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Snaith B, Clarkson M, Whitlock K, Carr R, Compton E, Bradshaw K, Mills K. Recognition of advanced level practice against multiprofessional capabilities: Experiences of the first radiography applicants. Radiography (Lond) 2024; 30:1243-1248. [PMID: 38959619 DOI: 10.1016/j.radi.2024.06.013] [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: 04/10/2024] [Accepted: 06/13/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Advanced practice is well established in the health professions with multiprofessional capabilities in place in England. To recognise achievement of these capabilities an ePortfolio (supported) route was initiated in 2022. This study aimed to review the demographics and experiences of radiographers applying for recognition in the first year of operation. METHODS The multi method evaluation consisted of quantitative data analysis of information regarding the first three cohorts of radiographers (n = 40) participating in the NHS England (NHSE) scheme. Interviews with 12 participants was undertaken with thematic analysis of the transcripts. RESULTS Self-rated scores of expertise were significantly higher by therapeutic radiographers (n = 8) compared to their 32 diagnostic colleagues (t = 5.556; p < 0.01). Radiographers saw the ePortfolio as an opportunity to validate their experience and to evidence parity with other professions. Participants felt the process also enabled critical reflection and gave unseen insight into themselves and their roles. The support of experienced educational supervisors was felt to be vital in this process and for successful completion of portfolio. CONCLUSIONS Several radiographers have now achieved the necessary standards to achieve NHSE recognition. The evaluation exposed that most radiographers did not have the relevant evidence to hand and the ongoing collection of evidence around capabilities and impact is critical to evidencing advanced practice capabilities. IMPLICATIONS FOR PRACTICE Radiographers are able to achieve the capabilities expected for multiprofessional practice. Cultural change is required to normalise recording of evidence within practice including case-based discussions, clinical supervision and feedback from colleagues and patients. The support of an experienced educational supervisor aided the critical reflection on practice level.
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Affiliation(s)
- B Snaith
- University of Bradford, Bradford, BD7 1DP, UK; Mid Yorkshire Teaching NHS Trust, Wakefield, WF1 4DG, UK.
| | - M Clarkson
- Sheffield Hallam University, Sheffield, UK. https://twitter.com/mclarkson20
| | - K Whitlock
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. https://twitter.com/kwhitlock03
| | - R Carr
- RC Sonography, Hove, UK. https://twitter.com/ryac1601
| | - E Compton
- Guy's and St Thomas' NHS Trust, London, UK. https://twitter.com/EmmaDRad
| | - K Bradshaw
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - K Mills
- NHS England Workforce Training & Education Directorate, Birmingham, UK. https://twitter.com/kerryannemills
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McNulty JP. Radiography: Celebrating our reviewers and authors. Radiography (Lond) 2024; 30:1240-1242. [PMID: 38937214 DOI: 10.1016/j.radi.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- J P McNulty
- University College Dublin, School of Medicine, Health Sciences Centre, Dublin, Ireland.
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Sarchosoglou A, Couto JG, Khine R, O'Donovan T, Pisoni V, Bajinskis A, England A. A European Federation of Radiographer Societies (EFRS) position statement on sustainability for the radiography profession. Radiography (Lond) 2024; 30 Suppl 1:19-22. [PMID: 38848653 DOI: 10.1016/j.radi.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Affiliation(s)
- A Sarchosoglou
- European Federation of Radiographers Societies (EFRS), Portugal; Radiation Oncology Department, General Oncological Hospital of Kifisia "Oi Agioi Anargyroi", Athens, Greece; Department of Biomedical Sciences, Radiology & Radiotherapy Sector, University of West Attica, Athens, Greece.
