Skubish Samantha, Starrs Clodagh, McDonagh Danielle
Department of Radiation Oncology, Mount Sinai Health System, 1184 5 Avenue, New York, NY 10029, United States.
Department of Radiation Oncology, Mount Sinai Hospital, 1184 5 Avenue, New York, NY 10029, United States.
Tech Innov Patient Support Radiat Oncol. 2021 Mar 18;17:59-62. doi: 10.1016/j.tipsro.2021.01.005. eCollection 2021 Mar.
The evolution of practice of Radiation Therapy in the United States (U.S.) is inevitable. The scope of a radiation therapists role has progressed with advancing technology, implementation of special procedures and patient care requirements. Internationally, Canada, Australia and the United Kingdom have formalized this evolution through the Advanced Practice Radiation Therapist (APRT) role to provide new models of care, to meet growing demands in the practice of Radiation Oncology, to increase efficiency, decrease cost and retain skilled staff (Harnett et al., 2018; Society of Radiographers; Linden et al., 2019; Coleman et al., 2014) [1], [2], [3], [4]. Through evidence based practice, the APRT role has proven to provide benefits for multiple stakeholders including service-reconfiguration to reduce wait times, developing and retaining highly skilled radiation therapists, treatment review and most importantly improving patient care within much needed patient cohorts such as the palliative population (Duffton et al., 2019) [5]. The U.S. is no exception to requiring innovative care models and solutions to similar complex, care delivery challenges experienced internationally. The U.S. is experiencing an increase in demand for cancer services and a rapid rate of technological and treatment advancements. Under the current infrastructure, this has impacted the daily tasks of physicians; increasing workload, increasing the complexity of clinical decision making, increasing movement toward site specific subspecialty practice and pushing the scope of radiation therapists informally toward maximization, increased autonomy and a higher level of education and specialized skills (American Society of Clinical Oncology, 2016; ARRT, 2020; Vu et al., 2018) [6], [7], [8]. The following reviews the current radiation therapy practice and professional landscape in the United States as it relates to advanced practice, exploring opportunities and challenges under the U.S. health care infrastructure. This broad analysis provides comparison to other countries and disciplines such as the Radiologist Assistant and Nurse Practitioner for potential pathways to establishing the role and describes current needs and value of the expanding scope of RT's practicing in the U.S.
美国放射治疗实践的演变是不可避免的。随着技术的进步、特殊程序的实施以及患者护理要求的提高，放射治疗师的角色范围也在不断发展。在国际上，加拿大、澳大利亚和英国已通过高级实践放射治疗师（APRT）的角色将这一演变正式化，以提供新的护理模式，满足放射肿瘤学实践中不断增长的需求，提高效率，降低成本并留住技术熟练的员工（哈内特等人，2018年；放射技师协会；林登等人，2019年；科尔曼等人，2014年）[1]，[2]，[3]，[4]。通过循证实践，APRT的角色已被证明能为多个利益相关者带来益处，包括重新配置服务以减少等待时间、培养和留住高技能的放射治疗师、进行治疗审查，最重要的是在急需护理的患者群体（如姑息治疗人群）中改善患者护理（达夫顿等人，2019年）[5]。美国也不例外，同样需要创新的护理模式和解决方案来应对国际上类似的复杂护理交付挑战。美国对癌症服务的需求在增加，技术和治疗的进步速度也很快。在当前的基础设施下，这已经影响了医生的日常工作；工作量增加、临床决策的复杂性增加以及向特定部位亚专业实践的趋势增强，并且在非正式地推动放射治疗师的角色范围朝着最大化、更高的自主权以及更高水平的教育和专业技能发展（美国临床肿瘤学会，2016年；ARRT，2020年；武等人，2018年）[6]，[7]，[8]。以下将审视美国当前与高级实践相关的放射治疗实践和专业现状，探讨美国医疗保健基础设施下的机遇和挑战。这种广泛的分析将与其他国家和学科（如放射科助理和执业护士）进行比较，以寻找确立该角色的潜在途径，并描述美国不断扩大的放射治疗实践范围的当前需求和价值。
