) questions. RESULTS Responses were received from 83% of RMIT and 31% of UoL students. Over 42% of respondents enjoyed the opportunity to interact with overseas peers, while 14.7% did not; 40% of respondents felt the intervention helped in their understanding of research methods, whilst 28% indicated it had not. The main positive themes were learning the research process, team working skills, networking opportunities, and understanding cultural differences. Interpreting data were invaluable; only a minority valued the engagement with their overseas counterparts. There was poor engagement with social media. CONCLUSIONS Students reported clear value of the innovation for learning research skills and process. The extent of research skills learning supports changes in research activity and culture in the past 10 years. With internationalisation becoming increasingly important in today's health care economy, the degree to which the students identified this aspect of the research as a key learning point highlights the benefits of the active approach. The negative appraisal of the social media support was interpreted as a response to the platform (WhatsApp) and privacy issues with sharing phone numbers.
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TRUFU: Therapeutic radiographer undertaking follow up for prostate cancer patients. Radiography (Lond) 2018; 24:298-303. [PMID: 30292497 DOI: 10.1016/j.radi.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/10/2018] [Accepted: 06/01/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION A study was proposed to examine the impact to patients and the Oncology review team, of extending the role of the Therapeutic Radiographer to undertake follow up review of prostate cancer patients who have completed a radical course of external beam radiotherapy treatment. METHOD A total of 30 patients attending for routine radiotherapy follow up were included in an observational study. Patients were assigned for review with a Doctor or a Therapeutic Radiographer using 1:1 randomisation and a number of time points were recorded and analysed. RESULTS Of the 44 patients screened, 30 patients were recruited. Average time from scheduled appointment time to departure from clinic was 36 min for both the doctor and Therapeutic Radiographer. The average length of Consultation was 19 min for the Therapeutic Radiographer and 10 min for the Doctor. Average length of wait for patients from scheduled appointment time to being taken for review was 17 min for the Therapeutic Radiographer and 25 min for the Doctor. Of the patients who completed questionnaires, 23/28 had no preference of reviewer, 2/28 declared a preference to be seen by a doctor, whilst 3/28 stated a preference for review with a Therapeutic Radiographer. CONCLUSION The results of the study are encouraging and should be further investigated in an attempt of developing what would be a very rewarding aspect of the Therapeutic Radiographers role.
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Martens B, Veldman L, Singleton M, Fawcett S, Ali S. Radiation Therapists' Perceptions of Advanced Practice in Alberta. J Med Imaging Radiat Sci 2018; 49:62-69. [DOI: 10.1016/j.jmir.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/09/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
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How does fatigue management education impact radiographer competence and confidence in supporting patients during radiotherapy? JOURNAL OF RADIOTHERAPY IN PRACTICE 2017. [DOI: 10.1017/s146039691700036x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAimThe primary outcome of this study is to establish whether fatigue management education impacts on radiographers’ perceived competence and confidence in supporting patients undergoing radiotherapy.Materials and methodsA single-centre mixed method study was conducted. Participants completed a questionnaire determining baseline fatigue support practice, undertook an education package, then repeated the questionnaire to determine any change in their competence and confidence. Semi-structured interviews were used to gain insight into practice and perceived barriers.ResultsIn all, 17 radiographers (100%) participated. Some areas of practice were affected significantly by the education package, namely highlighting the need for training, perceived competence and confidence in providing support, knowledge of effective treatment options and risk factors, the effect of fatigue on the patient and greater agreement that their professional qualification means they are qualified to support patients with fatigue.FindingsFatigue management education impacts on radiographers’ perceived competence and confidence in supporting patients during their radiotherapy. Interviews highlighted that knowledge of cancer-related fatigue is built up through day-to-day practice. Although there is greater awareness and support of fatigue, barriers exist, including patient compliance, lack of practical training, provision to monitor patients and unclear referral pathways.