| | - J G Couto
- European Federation of Radiographers Societies (EFRS), Portugal; Radiography Department, University of Malta, Malta
| | - R Khine
- European Federation of Radiographers Societies (EFRS), Portugal; Institute of Health Sciences Education (IHSE), Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - T O'Donovan
- European Federation of Radiographers Societies (EFRS), Portugal; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - V Pisoni
- European Federation of Radiographers Societies (EFRS), Portugal; Radiation Oncology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza MB, Italy; School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - A Bajinskis
- European Federation of Radiographers Societies (EFRS), Portugal; University of Latvia, Latvia
| | - A England
- European Federation of Radiographers Societies (EFRS), Portugal; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
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Leech M, Abdalqader A, Alexander S, Anderson N, Barbosa B, Callens D, Chapman V, Coffey M, Cox M, Curic I, Dean J, Denney E, Kearney M, Leung VW, Mortsiefer M, Nirgianaki E, Povilaitis J, Strikou D, Thompson K, van den Bosch M, Velec M, Woodford K, Buijs M. The Radiation Therapist profession through the lens of new technology: A practice development paper based on the ESTRO Radiation Therapist Workshops. Tech Innov Patient Support Radiat Oncol 2024; 30:100243. [PMID: 38831996 PMCID: PMC11145757 DOI: 10.1016/j.tipsro.2024.100243] [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: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 06/05/2024] Open
Abstract
Technological advances in radiation therapy impact on the role and scope of practice of the radiation therapist. The European Society of Radiotherapy and Oncology (ESTRO) recently held two workshops on this topic and this position paper reflects the outcome of this workshop, which included radiation therapists from all global regions. Workflows, quality assurance, research, IGRT and ART as well as clinical decision making are the areas of radiation therapist practice that will be highly influenced by advancing technology in the near future. This position paper captures the opportunities that this will bring to the radiation therapist profession, to the practice of radiation therapy and ultimately to patient care.
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Affiliation(s)
- Michelle Leech
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
- Trinity St. James’s Cancer Institute, Dublin, Ireland
| | | | - Sophie Alexander
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Nigel Anderson
- Department of Radiation Oncology, Olivia Newton-John Cancer Wellness & Research Centre - Austin Health, Heidelberg, Australia
| | - Barbara Barbosa
- Escola Internacional de Doutoramento, Universidad de Vigo, 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), Porto, Portugal
| | - Dylan Callens
- University Hospital Leuven, Department of Radiation Oncology, Leuven, Belgium
- KU Leuven, Laboratory of Experimental Radiotherapy, Leuven, Belgium
| | | | - Mary Coffey
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
| | - Maya Cox
- Auckland City Hospital, Auckland, New Zealand
| | - Ilija Curic
- Radiosurgery and Stereotactic Radiotherapy Department, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jenna Dean
- Department of Radiation Oncology, Olivia Newton-John Cancer Wellness & Research Centre - Austin Health, Heidelberg, Australia
| | | | - Maeve Kearney
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Ireland
- Trinity St. James’s Cancer Institute, Dublin, Ireland
| | - Vincent W.S. Leung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong
| | | | | | - Justas Povilaitis
- The Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania
| | - Dimitra Strikou
- Radiation Oncology Unit, University and General Attikon Hospital, Athens, Greece
| | - Kenton Thompson
- Department of Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Michael Velec
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Katrina Woodford
- Department of Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia
| | - Monica Buijs
- InHolland Haarlem, University of Applied Science, Haarlem, the Netherlands
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Duffton A, Harnett N, McNair HA, Bennett E, Clarkson M, Guilherme Couto J, Lawler G, Matthews K, Oliveira C, Rozanec N, Simões R, Tsang Y. RTT advanced practice and how it can change the future of radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100245. [PMID: 38595787 PMCID: PMC11002743 DOI: 10.1016/j.tipsro.2024.100245] [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: 03/14/2024] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024] Open
Abstract
The radiation therapy (RT) landscape is continuously evolving, necessitating adaptation in roles and responsibilities of radiation therapists (RTTs). Advanced Practice Radiation Therapists (APRTs) have taken on a proactive role in expanding services and assuming responsibilities within multi-professional teams. A European Society for Radiotherapy and Oncology (ESTRO) brought geographically diverse and experienced RTTs together, to discuss how advanced practice (AP) in the RTT profession should be future-proofed and create a global platform for collaboration. Challenges in achieving consensus and standardisation of APRT was identified across jurisdictions, emphasising the importance of international collaboration. Whilst highlighting the pivotal role of APRTs in driving innovation, improving patient care, and navigating the complexities of modern RT practice, this position paper presents outcomes and recommendations from the workshop. Discussions highlighted the need for standardised role definitions, education frameworks, regulatory support, and career development pathways to enable the advancement of APRT effectively. Increasing networks and collaboration is recommended to ensure APRTs can shape the future of RT.
