Leung John, Lehman Margot
Department of Radiation Oncology, Adelaide Radiotherapy Centre, Adelaide, South Australia, Australia.
Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
J Med Imaging Radiat Oncol. 2017 Dec;61(6):791-796. doi: 10.1111/1754-9485.12635. Epub 2017 Jun 30.
This paper reports the key findings of the first survey of Australian and New Zealand Radiation Oncology Directors of Training (DoTs) dealing with their perspectives, experiences and challenges.
The survey was conducted in September 2016 using a 34-question instrument. It was emailed to all radiation oncology DoTs listed on the Royal Australian and New Zealand College of Radiologists (RANZCR) database. The questions related to demographics, protected time, weekly activities, support, the value of curriculum assessments, challenges and suggested improvements. Respondents were assured that their responses were anonymous.
The response rate was 59.6% (31/52). The median age of respondents was in the 41 to 45 age bracket, but nearly one quarter were over 45 years of age. The median time respondents had been in the role was three to five years (range <0.5 to >10) with the median number of trainees supervised being four (range 1-8). Thirty-five percent had a co DoT. DoTs spent a median of three hours per week on the role (range <1 to >8) with most respondents (67.7%) requiring time during and out of work performing the role, but ten percent claimed it was done out of hours only. Nearly all DoTs were aware they should have protected time, but only just half received it. The educational aspects of training dominated weekly activities, but rostering, specific trainee issues and administration were also featured. Time issues were the greatest challenge for respondents with clinical assignments the most challenging assessment. However, more emphasis on contouring and planning was thought to be required. All DoTs found the dedicated DoT workshops useful, but felt future discussions on trainees in difficulty could be emphasized. The vast majority felt supported by their training site and the College. All respondents believed in the role with most having an interest in educational activities. The majority of respondents (85%) intended to continue in the role for the next 1 to 2 years, but this dropped to 45% when asked about continuing for 5 years.
This survey of predominantly experienced DoTs, indicated that the role was deemed to be of value in delivering optimal training. The most significant challenges faced by DoTs were finding sufficient time to deal with the responsibilities of the role and dealing with underperforming trainees. Feedback on the currently employed work based assessments will be considered as FRO transitions into programmatic assessment. Furthermore, a desire for training in how to deal with trainees in difficulty, underperforming or unsuitable trainees is noted. Future work is planned following refinements of the survey instrument; and, will also explore stress and burnout in the DoT cohort.
本文报告了对澳大利亚和新西兰放射肿瘤学培训主任（DoTs）进行的首次调查的主要结果，涉及他们的观点、经验和挑战。
该调查于2016年9月进行，使用了一份包含34个问题的问卷。问卷通过电子邮件发送给澳大利亚和新西兰皇家放射科医师学院（RANZCR）数据库中列出的所有放射肿瘤学DoTs。问题涉及人口统计学、受保护时间、每周活动、支持、课程评估的价值、挑战和建议改进。受访者被保证其回答将是匿名的。
回复率为59.6%（31/52）。受访者的年龄中位数在41至45岁之间，但近四分之一的受访者年龄超过45岁。受访者担任该职位的时间中位数为三至五年（范围为<0.5至>10年），监督的学员数量中位数为四名（范围为1 - 8名）。35%的人有联合DoT。DoTs每周在该职位上花费的时间中位数为三小时（范围为<1至>8小时），大多数受访者（67.7%）需要在工作时间内和工作时间外花费时间履行职责，但10%的人声称仅在工作时间外完成。几乎所有DoTs都意识到他们应该有受保护时间，但只有一半的人获得了。培训的教育方面主导了每周活动，但排班、特定学员问题和行政管理也有涉及。时间问题是受访者面临的最大挑战，临床任务是最具挑战性的评估。然而，人们认为需要更多地强调轮廓勾画和治疗计划。所有DoTs都认为专门的DoT研讨会很有用，但觉得未来可以更加强调对有困难学员的讨论。绝大多数人感到得到了培训地点和学院的支持。所有受访者都认可该职位，大多数人对教育活动感兴趣。大多数受访者（85%）打算在未来1至2年内继续担任该职位，但当被问及是否继续担任5年时，这一比例降至45%。
这项对主要是经验丰富的DoTs的调查表明，该职位在提供最佳培训方面被认为具有价值。DoTs面临的最重大挑战是找到足够的时间来履行该职位的职责以及应对表现不佳的学员。随着FRO向基于项目的评估过渡，将考虑对目前采用的基于工作的评估的反馈。此外，注意到对如何处理有困难、表现不佳或不合适学员的培训有需求。在完善调查问卷后计划开展进一步工作；并且，还将探索DoT群体中的压力和倦怠情况。
