Chan Kitty, Chan Biu, Linden Kelly, Erler Darby, D'Alimonte Laura, Kong Vickie, Kraus Julie, Harnett Nicole
Princess Margaret Cancer Centre, Canada.
Department of Radiation Oncology, University of Toronto, Canada.
Tech Innov Patient Support Radiat Oncol. 2024 Jan 17;29:100238. doi: 10.1016/j.tipsro.2024.100238. eCollection 2024 Mar.
Advanced practice (AP) in radiation therapy (RT) is being implemented around the globe. In an effort to advance the understanding of the similarities and differences in APRT roles in Ontario, Canada, a community of practice (CoP) sought ways to provide quantitative data on the nature of APRT clinical activities and the frequency with which these activities were being executed.
In 2017, a consensus building project involving 20 APRTs and 14 radiation therapy (RT) department managers in Ontario was completed to establish a mechanism to quantify APRTs' clinical impact. In Round 1 & 2, expert feedback was gathered to generate an Advanced Practice (AP) Activity List. In Round 3: 20 APRTs completed an online survey to assess the importance and applicability of each AP Activity to their role using Likert scale (0-5). A final AP Activity List & Definitions was generated.
RESULTS & DISCUSSION: Round 1: Forty-seven AP activities were identified. Round 2: 3/14 RT managers provided 145 feedback statements on Round 1 AP Activity List. The working group used RT managers' feedback to clarify AP activities and definitions, specifically merging 33 unique AP activities to create 11 inclusive AP activities and eliminating 8 activities identified from Round 1. The most inclusive AP activity created was #1 New Patient Consultation, this AP Activity is merged from 7 unique AP activities. Incorporating RT managers' feedback with the internal AP clinical workload lists from 2 Ontario cancer centres resulted in a revised AP Activity List with 20 AP inclusive activities. Round 3: 14/20 APRTs provided Likert scores on this revised list. The most applicable AP activities (mean score) were #16 Technical Consultation (4.0), #15 Contouring Target Volume (3.8) and #2 Planning Consultation (3.8); the least applicable was #18 MR Applicator Assessment (0.9).
This is the first systematic attempt to build consensus on AP clinical activities. Non-clinical APRT activities related to research, education, innovation, and program development were not in the scope of this project. The Final AP Activity List & Definitions serves as a framework that allows standardized and continuous monitoring of AP clinical activities and impact.
放射治疗（RT）高级实践（AP）正在全球范围内实施。为了增进对加拿大安大略省APRT角色异同的理解，一个实践社区（CoP）寻求方法来提供关于APRT临床活动性质以及这些活动执行频率的定量数据。
2017年，一个涉及安大略省20名APRT和14名放射治疗（RT）部门经理的共识构建项目完成，以建立一种量化APRT临床影响的机制。在第1轮和第2轮中，收集专家反馈以生成高级实践（AP）活动清单。在第3轮中：20名APRT完成了一项在线调查，使用李克特量表（0 - 5）评估每个AP活动对其角色的重要性和适用性。生成了最终的AP活动清单及定义。
第1轮：确定了47项AP活动。第2轮：14名RT经理中的3名对第1轮AP活动清单提供了145条反馈意见。工作组利用RT经理的反馈来澄清AP活动和定义，具体而言，将33项独特的AP活动合并为11项包容性的AP活动，并删除了第1轮中确定的8项活动。创建的最具包容性的AP活动是#1新患者咨询，该AP活动由7项独特的AP活动合并而成。将RT经理的反馈与安大略省两个癌症中心的内部AP临床工作量清单相结合，得到了一份修订后的包含20项AP活动的清单。第3轮：20名APRT中的14名对这份修订后的清单给出了李克特评分。最适用的AP活动（平均得分）是#16技术咨询（4.0）、#15靶区轮廓勾画（3.8）和#2计划咨询（3.8）；最不适用的是#18磁共振施源器评估（0.9）。
这是首次就AP临床活动达成共识的系统性尝试。与研究、教育、创新和项目开发相关的非临床APRT活动不在本项目范围内。最终的AP活动清单及定义作为一个框架，允许对AP临床活动及其影响进行标准化和持续监测。