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Affiliation(s)
- Aileen Duffton
- Radiotherapy Department, Beatson West of Scotland Cancer Centre, Glasgow, UK
- Institute of Cancer Science, University of Glasgow, UK
| | - Nicole Harnett
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CA
- Department of Radiation Oncology, University of Toronto, CA
| | - Helen A McNair
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Erica Bennett
- Bon Secours Radiotherapy Cork in partnership with UPMC Hillman Cancer Centre, Cork, IE
| | - Melanie Clarkson
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, UK
| | | | - Gavin Lawler
- Research & Innovation Infrastructures Unit, Research Strategy & Funding Directorate, Health Research Board, Dublin, IE
| | - Kristie Matthews
- Faculty of Medicine, Nursing and Health Sciences, Monash University, AU
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, AU
| | - Celeste Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), PT
| | - Natalie Rozanec
- Department of Radiation Oncology, University of Toronto, CA
- Stronach Regional Cancer Centre, Southlake Regional Health Centre, CA
| | - Rita Simões
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
- University College London Hospitals, London, UK
- Radiotherapy Trials quality assurance (RTTQA) group, UK
| | - Yatman Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CA
- Department of Radiation Oncology, University of Toronto, CA
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Oliveira C, Barbosa B, Couto JG, Bravo I, Hughes C, McFadden S, Khine R, McNair HA. Advanced practice in radiotherapy across Europe: stakeholders' perceptions of implementation and evolution. Radiography (Lond) 2024; 30:896-907. [PMID: 38608565 DOI: 10.1016/j.radi.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/09/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Adapting radiotherapy services with workforce innovation using skills-mix or task-shifting optimises resources, supporting current and future demands. Advanced practitioners (APs) work at a different level of practice (beyond initial registration) across four pillars: clinical practice, leadership and management, education, and research. There is limited cross-country research on the advanced therapeutic radiographers/radiation therapists (TR/RTTs), particularly in Europe. This study aimed to investigate European radiotherapy stakeholders' perceptions regarding current and future advanced practice (AP). METHODS From June to September 2022, one-to-one online semi-structured interviews were conducted in English, and audio and video were recorded. Full verbatim audio files were independently transcribed and checked by interviewer and interviewees. Braun and Clarke's seven steps guided the thematic analysis (using NVivo). RESULTS Thirty-three interviewees working or studying in 16 European countries represented practitioners (n=14), managers (n=6), educators (n=4), professional bodies (n=4), students (n=3), and regulators (n=2). Four overarching themes emerged: "AP drivers and outcomes", "AP challenges vs enablers", "Current vs future AP", "Becoming and being advanced practitioner". Participants identified research as the neglected AP pillar due to a lack of protected time, limited staff skills, no research culture, no funding, workload, and clinical priorities. Interviewees highlighted the importance of consistency in job titles, harmonisation of education models and curricula, definition of AP requirements, and support for all AP pillars through job plans and workforce planning. CONCLUSION Neither the profession nor education of TR/RTTs are harmonised across Europe, which is highly reflected in advanced-level practice. Advanced TR/RTTs should work across all pillars, including research, and these should be embedded in master's programmes, including leadership. IMPLICATIONS FOR PRACTICE This study highlights a policy gap in the education and practice of APs in radiotherapy.
