Ethics and professionalism in medical physics: a survey of AAPM members

Professional ethics in the French medical physicist community: Survey results and implications

INTRODUCTION

Since 2017, in France, medical physicists (MP) are finally defined by law as health professionals and as such, the roles and responsibilities of an MP lean on those medical professional ethics but MPs lack initial or continuing training in this subject. In order to find out how our colleagues feel about this subject, the following survey was conducted.

METHODS

French Society of Medical Physics (SFPM) designed a web survey addressed to its members and non-members concerning ethics based on the 2013 AAPM work; experience and training were highlighted as particularly important within the survey structure.

RESULTS

249 answers were collected and showed a pronounced concern at the lack of initial and continuous training in this subject. Professional experience of non-ethical behaviour was attributed to the lack of training, resources or competences and hostile work environments.

CONCLUSION

To address the shortcomings highlighted in the survey, SFPM has created a dedicated voluntary working group aimed at producing a professional code of ethics for MP and training modules to be applied at entry level or as continuing professional development for education.

Training for the future: Introducing foundational skills necessary to promote patient-centered care practice in medical physics graduate programs

Current medical physics graduate training in the United States seldom explicitly includes education on foundational skills necessary to produce Patient-Centered Care (PCC)-focused healthcare providers. Such abilities include effective communication, critical reflection, and ethical decision-making. In this article, we present examples of curricula used to purposefully introduce these skills into graduate training to fill this gap. Presented didactic activities include an introduction to patient communication, ethics in medical physics, and a primer in health disparities for medical physicists. Although development of new curricula is resource-intensive when left to individual programs, we here propose resource-sharing and interprofessional collaboration to overcome these barriers.

CZECH RADIOGRAPHERS' PERCEPTION OF ETHICAL ASPECTS OF RADIOLOGICAL PROTECTION

This study assessed the perception of ethics by 40 radiographers and 30 radiography students in the Czech Republic. Most respondents confirmed that they considered the topic to be important for their profession. The majority of radiographers, but only few students, had encountered some ethical dilemma during their work. Almost all were aware of the existence of a Code of Ethics for radiographers, and the majority had at least some ethics education during their professional training. Our findings differ from those of similar surveys in the USA published in 2013 and 2015. In these, two-thirds of the respondents stated that they had not received any instruction in ethics during their training, and one-third indicated that they had witnessed unethical behaviour in their profession. We conclude that the ethics education of Czech radiographers makes them more aware of ethical problems when they encounter them.

Prevalence of Research Misconduct and Questionable Research Practices: A Systematic Review and Meta-Analysis

Irresponsible research practices damaging the value of science has been an increasing concern among researchers, but previous work failed to estimate the prevalence of all forms of irresponsible research behavior. Additionally, these analyses have not included articles published in the last decade from 2011 to 2020. This meta-analysis provides an updated meta-analysis that calculates the pooled estimates of research misconduct (RM) and questionable research practices (QRPs), and explores the factors associated with the prevalence of these issues. The estimates, committing RM concern at least 1 of FFP (falsification, fabrication, plagiarism) and (unspecified) QRPs concern 1 or more QRPs, were 2.9% (95% CI 2.1-3.8%) and 12.5% (95% CI 10.5-14.7%), respectively. In addition, 15.5% (95% CI 12.4-19.2%) of researchers witnessed others who had committed at least 1 RM, while 39.7% (95% CI 35.6-44.0%) were aware of others who had used at least 1 QRP. The results document that response proportion, limited recall period, career level, disciplinary background and locations all affect significantly the prevalence of these issues. This meta-analysis addresses a gap in existing meta-analyses and estimates the prevalence of all forms of RM and QRPs, thus providing a better understanding of irresponsible research behaviors.

A survey of surface imaging use in radiation oncology in the United States

Surface imaging (SI) has been rapidly integrated into radiotherapy clinics across the country without specific guidelines and recommendations on its commissioning and use aside from vendor-provided information. A survey was created under the auspices of AAPM TG-302 to assess the current status of SI to identify if there is need for formal guidance. The survey was designed to determine the institutional setting of responders, availability and length of its use, commissioning procedures, and clinical applications. This survey was created in REDCap, and approved as IRB exempt to collect anonymized data. Questions were reviewed by multiple physicists to ensure concept validity and piloted by a small group of independent physicists to ensure process validity. All full members of AAPM self-identified as "therapy" or "other" were sent the survey link by email. The survey was active from February to March 2018. Of 3677 members successfully contacted, 439 completed responses; the summary of these responses provides insight on current surface imaging clinical practices, though they should not be assumed to be representative of radiation oncology as a whole. Results showed that 53.3% of respondents have SI in their clinics, mostly in treatment rooms, rarely in simulation rooms. Half of those without SI plan on purchasing it within 3 years. Over 10% have SI but do not use it clinically, 36.8% classify themselves as "expert" users, and 85.5% agreed/strongly agreed that SI guidelines are needed. Initial positioning with SI is most common for breast/chestwall and SRS/SBRT treatments, least common for pediatrics. Use of SI for intra-fraction monitoring follows a similar distribution. Gating with SI is most prevalent for breast/chestwall (66.0%) but also used in SBRT (33.0%), and non-SBRT lung/abdomen (<30%) treatments. SI is a rapidly growing technology in the field with widespread use for several anatomic sites. Guidelines and recommendations on commissioning and clinical use are warranted.

Participation of women medical Physicists in European scientific events: The European experience

PURPOSE

Though the number of women scientists is increasing over the years, studies show that they are still under-represented in leadership roles. The purpose of this work is to establish the percentage of women Medical Physicists (wMPs) that have participated in European scientific events and evaluate it as an indication of the current position of women in the field of Medical Physics in Europe and to propose possible ways to encourage their participation.

MATERIALS AND METHODS

Data regarding the participants in European scientific events of Medical Physics were collected. The participants were divided into categories according to the program of the events and their gender was identified. The percentage of wMPs in each category was evaluated.

RESULTS

The participation of wMPs attending courses is greater than 50%. The categories with the greatest participation are "Organizing Committees", "Chairpersons-Moderators" and "Oral Presentations". The categories with the lower participation of wMPs are "Scientific Committee", "Symposiums" and "Invited Speakers". None of wMPs were represented as "Course Directors".

CONCLUSIONS

The attendance of wMPs in courses is slightly greater than average. However, wMPs do not have an equally important recognition in special invited roles in conferences. They are still under-represented in "Scientific Committees", "Invited Speakers", "Symposiums" and "Course directors". wMPs should be encouraged to participate even more actively in European conferences and the organizing committees should invite more wMPs in special roles. More studies concerning the status of female MPs in each country separately should be encouraged as they will help in understanding the position of wMPS in Europe.

Development of a residency program in radiation oncology physics: an inverse planning approach

Over the last two decades, there has been a concerted effort in North America to organize medical physicists' clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety-conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two-year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%-10% is spent in obtaining formal training in nontechnical "soft skills".