Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina; Carolina Health Informatics Program, School of Information and Library Science, University of North Carolina, Chapel Hill, North Carolina.
Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina; Carolina Health Informatics Program, School of Information and Library Science, University of North Carolina, Chapel Hill, North Carolina.
Pract Radiat Oncol. 2017 Sep-Oct;7(5):e309-e316. doi: 10.1016/j.prro.2017.02.005. Epub 2017 Feb 17.
To help with ongoing safety challenges in radiation therapy (RT), the objective of this research was to develop and assess the impact of a simulation-based training intervention on radiation oncology providers' workload and performance during treatment planning and quality assurance (QA) tasks.
Eighteen radiation oncology professionals completed routine treatment planning and QA tasks on 2 clinical scenarios in a simulation laboratory as part of a prospective institutional review board-approved study. Workload was measured at the end of each assessment/scenario using the NASA Task-Load Index. Performance was quantified based on procedural compliance (adherence to preset/standard QA tasks), time-to-scenario completion, and clinically relevant performance. Participants were then randomized to receive (vs not receive) simulation-based training intervention (eg, standardized feedback on workload and performance) and underwent repeat measurements of workload and performance. Pre- and postintervention changes in workload and performance from participants who received (vs did not receive) were compared using 2-way analysis of variance.
Simulation-based training was associated with significant improvements in procedural compliance (P = .01) and increases in time-to-scenario completion (P < .01) but had no significant impact on subjective workload or clinically relevant performance.
Simulation-based training may be a tool to improve procedural compliance of RT professionals and to acquire new skills and knowledge to proactively maintain RT professionals' preoccupation with patient safety.
为了应对放射治疗(RT)中持续存在的安全挑战,本研究旨在开发并评估基于模拟的培训干预对放射肿瘤学专业人员在治疗计划和质量保证(QA)任务中的工作负荷和表现的影响。
18 名放射肿瘤学专业人员在模拟实验室中完成了 2 个临床场景的常规治疗计划和 QA 任务,作为前瞻性机构审查委员会批准的研究的一部分。在每次评估/场景结束时,使用 NASA 任务负荷指数测量工作负荷。根据程序合规性(遵守预设/标准 QA 任务)、完成场景所需的时间和临床相关表现来量化性能。然后,参与者被随机分配接受(与不接受)基于模拟的培训干预(例如,对工作负荷和表现的标准化反馈),并再次测量工作负荷和表现。接受(与不接受)培训的参与者的工作负荷和表现的预干预和后干预变化使用双向方差分析进行比较。
基于模拟的培训与程序合规性的显著提高(P =.01)和完成场景所需时间的增加(P <.01)相关,但对主观工作负荷或临床相关表现没有显著影响。
基于模拟的培训可能是一种工具,可以提高 RT 专业人员的程序合规性,并获得新的技能和知识,以积极维护 RT 专业人员对患者安全的关注。