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Affiliation(s)
- C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Spain; Medical Physics, Radiobiology Group and Radiation Protection Group, IPO Porto Research Centre (CI-IPOP), Instituto Português de Oncologia do Porto (IPO Porto), Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, 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), Portugal.
| | - C Hughes
- School of Health Sciences, Ulster University, United Kingdom.
| | - S McFadden
- School of Health Sciences, Ulster University, United Kingdom.
| | - R Khine
- European Federation of Radiographer Societies, Utrecht, Netherlands; Institute of Health Sciences Education, Faculty of Medicine & Dentistry, Queen Mary, University of London, 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, United Kingdom.
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Lawlor S, Leech M. Established advanced practice roles in radiation therapy: A scoping review. J Med Imaging Radiat Oncol 2024; 68:342-352. [PMID: 38450863 DOI: 10.1111/1754-9485.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
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.
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Affiliation(s)
- Sarah Lawlor
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity St. James's Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Michelle Leech
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity St. James's Cancer Institute, Trinity College Dublin, Dublin, Ireland
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Sá Dos Reis C, De Labouchere S, Campeanu C, Ghotra SS, Flaction L, Marmy L, Vorlet P, Al-Musibli A, Franco L, Champendal M. Alumni, radiographers, clinical placement tutors and industry insights about current radiographers practice, competences and autonomy in western Switzerland. Radiography (Lond) 2024; 30:193-201. [PMID: 38035433 DOI: 10.1016/j.radi.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/02/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Radiographers' profession is constantly evolving, which demands adaptation of education and training programs to build up medical imaging and radiation therapy professionals (MIRTPs) that provide healthcare to improve patient experience and outcomes. This study aimed to map radiographers' practices, competences, and autonomy level in Western Switzerland. METHODS Data was collected by 2 cross-sectional online surveys targeting Alumni, radiographers, clinical placement tutors and medical imaging equipment specialists from industry, with opened and closed-end questions. Descriptive statistics and thematic analysis were used to analyse the data. RESULTS 81 Alumni and 93 Chief-Radiographers, clinical tutors, practitioner-radiographers and industry answered the questionnaires. The competences considered as the most "acquired or completely acquired" by the Alumni were: adopt a reflective posture on practice (90.1 %; 73/81), adopt ethical behaviour (90.1 %; 73/81), carrying out and providing radiological services for diagnostic, therapeutic and preventive purposes (81.5 %; 68/81), adapting communication to the other surrounding persons (81.5 %; 66/81), and check compliance of procedures with standards (69.1 %; 56/81). Similar results were referred by Employers. The autonomy of the participant radiographers was considered as average, and it focuses only the preparation of the patient and the protocol optimisation. The development and integration of research is weak as well as the application of competences regarding professionalism. CONCLUSIONS A better link between educational institutions and clinical practice can help on the integration of research and evidence-based on practice, necessary to progress the radiographers' profession in Western Switzerland. The autonomy needs to be further developed and leadership courses must be integrated in the curricula to facilitate the implementation of new approaches to reinforce radiographer's profession. IMPLICATIONS FOR PRACTICE Practice must be revised to integrate evidence-based; to facilitate research development, the managers need to increase support.
