Adleman Jenna, Gillan Caitlin, Caissie Amanda, Davis Carol-Anne, Liszewski Brian, McNiven Andrea, Giuliani Meredith
Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2017 Jun 1;98(2):428-437. doi: 10.1016/j.ijrobp.2016.11.031. Epub 2017 Feb 14.
To develop an entry-to-practice quality and safety competency profile for radiation oncology residency.
A comprehensive list of potential quality and safety competency items was generated from public and professional resources and interprofessional focus groups. Redundant or out-of-scope items were eliminated through investigator consensus. Remaining items were subjected to an international 2-round modified Delphi process involving experts in radiation oncology, radiation therapy, and medical physics. During Round 1, each item was scored independently on a 9-point Likert scale indicating appropriateness for inclusion in the competency profile. Items indistinctly ranked for inclusion or exclusion were re-evaluated through web conference discussion and reranked in Round 2.
An initial 1211 items were compiled from 32 international sources and distilled to 105 unique potential quality and safety competency items. Fifteen of the 50 invited experts participated in round 1: 10 radiation oncologists, 4 radiation therapists, and 1 medical physicist from 13 centers in 5 countries. Round 1 rankings resulted in 80 items included, 1 item excluded, and 24 items indeterminate. Two areas emerged more prominently within the latter group: change management and human factors. Web conference with 5 participants resulted in 9 of these 24 items edited for content or clarity. In Round 2, 12 participants rescored all indeterminate items resulting in 10 items ranked for inclusion. The final 90 enabling competency items were organized into thematic groups consisting of 18 key competencies under headings adapted from Deming's System of Profound Knowledge.
This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.
制定放射肿瘤学住院医师培训从入职到实践的质量与安全能力概况。
从公共资源、专业资源以及跨专业焦点小组中生成了一份潜在质量与安全能力项目的综合清单。通过研究者共识消除了冗余或超出范围的项目。其余项目经过两轮国际改良德尔菲法，参与人员包括放射肿瘤学、放射治疗和医学物理领域的专家。在第一轮中，每个项目按照9分李克特量表独立评分，以表明其是否适合纳入能力概况。对于纳入或排除排名不明确的项目，通过网络会议讨论进行重新评估，并在第二轮中重新排名。
最初从32个国际来源汇编了1211个项目，并提炼为105个独特的潜在质量与安全能力项目。受邀的50位专家中有15位参与了第一轮：来自5个国家13个中心的10位放射肿瘤学家、4位放射治疗师和1位医学物理学家。第一轮排名结果为80个项目被纳入，1个项目被排除，24个项目不确定。在后一组项目中，有两个领域更为突出：变革管理和人为因素。与5名参与者进行的网络会议对这24个项目中的9个进行了内容或清晰度编辑。在第二轮中，12名参与者对所有不确定项目重新评分，结果有10个项目被列为纳入项目。最终的90项赋能能力项目被组织成主题组，由18项关键能力组成，标题改编自戴明的深刻知识体系。
这份质量与安全能力概况可为放射肿瘤学住院医师培训项目的最低培训标准提供参考。