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Nightingale H, Conroy R, Elliott T, Coyle C, Wylie J, Choudhury A. A national survey of current practices of preparation and management of radical prostate radiotherapy patients during treatment. Radiography (Lond) 2017; 23:87-93. [DOI: 10.1016/j.radi.2017.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/18/2016] [Accepted: 01/03/2017] [Indexed: 11/26/2022]
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Milner RC, Snaith B. Are reporting radiographers fulfilling the role of advanced practitioner? Radiography (Lond) 2016; 23:48-54. [PMID: 28290340 DOI: 10.1016/j.radi.2016.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/05/2016] [Accepted: 09/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Advanced practice roles are emerging in all disciplines at a rapid pace and reporting radiographers are ideally placed to work at such level. Advanced practitioners should demonstrate expert practice and show progression into three other areas of higher level practice. Most existing literature has focussed on the image interpretation aspect of the role, however there is little evidence that plain film reporting radiographers are undertaking activities beyond image interpretation and fulfilling the role of advanced practitioner. METHOD Letters were posted to every acute NHS trust in the UK, inviting reporting radiographers to complete an online survey. Both quantitative and qualitative information was sought regarding demographics and roles supplementary to reporting. RESULTS A total of 205 responses were analysed; 83.3% of reporting radiographers describe themselves as advanced practitioner, however significantly less are showing progression into the four core functions of higher level practice. A total of 97.0% undertake expert practice, 54.7% have a leadership role, 19.8% provide expert lectures and 71.1% have roles encompassing service development or research, though most of these fall into the service development category. 34.5% felt that they were aware of the differences between extended and advanced practice though much less (9.3%) could correctly articulate the difference. CONCLUSION Few individuals are aware of the difference between extended and advanced practice. Though the majority of plain film reporting radiographers identify themselves as advanced practitioners, significantly less evidence all four core functions of higher level practice. The number of individuals undertaking research and providing expert-level education is low.
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Affiliation(s)
- R C Milner
- Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, UK.
| | - B Snaith
- Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, UK; Faculty of Health Studies - Horton A, University of Bradford, Richmond Road, Bradford, West Yorkshire, BD7 1DP, UK
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Sale C, Halkett G, Cox J. National survey on the practice of radiation therapists in Australia. J Med Radiat Sci 2016; 63:104-13. [PMID: 27350890 PMCID: PMC4914814 DOI: 10.1002/jmrs.155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/10/2015] [Accepted: 11/14/2015] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Radiation therapy (RT), like many allied health professions, has lacked professional practice clarity, which until 2008 had not been comprehensively investigated. This manuscript describes the first phase of a three-phase project investigating the current and future practices of radiation therapists (RTs) in Australia. The aim of phase 1 was to define the practice of RTs in Australia. METHODS A quantitative approach was used to gain an understanding of RT practice. A national survey was distributed to RTs in Australia. Descriptive statistics and content analysis were used to analyse the data. RT practice was analysed in relation to core and non-core roles, where non-core roles were further divided into basic and advanced practices. RESULTS The data from the national survey were representative of the Australian RT population (n = 525). The current practice of RTs is presented in summary tables for each area of work (treatment, planning, simulation, mould room and general). CONCLUSION This study provided clarification of RT practice and indicated there was a desire to relinquish administrative roles to focus on RT-specific practice. There was evidence that some advanced roles were currently practiced in Australia; however, there was no structure to support these roles and they were based only on local need. This study identified that the profession needs to consider how they will maintain core RT practice, while encouraging the development of new roles, and whether some roles need to be relinquished.
