Pathway for radiation therapists online advanced adapter training and credentialing

Abstract

Online adaptive radiotherapy (oART) is an emerging advanced treatment option for cancer patients worldwide. Current oART practices using magnetic resonance (MR) and cone beam computed tomography (CBCT) based imaging are resource intensive and require physician presence, which is a barrier to widespread implementation. Global evidence demonstrates Radiation Therapists (RTTs) can lead the oART workflow with decision support tools and on 'on-call' caveats in a 'clinician-lite' approach without significantly compromising on treatment accuracy, speed or patient outcomes. With careful consideration of jurisdictional regulations and guidance from the multi-disciplinary team, RTTs can elevate beyond traditional scopes of practice. By implementing robust and evidence-based credentialing activities, they enable service sustainability and expand the real-world gains of adaptive radiotherapy to a greater number of cancer patients worldwide. This work summarises the evidence for RTT-led oART treatments and proposes a pathway for training and credentialing.

Images and images: Current roles of therapeutic radiographers

“…Education through accreditation is recommended for TRs involved with MRIgRT. 3,9,10,35 The high proportion of participants with post-graduate education, although this may be a self-selected sample, demonstrates the profession's investment in education. The benefits gained would include a standardised competency for all ACP roles not just MRIgRT and a reduction in inequalities in access to care across the UK.…”

“…Therapeutic radiography is a small profession 1 and has struggled with recruitment, retention, and recognition. 2,3,4,5 The increasing demand on the National Health Service (NHS), 2,6,7 increased advanced techniques required for radiotherapy, 8,9 alongside a shortage and/or availability of key radiotherapy multi-disciplinary team members (MDT) 2,10,11 has exacerbated the situation. Therapeutic Radiographers (TRs) play a pivotal role within radiotherapy and, to maintain efficient radiotherapy delivery, 2,8,12,13 have adapted roles in response to advanced techniques.…”

“…23 However, role extension is needed because many required skills are not routinely taught at undergraduate level. 2,10,24 In some MRIgRT settings, TRs are already performing roles that were previously the remit of other MDT members to streamline the workflows and facilitate easier implementation. 24,25,26,27,28 In other MRIgRT centres, the number of treatment sites are increasing due to the success and tolerability of the pathway.…”

“…24,25,26,27,28 In other MRIgRT centres, the number of treatment sites are increasing due to the success and tolerability of the pathway. 26,27,29 Good, 'standard' radiotherapy skills are a necessity for MRIgRT and subsequent role development 10,24 and is the case with other role extensions, advanced technique developments, and for existing ACP TR roles. 14,18e21 This report is part of a larger study investigating skills and knowledge required to deliver adaptive radiotherapy (ART).…”

Advanced practice roles of therapeutic radiographers/radiation therapists: A systematic literature review

“…Additional studies since the SLR Since the review presented here, an additional seven articles exploring AP roles amongst TR/RTTs have been identified. 187,188,196e200 These include: an innovative AP role (sexual care after RT) 197 and a pathway for credentialing online adaptive RT role 188 in collaboration with different countries.…”