Advanced practice radiation therapists: an Australian context

Abstract

The purpose of this scoping review is to examine the literature regarding the development, implementation, scope and extent of Advanced Practice Radiation Therapist (APRT) roles in Australia in peer reviewed journals, government reports, conference proceedings and reports. A search was undertaken of PubMed, Web of Science and CINAHL, the ASMIRT website and, and Google Scholar to identify relevant documents. Combinations of keywords with Boolean operators ((advanced practice) OR (advanced practitioner) OR (specialist)) AND ((radiation therapist) OR (radiation therapy)) were used. Online and physical searches were conducted between July 16 and 23 2017. Results were not date limited. The searches retrieved 352 after duplicates were removed with 46 remaining after filtering for eligibility criteria. Items consisted of journal articles, conference abstracts, presentation slides, online presentations, State government and ASMIRT reports. A number of potential and existing APRT roles were found in the identified articles, including image review, stereotactic, treatment review, breast localisation, palliative radiotherapy, brachytherapy, radiation engineering and urology. Despite reports indicating that radiation therapists in Australia have been concerned with professional directions since 2001, there is little evidence of formal progress towards defined APRT roles. Several centres have implemented roles in a number of practice areas. The success of APRT roles lies in the ability to demonstrate that implementation goals have been achieved and that patient care has improved. The literature suggests that this is occurring, however, the presented evidence is not compelling.

Advanced practice: An ESTRO RTTC position paper

“…Although references do support examples of AP, individuals working in new AP roles should be encouraged to add research to the evidence base. By clearly quantifying benefit, these posts can gain further recognition [17].…”

An evaluation of an advanced practice role in palliative radiation therapy

“…The development and integration of advanced practice in radiation therapy internationally was seen to address problems such as oncology staff shortages, expansion and improvement of cancer services, career development and staff retention and recruitment. Aligning with international models, the development of advanced practice in radiation therapy in Australia has been identified as an opportunity to extend clinical roles and to improve coordination of care, efficiency and productivity …”

Leadership in the radiation therapy profession: The importance of understanding the potential benefits and theoretical perspectives

“…RTs are highly trained professionals working in many areas of practice as clinical practitioners, educators/trainers, managers, and researchers. Many occupy roles as Advanced Practitioner RTs in countries such as Australia, the United Kingdom, Canada, New Zealand, and Ireland 14,15 and have taken on tasks once traditionally completed by radiation oncologists or medical physicists. 16 In job advertisements, titles such as Clinical Leads, Specialist or Consultant Practitioners and Charge RTs are now common.…”

“…The authors also reported leadership skills were demonstrated in the areas of project management, technical innovation, and practice implementation. 16 In the Australian context, Hilder et al 14 also discussed the Advanced Practitioner roles and suggested the need to understand how these roles can improve service delivery and patient care.…”