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Affiliation(s)
- Charlotte Sale
- School of Medical ScienceRMIT UniversityMelbourneVicAustralia
| | - Georgia Halkett
- School of Nursing and MidwiferyFaculty of Health SciencesCurtin UniversityPerthWAAustralia
| | - Jenny Cox
- Royal North Shore Hospital – Northern Sydney Cancer CentreNSWAustralia
- University of Sydney – Faculty of Health SciencesSydneyNSWAustralia
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A survey of prostate cancer patients’ perceptions of the support they receive during radical radiotherapy: is there room for improvement? JOURNAL OF RADIOTHERAPY IN PRACTICE 2016. [DOI: 10.1017/s1460396916000169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAimThe aim of this study was to ascertain prostate cancer patients’ perceptions of the quality of physical and emotional support they receive as standard during their course of radiotherapy treatment.MethodSemi-structured interviews were conducted on 13 patients undergoing radical radiotherapy treatment for prostate cancer. Interviews were conducted between fractions 32 and 37 and data were analysed using the Giorgi method.ResultsA number of themes emerged from the data including, interestingly, the value of patients’ place on the ‘waiting room support’ with 46% finding this to be a positive aspect of their experience. On the whole, patients felt well supported during their treatment by both radiographers and fellow patients. However, the results highlighted areas for further improvements, particularly around bowel and bladder preparation.ConclusionsThis small single-centre study has highlighted the importance of good quality, timely information provision. Although patients were, for the most part very happy with the services they were being provided with, areas in need of development where also highlighted. If a more structured review process is to be further investigated then the role of the ‘review radiographer’ should be considered as part of this. The potential benefits of patient peer support is also worthy of further exploration.
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Hardy M, Johnson L, Sharples R, Boynes S, Irving D. Does radiography advanced practice improve patient outcomes and health service quality? A systematic review. Br J Radiol 2016; 89:20151066. [PMID: 27008104 DOI: 10.1259/bjr.20151066] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. METHODS Using the World Health Organization definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs, and data were systematically extracted using electronic data extraction pro forma. RESULTS 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n = 7) focusing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The articles were generally considered to be of low-to-moderate quality, with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, the included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No articles reported data relating to time to diagnosis, time to recovery or patient mortality. CONCLUSION Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. ADVANCES IN KNOWLEDGE This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality.
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Affiliation(s)
- Maryann Hardy
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Louise Johnson
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | - Stephen Boynes
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Donna Irving
- Faculty of Health Studies, University of Bradford, Bradford, UK
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A development framework for the consultant radiographer in oncology: the Leeds experience. JOURNAL OF RADIOTHERAPY IN PRACTICE 2016. [DOI: 10.1017/s1460396916000042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe role of the consultant radiographer in radiotherapy is a relatively new concept and to date the number of post holders in these roles remains low. Despite challenges to role creation for the non-medical consultant, the benefits of role development and skill mix within the national health service are evident. Among these challenges is the need to ensure appropriate and credible training of the consultant radiographer. This case study focusses on the local experience of developing a suitable competency framework for the first Consultant Radiographer at the Leeds Cancer Centre. It highlights elements of the framework that equip the post holder to carry out the role and how the governance underpinning such a framework could be used by other radiotherapy centres across the United Kingdom.
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Advanced Practice in Radiotherapy and Oncology: an interview with Angela Eddy, MSc, Senior Lecturer and Course Leader for the MSc Advancing Practice in Radiotherapy and Oncology at Sheffield Hallam University, Sheffield, UK. JOURNAL OF RADIOTHERAPY IN PRACTICE 2015. [DOI: 10.1017/s1460396915000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Matthews K, Wright C, Osborne C. Blending work-integrated learning with distance education in an Australian radiation therapy advanced practice curriculum. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Coleman K, Jasperse M, Herst P, Yielder J. Establishing radiation therapy advanced practice in New Zealand. J Med Radiat Sci 2014; 61:38-44. [PMID: 26229634 PMCID: PMC4175832 DOI: 10.1002/jmrs.33] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/18/2013] [Accepted: 10/18/2013] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005-2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. METHODS All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. RESULTS RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. CONCLUSION The authors recommend (1) the development of one scope of practice titled 'advanced practitioner' with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.