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Affiliation(s)
- C Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - S De Labouchere
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; Cantonal University Hospital Vaud (CHUV), Bugnon 46, 1011 Lausanne, Switzerland.
| | - C Campeanu
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - S S Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400 Yverdon-les-Bains, Switzerland.
| | - L Flaction
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - L Marmy
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - P Vorlet
- Cantonal University Hospital Vaud (CHUV), Bugnon 46, 1011 Lausanne, Switzerland.
| | - A Al-Musibli
- Geneva School of Health Sciences (HEdS - Geneva), University of Applied Sciences and Arts Western Switzerland (HES-SO), Genève 1206, Switzerland.
| | - L Franco
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - M Champendal
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
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Boisbouvier S, Bayart É, Chamois J, Clavère P, Corbin S, De Oliveira A, Geffroy-Hulot C, Hannoun-Lévi JM, Hasbini A, Le Tallec P, Monpetit É, Santini JJ, Bougier C. [Survey by SFRO, SNRO and AFPPE about the evolution of the radiation therapist profession in France]. Cancer Radiother 2023; 27:712-717. [PMID: 37891038 DOI: 10.1016/j.canrad.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/09/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE As part of the multidisciplinary team, radiation therapists are in charge of elements of treatment preparation and delivery of radiotherapy to cancer patients. Helping scientific and technological improvements, more and more patients with cancer were treated with radiotherapy including hypofractionnated radiotherapy, that explain the increase of demands on services. The professional impacted by this increase of demands are radiation oncologists and medical physicists. The opportunity to push forward the radiation therapist's competencies appears with the possibility to shift them some tasks. In this context, a first work was performed with objectives to have an overview of the tasks shifted to radiation therapists in France, the tasks that they could perform but also to evaluate some criteria of job satisfaction. MATERIAL AND METHODS The committee of "new status and value of status" including six radiation oncologists (the French society of radiation oncology [SFRO] et national union of radiation oncologists [SNRO]) and six radiation therapists committee members of the French association of radiation therapists (AFPPE), built a questionnaire including three parts: demographic characteristics, tasks shifted and job satisfaction criteria. In total, the questionnaire included 19 questions and 24 items assessed with a four point-Likert scale (ranging from "completely disagree" to "completely agree"). This survey, formatting with google form, was tested by the committee members and the final version was sent to the SFRO, AFPPE and SNRO members, before being disseminated on the social networks. RESULTS From November 18th 2022 to December 31st 2022, 492 responses were received (response rate=18.3%): 55 % of the respondents had at least 11 years of experience in radiotherapy. The respondents worked in different type of health facilities (36 % in specialized cancer centres, 19.5 % in private centers, 17.5% in university and general hospital, 10.2% in general hospital). More than ¼ of the respondents had a teaching lecturer activity, 20% had a management team activity and a research activity for 18%. Less than 10% of the respondents had another degree than that of radiation therapist: university degree (n=27), degree in dosimetry (n=11) and master (n=3). More than 76% would like to be trained and to have access to the advanced practice, more than 50% would like expend competencies with a university degree, 30% with a master and 67% would like to participate in research. Forty-two percent of the respondents were involved in a task shifting (excluding decree relating to acts and activities carried out by radiation therapists) and among the radiation therapists non-involved, 63% would be interested in being. Regarding job satisfaction, 53% of the respondents were satisfied with their job and their salary and 68% believed that their job occupation is in line with their professional aspirations. More than 2/3 of the respondents described a significant workload and mental load, 53% thought to have time for their patient care and 70% felt some organisational difficulties. CONCLUSION This survey shows: (i) A significant involvement of radiation therapists in the task shifting; (ii) A very strong demand for career development, in particular with existing degrees or to be created degree such as advanced practice; and (iii) The need to reinforce a job satisfaction for almost the half of the respondents, linked to a workload, a mental load and some organisational difficulties.
