Systematic review — role expansion in radiation therapy: from an international perspective to an Australian context

Acharya, Urvi; Acharya, V; Vatsavayi, S Raja; Cox, Jennifer

doi:10.1002/j.2051-3909.2009.tb00108.x

Cited by 7 publications

(28 citation statements)

References 21 publications

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“…Despite interest shown in an AP model, a review published in 2009 identified a lack of data in Australia identifying or evaluating APRT roles with a further study noting little progress had been made towards formal APRT roles. Further to this, in 2009, Dempsey and Burr noted that radiation therapists were “reluctant to progress the issue of responsibility for higher level plans and treatment…..without the appointment at a senior or advanced practitioner level” .…”

Section: Discussionmentioning

confidence: 99%

Advanced practice radiation therapists: an Australian context

Hilder

Dam

Doherty

2018

J of Medical Radiation Sci

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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.

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Section: Discussionmentioning

confidence: 99%

Advanced practice radiation therapists: an Australian context

Hilder

Dam

Doherty

2018

J of Medical Radiation Sci

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“…There is need for further qualitative research into ROs' concerns. Acharya et al . suggest that this may be dealt with by providing support and training and targeting RTs who have substantial clinical experience to underpin their extended role.…”

Section: Discussionmentioning

confidence: 99%

An exploration of the feasibility of radiation therapist participation in treatment reviews

Monk

Wrightson

Smith

2013

J of Medical Radiation Sci

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IntroductionAs radiation oncologists' (ROs') workload has increased over time, treatment review clinics have become recognized as an area of RO practice into which radiation therapist (RT) practice could extend. There has been limited utilization of RTs in this role in Australia and a paucity of data on the acceptability and opinions regarding RTs practising in this role in an Australian context. The purpose of this audit was to investigate the feasibility of RT participation in review clinics at Calvary Mater Newcastle.MethodsFeasibility was determined by two methods: an audit of 200 treatment reviews to determine medical intervention (MI) levels required and a survey of 80 clinical staff to explore attitudes towards RT participation in clinics.ResultsMedical intervention was required in 59% (n = 118) of observed reviews, with the lowest being for breast (33%) and prostate (28%) cancers. MI peaked at 73% between fractions 16–20 and was lowest early and late in the treatment period at 48%. There were 60 responses to the staff survey. All but one respondent agreed that RTs would be willing to participate in treatment review clinics, but all five consultant ROs indicated they would not be willing to delegate reviews to RTs.ConclusionsNeither feasibility measure reached acceptable levels to recommend RT participation in treatment review clinics. Further investigation and RT education are required to help meet the future RO workforce shortfall. As MI rates are lowest for breast and prostate cancer RT participation could be targeted to these clinics.

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“…15,18,33,45 The role of the radiation therapist in obtaining informed consent for radiotherapy A multidisciplinary team approach to care has allowed other professions to embrace skills once considered being within medical domains. 54,60 In Ontario, advanced practice roles, currently under development, are incorporating the delegated act of informed consent into practice for specific site groups (i.e. 56 Radiation therapists (RTs) are currently major contributors in providing information to patients regarding the radiotherapy process.…”

Section: Clinical Implications For Radiotherapy Practicementioning

confidence: 99%

“…54 Advanced practice roles could help minimise the large amounts of overlapping information patients receive and would allow for a formal opportunity to integrate consent into the RT role. 60 The development of professional frameworks for practice is required to support development of the specialised skill sets recommended for advanced practice roles (Table 2). 60 The development of professional frameworks for practice is required to support development of the specialised skill sets recommended for advanced practice roles (Table 2).…”

Section: Clinical Implications For Radiotherapy Practicementioning

confidence: 99%

“…58 Despite findings that RTs have little confidence in their abilities to discuss the 'reasons for prescribing radiotherapy' and to accept the full responsibility of obtaining informed consent, 54,58 RTs are believed to be capable of obtaining consent because of their direct association with treatment delivery and ability to provide patients with treatmentspecific information. 54,56,60 In addition to training, individuals taking on informed consent roles must be fully aware of the ethical and legal obligations/ responsibilities such as providing appropriate information, as per the Health Care Consent Act, to ensure patients provide informed treatment decisions. Although there is currently no definitive guidelines indicating the level of education required for advanced practice roles, for radiation therapy or other allied health professions, current recommendations call for a minimum of a Master's degree level in addition to supervised practice before assuming the role.…”

Section: Clinical Implications For Radiotherapy Practicementioning

confidence: 99%

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Shared decision making in palliative cancer care: a literature review

Feuz

2013

J Radiother Pract

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Background: Patients require information to make informed decisions and consent to medical treatment. Shared decision making (SDM) is a methodology that promotes a patient-centred approach to informed consent and demonstrates respect for autonomy Purpose: The purpose of this paper is to critically review the legal and ethical issues relevant to Canadian and UK informed consent and SDM practices and how these processes relate to current palliative care practices, with a particular emphasis on radiation therapy.Methodology: A review of the English literature from 2003 to 2013 was performed using the databases PubMed (NML), OVID Medline and Google Scholar. Results and Conclusions:The literature identifies that palliative cancer patients desire the opportunity to be involved with decision-making discussions, which has shown to increase knowledge and result in better health-related outcomes. However, ethical and legal issues regarding the practicality of including this patient population in SDM discussions raises questions about validity of consent. For SDM to be considered a valid methodology to obtain informed consent, open and honest communication between the patient and multidisciplinary team is essential. Treatment options for palliative cancer patients are often complex and SDM allows healthcare professionals and patients to exchange information and negotiate feasible treatment options based on medical expertise and patient preferences.Legal frameworks have defined current standards of practice for various healthcare professions, including radiation therapy. Radiation therapists, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the radiotherapy process. Individuals working within advanced practice roles have the ability to develop skills once considered to be within medical domains and have begun to incorporate the delegated act of obtaining informed consent into practice which has shown to increase professional autonomy, accountability and improves patient-centred care.

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Systematic review — role expansion in radiation therapy: from an international perspective to an Australian context

Cited by 7 publications

References 21 publications

Advanced practice radiation therapists: an Australian context

Advanced practice radiation therapists: an Australian context

An exploration of the feasibility of radiation therapist participation in treatment reviews

Shared decision making in palliative cancer care: a literature review

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