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Affiliation(s)
- Karen Coleman
- Department of Radiation Therapy, University of OtagoWellington, New Zealand
| | - Marieke Jasperse
- Department of Radiation Therapy, University of OtagoWellington, New Zealand
| | - Patries Herst
- Department of Radiation Therapy, University of OtagoWellington, New Zealand
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Exploring attitudes and opinions of radiation therapists in British Columbia towards advanced practice. JOURNAL OF RADIOTHERAPY IN PRACTICE 2013. [DOI: 10.1017/s1460396913000319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIntroductionAlthough the notion of advanced practice (AP) has been widely accepted and implemented in some countries, for example, the United Kingdom, in Canada it is has yet to be widely tested as a model of working. Currently it has been implemented and evaluated in Ontario, but this approach is not widespread across the country. To date in British Columbia (BC), there are no advanced practitioners and no research has been conducted regarding the opinions and attitudes of radiation therapists (RTs) in BC towards the implementation of AP. Understanding RTs attitudes and perceptions towards AP may be important when considering the acceptance and implementation of new roles. The research objectives were to explore the attitudes and opinions of RTs and establish what the term AP means to BC RTs, and also to discover what they consider to be benefits, and barriers to implementing AP.Materials and methodsA quantitative approach was utilised and an on-line questionnaire was sent to 266 RTs that currently practice in BC. Likert and demographic questions were used to explore the definition of AP and ascertain opinions about the barriers and benefits of implementing AP in BC.ResultsA total of 183 questionnaires were completed for a response rate of 69%. The majority of respondents agreed with the Canadian Association of Medical Radiation Technologies (CAMRT) and the literature's definition of AP. Cost, time, lack of support and training and issues of medical dominance were cited as barriers. Job satisfaction, autonomy, and increased recruitment and retention of staff were considered benefits.ConclusionsAlthough RTs believe there are obstacles to be overcome regarding the adoption and implementation of AP, these are outweighed by the potential benefits such as enhanced patient care due to increased levels of professional knowledge and development that can lead to increased levels of job satisfaction. These are seen as important drivers for creating the AP role in BC.
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Field LJ, Snaith BA. Developing radiographer roles in the context of advanced and consultant practice. J Med Radiat Sci 2013; 60:11-5. [PMID: 26229602 PMCID: PMC4175793 DOI: 10.1002/jmrs.2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 11/28/2012] [Accepted: 12/20/2012] [Indexed: 11/30/2022] Open
Abstract
Skill-mix initiatives have provided opportunities for radiographers to develop roles and achieve their potential, thus contributing to radiographer retention rates and increased job satisfaction. This reflective article explores two radiographic roles within an interprofessional context including the implications for confidence, competence, and future sustainability. These were reporting roles which extended into two modalities, one into bone densitometry and another into ultrasound. This article discusses how successful skill mix can benefit the individual, their department, and NHS organization and that role expansion can develop a more dynamic and resourceful workforce with transferability of skills and attributes.
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Affiliation(s)
- Lisa J Field
- Radiology Department, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital Aberford Road, Wakefield, WF1 4DG, U.K
| | - Beverly A Snaith
- Radiology Department, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital Aberford Road, Wakefield, WF1 4DG, U.K
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Acharya U, Cox J, Rinks M, Gaur P, Back M. Ability of radiation therapists to assess radiation-induced skin toxicity. J Med Imaging Radiat Oncol 2013; 57:373-7. [PMID: 23721149 DOI: 10.1111/1754-9485.12034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 11/04/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Radiation therapy has seen enhancement of the radiation therapist (RT) role, with RTs and nurses performing duties that were traditionally in the radiation oncologist's (RO) domain. This study aimed to assess whether RTs can consistently grade radiation-induced skin toxicity and their concordance with the gradings given by ROs. METHOD Digital photographs of skin reactions were taken at weeks 1, 3 and 6 of radiotherapy on nine patients with breast cancer. The randomly ordered photographs were reviewed once by eight ROs and four RO registrars and on two occasions separated by 6 weeks by 17 RTs. All graded the skin toxicities using the revised Radiation Therapy Oncology Group system. RESULTS No significant difference was seen between the median scores of the RTs at the first scoring session and the RO/Registrar group. The RTs at both measurement times showed greater inter-rater reliability than the RO/Registrars (W = 0.6866, time 1 and 0.6981 time 2, vs. 0.6517), with the experienced RTs the most consistent (W = 0.7078). The RTs also showed high intra-rater reliability (rho = 0.8461, P < 0.0010). CONCLUSION These results from RTs with no specific preparation indicate that experienced RTs could assess breast cancer skin toxicity as part of their role.
