An examination of Advanced Clinical Practice: Qualitative insights from therapeutic radiography advanced and consultant practitioners based in England

Abstract

Introduction Therapeutic radiographers play a vital and changing role in the delivery of radiotherapy services treating patients with cancer. Advanced Practitioners (AP) and Consultant Practitioners (CP) in radiotherapy have developed advanced clinical skills and specialisms, enhancing the ability of the profession to offer a greater depth of cancer services and ease pressure elsewhere in the system. The aim of this study was to define the opportunity and potential for Advanced Clinical Practice (ACP) roles in oncology services. Specific objectives were to explore local profiles, role development and opportunities for standardisation of ACPs in therapeutic radiography and to determine resource requirements to roll out and ensure continuation of the existing and new roles. Material and methods The research was addressed through a qualitative study design using focus groups. Convenience sampling was used to recruit therapeutic radiography advanced and consultant practitioners (N = 36) from the respective radiotherapy departments in England to participate in regional focus groups. Four regional areas were identified for inclusion. Data generated was analysed thematically. Results The findings are presented in four themes: ownership of professional identity, desire for standardisation and guidance, drivers of role development and self-directed educational routes. Conclusion Key findings from the focus groups indicated the need for standardisation in job descriptions, roles and responsibilities and a key understanding of career progression. The professional identity of the AP is acknowledged by independent, autonomous working; however, this can only be facilitated if the correct training is undertaken and the necessary support structures are in place to enable career progression. Challenges associated with role development are 1) lack of career and pathway guidance, 2) lack of clear educational routes, 3) lack of standardised roles.

Pathway for radiation therapists online advanced adapter training and credentialing

“…But rather, serve as a vehicle to enhance global collaboration in transitioning RTTs to advanced adapters in a ‘clinician-lite’ oART workflow. Development of an advanced career pathway for RTTs will promote life-long learning, resulting in a more employable workforce with greater levels of retention within the profession [35] , [36] . The application of oART into the clinic as routine, needs to harness the alliance of all radiation oncology professionals with the common goal of providing optimal care and improving patient outcomes.…”

“…Globally, governing bodies such as The Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and The Canadian Association of Medical Radiation Technologists (CAMRT) have established policies and frameworks to support RTT advanced practice in delivering models of care that expand beyond the traditional RTT scope of practice. Advanced practice pathways help to ensure a motivated and flexible workforce, retaining employees with high-level skills who provide high-quality care underpinned by postgraduate study [7] , [35] , [36] . ESTRO have also supported specialised advanced-practice RTTs, benchmarked with level 7 and 8 descriptors and competencies from the framework of European Higher Education Area (EHEA) [35] .…”

“…ESTRO have also supported specialised advanced-practice RTTs, benchmarked with level 7 and 8 descriptors and competencies from the framework of European Higher Education Area (EHEA) [35] . The framework describes level 8 practitioners having “knowledge at the most advanced frontier of a field of work or study and at the interface between fields” with examples provided for competencies in advanced OAR delineation and volume determination, underpinned by a Masters or Doctorate education [36] . In the UK, delegation of task by the prescribing RO allows RTTs the legal requirements for completing tasks confined to the prescribing RO [34] .…”

Working in a UK national proton radiotherapy facility: the therapeutic radiographer perspective

“…This enables a wider network of care for service users, further develops the skillset of radiographers and reduces department pressures. 26 Moving forward, shared learning of technical and educational developments through collaborative working is integral to enable a seamless national delivery of PBT. It is crucial that proton centres work collaboratively towards common goals, including PBT techniques, standardised treatment in the event of proton contingency and educating the future workforce.…”

The Last Lick: A Lived Experience of Non-incarcerated Partners

“…Thus, we deliberately (purposively) sampled non-incarcerated partners of inmates at Agodi-Ibadan medium correctional facility for this study, according to Bazen et al (2021). This procedure is in tandem with frequently used intentional sample techniques such as criterion sampling (Caskurlu et al, 2021;Yldrm et al, 2021); theoretical sampling (Levitt, 2021;Crick, 2021); convenience sampling (Khine et al, 2021;Wong & Wong, 2021); and snowball sampling (Leighton et al, 2021). According to Adlit (2022), "purposeful sampling" is also known as "judgmental," "selective," or "subjected" sampling.…”