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Affiliation(s)
- S Boisbouvier
- Département de radiothérapie, centre Léon-Bérard, rue Laënnec, 69008 Lyon, France.
| | - É Bayart
- Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
| | - J Chamois
- Département de radiothérapie, centre hospitalier privé Saint-Grégoire, Saint-Grégoire, France
| | - P Clavère
- Département de radiothérapie, centre hospitalier universitaire de Limoges, Limoges, France
| | - S Corbin
- Département de radiothérapie, institut Gustave-Roussy, Villejuif, France
| | - A De Oliveira
- Département de radiothérapie, institut Curie, Paris, France
| | - C Geffroy-Hulot
- Département de radiothérapie, centre Eugène-Marquis, Rennes, France
| | - J-M Hannoun-Lévi
- Département de radiothérapie, centre Antoine-Lacassagne, Nice, France
| | - A Hasbini
- Département de radiothérapie, clinique Pasteur, Brest, France
| | - P Le Tallec
- Association française du personnel paramédical d'électroradiologie, Montrouge, France
| | - É Monpetit
- Département de radiothérapie, clinique Saint-Yves, Vannes, France
| | - J-J Santini
- Département de radiothérapie, Institut régional du cancer de Montpellier, Montpellier, France
| | - C Bougier
- Département de radiothérapie, Institut régional du cancer de Montpellier, Montpellier, France; Fédération universitaire de radiothérapie oncologie de Méditerranée Occitanie, institut du cancer de Montpellier, université de Montpellier, U1194, Inserm, Montpellier, France
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McDonagh D, Tonning KL, Freeman B, Birring EJ, Dimopoulos M, Harnett N, Skubish S, Starrs C, Mei SWM, Vapiwala N, Matthews K. An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis. Int J Radiat Oncol Biol Phys 2023; 117:11-21. [PMID: 37169268 DOI: 10.1016/j.ijrobp.2023.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/23/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE In 2021, the Advanced Practice Radiation Therapy Working Group (APRTWG) was established in the United States as a grassroots alliance of multidisciplinary radiation oncology professionals-radiation therapists, physicians, dosimetrists, and administrators-located across the country, interested in studying and establishing the Advanced Practice Radiation Therapist (APRT) level of practice in the United States. The APRT model has shown success in the United Kingdom, Canada, Australia, Singapore, and other countries, documenting the value of the APRT to the quality and advancement of clinical care. In the United States, the APRTWG seeks to coordinate activities, align resources, and drive the national agenda to collectively develop and define novel models of care using APRT in line with the evolving needs of patients and the radiation therapy profession. This environmental scan aims to examine the context of radiation oncology medical practice in the United States to inform pathways ahead for a proposed APRT model through a Political, Economic, Social, Technological, Environmental, and Legal (PESTEL) analysis. METHODS AND MATERIALS A literature search was conducted to understand the chronological timeline of the development of APRT during the past 25 years. Items that included the activities, scope of practice, and implementation of APRT nationally and internationally were identified. Papers describing advanced practitioner roles that are commonly found in the multidisciplinary team in radiation oncology both in the United States and internationally, such as physician assistants and nurse practitioners, were excluded. RESULTS Despite the environmental scan outcome, it is acknowledged that data collation and analysis was not as robust as that anticipated by undertaking a systematic review. Papers were identified by the lead author that aligned with each of the PESTEL factors. Defined broadly, a new care model can adjust how health services are delivered by incorporating best practices in patient care for a specific population, person, or patient cohort. As patients enter different stages of their disease, the purpose of a new model is to provide individuals with the right care, at the right time, by the right team, in the right place. It is clear that the opportunity for positive change and impact on the current state of practice in radiation oncology exists. CONCLUSION The environmental scan findings demonstrate the complexities associated with implementing APRT in the United States, with multifactorial political, environmental, societal, technological, economic, and legal aspects to consider. The APRTWG will continue to lead and participate in such activities to demonstrate and identify APRT role opportunities in the United States and drive the nationwide implementation of the APRT level of practice in this country.