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Affiliation(s)
- Urvi Acharya
- Faculty of Health Science, The University of Sydney, Sydney, Australia
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HALKETT G, COX J, ANDERSON C, HEARD R. Establishing research priorities for Australian radiation therapists: what patient care priorities need to be addressed? Eur J Cancer Care (Engl) 2011; 21:31-40. [DOI: 10.1111/j.1365-2354.2011.01276.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Confidence in the use of information management and technology (IM&T) in radiography: Is age a barrier? Radiography (Lond) 2010. [DOI: 10.1016/j.radi.2010.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sonographer practitioner development in Australia: Qualitative analysis of an Australian sonographers' survey. Radiography (Lond) 2009. [DOI: 10.1016/j.radi.2009.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
AbstractIn the UK, radiotherapy research is being conducted at national and international levels which include multi-centre clinical trials. Local initiatives and trials are also ongoing where work is being performed to develop techniques or protocols for new technologies and service development. Active participation within these studies is now leading to a culture change with radiographers (radiation therapists) becoming an integral part of the research process. There are currently 70 radiographers in the UK participating in research. This accounts for 2.5% of the UK profession. With the extension of role diversification, research radiographers are undertaking many new roles; however, there is still scope for further development. The therapists’ role in working within this research environment is to ensure improved standards of care focussed on evidence-based practice.
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Hardy M, Legg J, Smith T, Ween B, Williams I, Motto J. The concept of advanced radiographic practice: An international perspective. Radiography (Lond) 2008. [DOI: 10.1016/j.radi.2008.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Price RC, Edwards HM. Harnessing competence and confidence: Dimensions in education and development for advanced and consultant practice. Radiography (Lond) 2008. [DOI: 10.1016/j.radi.2008.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rybovic M, Halkett GK, Banati RB, Cox J. Radiation therapists’ perceptions of the minimum level of experience required to perform portal image analysis. Radiography (Lond) 2008. [DOI: 10.1016/j.radi.2007.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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The role of the ‘on treatment’ review radiographer: what are the requirements? JOURNAL OF RADIOTHERAPY IN PRACTICE 2008. [DOI: 10.1017/s146039690800633x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPurpose: The aims of this study were to describe the scope of practice of the radiotherapy ’on treatment’ review radiographer. This included trying to gain an insight in to what knowledge, skills and characteristics are needed to operate in this role extension and to establish whether the role requires skills in areas of patient care and support which are beyond the generic training of a treatment floor therapy radiographer.Method: A qualitative grounded theory methodology was employed using semi-structured interviews with ’on treatment’ review radiographers from three different departments. The departments were selected to maximise the amount of data collected, consequently they were chosen due to the differences in the way their review service was set up. This ranged from full time, to team led, to part time review. Using coding and constant comparative analysis based on grounded theory, categories were developed describing attributes of the role.Results: The scope of practice and challenges of the role varied slightly between the departments. The core categories needed to operate in the role were identified as knowledge, listening skills and characteristics with sub categories of self-reflection, interpersonal skills and attitudes.Conclusions: To be a review radiographer requires advanced knowledge at Masters level, with well developed listening and interpersonal skills and enjoyment of the people side of the profession. These skills need to be regularly practised, updated and reflected upon. The requirements for further training needs are noted and recommendations for further research are identified along with the limitations of this research. The role appears to require knowledge and skills in areas of patient care and support, which are above the level of practice of a treatment floor therapy radiographer.
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Role development for therapy radiographers in breast planning: a case study and discussion of influencing factors. JOURNAL OF RADIOTHERAPY IN PRACTICE 2008. [DOI: 10.1017/s1460396907006267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPurpose:The purpose of this case study is to discuss factors that have an influence on the process of role development in radiotherapy breast planning.Key themes:This article describes the process of development as experienced by the author and discusses factors that hindered the process of role development. These factors include development of a career plan, professional issues, resources, organisational structures, support from consultants, managers, multi-disciplinary, and professional colleagues and peer resistance.Conclusion:The author makes recommendations that may contribute to improving the role development strategy in the profession and aid successful implementation of advanced practitioner and consultant roles for those radiographers who aspire to the consultant radiographer role in future. The article concludes that there is a need to identify, standardise and coordinate role development for therapy radiographers nationally to increase the appointment of more consultant radiographers.
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