Linden Kelly, Renaud Julie, Zohr Robert, Gaudet Marc, Haddad Alain, Pantarotto Jason, Dennis Kristopher
Radiation Medicine Program, The Ottawa Hospital, Ottawa, Ontario, Canada.
Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada.
J Med Imaging Radiat Sci. 2019 Dec;50(4):543-550. doi: 10.1016/j.jmir.2019.08.009. Epub 2019 Oct 24.
A clinical specialist radiation therapist (CSRT) position in palliative radiation therapy (RT) was created at our institution. Herein, we report the details of the CSRT's orientation, training, and support program.
We performed an audit and needs assessment of palliative RT services at our centre. This identified opportunities for improvement that could be facilitated by the CSRT. We defined the CSRT job description including priority responsibilities: (1) optimizing palliative RT services for outpatients and developing a rapid access palliative RT program, (2) optimizing palliative RT services for inpatients at our institution, (3) improving links to community physicians and hospitals caring for patients with advanced cancers. We formed a core resource team to provide ongoing support and to design and implement the orientation and training program. The program involved training in clerical and administrative systems as well as treatment planning and physics training relevant to palliative RT. Clinical placements at several hospitals were arranged in both inpatient and outpatient settings. The CSRT worked with radiation and medical oncologists, palliative care specialists, nurse practitioners, hospitalists, and social workers.
Through clinical placements and self-directed learning, the CSRT gained knowledge and competencies in patient care coordination, history taking and physical examination, clinical oncology practice including the evidence-based use of palliative RT and symptom control measures, treatment planning, communication, patient advocacy, and advance care planning. We provided practice resources including office space and a planning station, educational opportunities including workshops in palliative and psychosocial care, and research opportunities including methodologic and research ethics training.
To our knowledge, this is the first detailed report of its kind for an advanced practice radiation therapy role. We hope our report will inform the design and implementation of programs elsewhere to help prepare individuals for similar roles in palliative RT.
The CSRT in palliative RT at our institution underwent a comprehensive orientation and training program. Institutions with similar CSRT positions are encouraged to report the details of their own programs.
我们机构设立了姑息性放射治疗（RT）临床专科放射治疗师（CSRT）职位。在此，我们报告CSRT的入职培训、培训及支持计划的详细情况。
我们对本中心的姑息性RT服务进行了审核和需求评估。这确定了CSRT可推动的改进机会。我们定义了CSRT的工作职责，包括优先职责：（1）优化门诊姑息性RT服务并制定快速通道姑息性RT计划，（2）优化本机构住院患者的姑息性RT服务，（3）改善与社区医生及照顾晚期癌症患者的医院之间的联系。我们组建了一个核心资源团队，以提供持续支持，并设计和实施入职培训及培训计划。该计划包括文书和行政系统培训以及与姑息性RT相关的治疗计划和物理培训。安排在几家医院进行住院和门诊环境的临床实习。CSRT与放射肿瘤学家、医学肿瘤学家、姑息治疗专家、执业护士、住院医师和社会工作者合作。
通过临床实习和自主学习，CSRT在患者护理协调、病史采集和体格检查、临床肿瘤学实践（包括基于证据的姑息性RT使用和症状控制措施）、治疗计划、沟通、患者维权和预先护理计划方面获得了知识和能力。我们提供了实践资源，包括办公空间和计划工作站；提供了教育机会，包括姑息和心理社会护理方面的研讨会；还提供了研究机会，包括方法学和研究伦理培训。
据我们所知，这是关于高级放射治疗实践角色的此类第一份详细报告。我们希望我们的报告能为其他地方的计划设计和实施提供参考，以帮助个人为姑息性RT中的类似角色做好准备。
我们机构的姑息性RT中的CSRT接受了全面的入职培训和培训计划。鼓励设有类似CSRT职位的机构报告其自身计划的详细情况。