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Affiliation(s)
| | | | | | | | | | - Nicole Harnett
- Princess Margaret Cancer Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Neha Vapiwala
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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11
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McDonagh D, Dimopoulos M, Tonning KL, Freeman B, Birring EJ, Harnett N, Skubish S, Starrs C, Mei Mei SW, Vapiwala N, Matthews K. In Reply to Haley. Int J Radiat Oncol Biol Phys 2023; 117:289-290. [PMID: 37574245 DOI: 10.1016/j.ijrobp.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Neha Vapiwala
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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O'Neill AGM, Hughes CM, McClure P, Barbosa B, Muscat K, Oliveira C, Soares AL, McFadden S. Patient-reported perspectives of therapeutic radiographers when undergoing radiotherapy: A European multi-centre study. Radiography (Lond) 2023; 29 Suppl 1:S32-S39. [PMID: 36889995 DOI: 10.1016/j.radi.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Radiotherapy is delivered almost exclusively by therapeutic radiographers/radiation therapist (RTTs). Patient's perspectives of RTTs affect levels of trust and confidence in the profession and can have a significant impact on overall radiotherapy experience. The study reports patients' perspectives of RTTs from their experience of undergoing radiotherapy. Four partner sites collaborated in this research and included Malta, Poland, Portugal, and the UK (lead site). METHODS A survey was developed to gather information from patients receiving radiotherapy or who had had radiotherapy within the previous 24 months. Participants ranked their responses to 23 statements relating to person-centred care on a 5-point scale of 1 (strongly disagree) to 5 (strongly agree). Mann-Whitney or Kruskal Wallis tests were applied to test differences in responses to 5 key statements for patient characteristics including gender, age group, diagnosis, country, time spent with RTTs and number of fractions remaining at survey completion. RESULTS Three hundred and forty-seven surveys are included. Patients report a positive perception of RTTs (95.4% agree with 'I feel cared for'). Statistically significant differences in responses were found between gender, diagnosis, country, time spent with RTTs and fractions of radiotherapy remaining. Patients who had more time with RTTs and completed their surveys during radiotherapy had a more positive perception of RTTs. CONCLUSION This study suggests that sufficient time with RTTs is key to ensuring a positive radiotherapy patient experience. RTTs being attentive, understanding, and informative are most predictive of a positive overall patient experience. Timing of survey completion can influence responses. IMPLICATIONS FOR PRACTICE RTT education programmes should incorporate training on person-centred care at all levels. Further research into patient experience of RTTs is warranted.
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Affiliation(s)
- A G M O'Neill
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences, Magee Campus, Northland Road, Derry/Londonderry, Northern Ireland, UK.
| | - C M Hughes
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences, Magee Campus, Northland Road, Derry/Londonderry, Northern Ireland, UK
| | - P McClure
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences, Magee Campus, Northland Road, Derry/Londonderry, Northern Ireland, UK
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; 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
| | - K Muscat
- Faculty of Health Sciences, Department of Radiography, University of Malta, Mater Dei Hospital, Msida, MSD 2080, Malta; Radiotherapy Department, Sir Anthony Mamo Oncology Centre, Tal-Qroqq, Msida, MSD 2090, Malta
| | - C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal
| | - A L Soares
- Medical Physics Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - S McFadden
- Institute of Nursing and Health Research, Faculty of Life and Health Sciences, Magee Campus, Northland Road, Derry/Londonderry, Northern Ireland, UK
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An investigation of digital skills of therapeutic radiographers/radiation therapists: A european survey of proficiency level and future educational needs. Radiography (Lond) 2023; 29:479-488. [PMID: 36878157 DOI: 10.1016/j.radi.2023.02.009] [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: 09/08/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION This study aims to assess the proficiency level of digital skills, the factors influencing that level and the training needs of Therapeutic Radiographers/Radiation Therapists (TR/RTTs), due to the differences in technology availability and accessibility, variations in the regulation and education of TR/RTTs in European countries, and the lack of a digital skills framework. METHODS An online survey was distributed to TR/RTTs working in Europe to capture their self-assessment of proficiency levels of digital skills when performing their clinical role. Information was also gathered regarding training, work experience and level of information and communication technology (ICT) skills. Quantitative measures were analysed using descriptive statistics and correlation between variables, and qualitative responses using thematic analysis. RESULTS 101 respondents from 13 European countries completed the survey. Digital skills in treatment planning followed by management and research were the least developed skills, while the most developed were transversal digital skills followed by digital skills in treatment delivery. The Radiotherapy areas of practice where TR/RTT has experience (e.g. Planning Image, Treatment Planning, Treatment), as well as the level of generic ICT skills (communication, content creation and problem-solving), was related to the level of proficiency of TR/RTT digital skills. Greater scope of practice and level of generic ICT were associated with a higher level of TR/RTT digital skills. Thematic analysis allowed the identification of new sub-themes to be included in the training of TR/RTTs. CONCLUSION Education and training of TR/RTTs should be improved and adapted to the current needs of digitalisation to avoid differences in digital proficiency levels. IMPLICATIONS FOR PRACTICE Aligning TR/RTTs' digital skill sets with emerging digitalisation will improve current practice and ensure the best care to all RT patients.
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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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Morris L, O'Donovan A, Hashmi A, Agar M. Older adults and the unique role of the radiation therapist: Future directions for improving geriatric oncology training and education. Tech Innov Patient Support Radiat Oncol 2022; 23:21-26. [PMID: 36059564 PMCID: PMC9434163 DOI: 10.1016/j.tipsro.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022] Open
Abstract
This article reviews the status quo of the available evidence and guidance for geriatric oncology clinical practice, training and education for radiation therapists worldwide. We explore the unique clinical role that radiation therapists play in the management of older adults undergoing radiation therapy. We define multiple clinical care points in which the radiation therapists role could potentially expand or specialise into geriatric screening, assessment and intervention to optimise the care of older adults. Current GO educational offerings and future directions to improve RTT knowledge and skills around caring for older adults are outlined.
There is widespread recognition that the provision of high quality, appropriate and equitable care to older adults with cancer is a growing challenge in oncology practice. Radiation therapy (RT) is an effective and localised treatment that represents an attractive curative or palliative option for many older adults, and radiation therapists (RTT) play an important role in the delivery, support and quality of care for people during RT. The need to develop an evidence-based, global approach to improving all radiation oncology (RO) professionals’ knowledge and clinical practice in geriatric oncology (GO) has been previously identified. This article specifically focusses on the status quo of GO clinical practice and education for RTT worldwide. We explore the unique clinical role that RTT play in the management of older adults with cancer and define multiple clinical care points in which RTT could potentially participate in geriatric screening, geriatric assessment and intervention to optimise the care of older adults, with a focus on dementia. Directions for future efforts to improve the knowledge and clinical skills of RTT in caring for older adults are discussed.
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Affiliation(s)
- Lucinda Morris
- University of Technology Sydney (UTS), Faculty of Health, Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Ultimo, NSW, Australia
- St George Cancer Care Centre, St George Hospital, Sydney, NSW, Australia
- Corresponding author at: University of Technology Sydney (UTS), Faculty of Health, Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Ultimo, NSW, Australia.
| | - Anita O'Donovan
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James’s Cancer Institute, Trinity College, Dublin, Ireland
| | - Amira Hashmi
- Radiotherapy Department, The Christie NHS Foundation Trust, Manchester, UK
| | - Meera Agar
- University of Technology Sydney (UTS), Faculty of Health, Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Ultimo, NSW, Australia
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McFadden S, Couto G, McClure P, Hughes C, Beardmore C. The SAFE EUROPE project: What is it all about? Radiography (Lond) 2022; 28:874-875. [PMID: 35786493 DOI: 10.1016/j.radi.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S McFadden
- School of Health Sciences, Ulster University, UK.
| | - G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, UK.
| | - P McClure
- School of Health Sciences, Ulster University, UK.
| | - C Hughes
- School of Health Sciences, Ulster University, UK.
| | - C Beardmore
- European Federation of Radiographer Societies, Utrecht, The Netherlands.
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