Narratives in the Journal of Medical Imaging and Radiation Sciences: Publishing stories in an academic journal.

Healthcare narratives can be used for education to elicit an emotional or affective response, develop critical thinking, and gain perspective on individuals' experiences with life and illness to cultivate person-centered care. This editorial describes the recent experience of the Journal of Medical Imaging and Radiation Sciences (JMIRS) in developing a new narrative submission format. The processes of engaging and supporting patient authors as well as creating a more accessible submission and review process are presented. Finally, the paper discusses the emerging impact of published narratives and the benefit of working with patients as experts and authors.

Letter in response to Laing et al., "An evaluation of radiation therapy patient body mass index trends and potential impact on departmental resource planning".

"An evaluation of radiation therapy patient body mass index trends and potential impact on departmental resource planning" by Laing et al. The authors' comment that research into the experiences of larger bodied patients should focus on compassionately improving care for this patient population rather than framing large-bodied patients as a burden or problem, and should include commentary on the effects of weight-bias in the healthcare system.

Engagement in radiation therapy research: What happens after graduation?

BACKGROUND: To prepare undergraduate radiation therapy (RT) students for the professional role of Scholarly Practitioner the University of Alberta's Radiation Therapy Program (RADTH) provides research education, and students conduct novel research studies during their final practicum year with the final result being a publishable paper. A curriculum evaluation project was carried out to examine the impact of the RADTH undergraduate research education by examining the final outcomes of these research projects and whether the learners carried out further research after graduation. METHODS: Alumni who graduated from 2017 to 2020 were surveyed to seek information on the dissemination of their research projects, whether the projects resulted in a change to practice, policy, or patient care, if subsequent research has been performed by the graduates, and the motivators or barriers to conducting research post-graduation. A subsequent manual search of publication databases was conducted to fill in data gaps pertaining to publications. RESULTS: All RADTH research projects have been disseminated by conference presentation and/or publication. One project was reported to have had an impact on practice, with no impact reported for five projects and two respondents not sure about any impact. All respondents reported they have not participated in any new research projects since graduation. Barriers listed included: limited local opportunity, lack of topic ideas, other professional development, no interest in research, COVID impact, and lack of research knowledge. CONCLUSIONS: RADTH's research education curriculum successfully enables the RT students to conduct and disseminate research. All RADTH projects have been successfully disseminated by the graduates. However, participation in research post-graduation is not occurring due to a variety of factors. While MRT education programs are required to develop research skills, this education alone may not alter motivation nor ensure research participation post-graduation. Exploring other avenues of professional scholarship may be key to ensuring contribution to evidence-informed practice.

A survey to explore the psychological impact of the COVID-19 pandemic on radiation therapists in Norway and Canada: A tale of two countries.

INTRODUCTION: Several studies have demonstrated the psychological impact of the COVID-19 pandemic on health care providers. However, there is little known about how the COVID-19 pandemic has impacted radiation therapists (RTs) in Norway or Canada. The aim of this investigation was to study the psychological impact of working during the COVID-19 pandemic among RTs in Canada and Norway. METHODS: Online surveys were administered to a convenience sample of RTs and RT department managers. Approximately 2000 and 300 RTs were invited to participate from Canada and Norway, respectively. The RT survey collected information on demographics, work-related stressors, psychological impact, quality of life, and workplace support programmes. The RT manager survey collected information on departmental changes, patient volumes, staff shortages and redeployment, personal protective equipment, and infection control measures. Descriptive analysis, group comparisons and logistic regression were used to examine the impact of COVID-19 on RTs in the two countries, while open-ended questions were examined through thematic analysis. RESULTS: Work-related stress and anxiety were prevalent among Canadian (n = 155) and Norwegian RTs (n = 124), with Canadian RTs reporting higher levels. Fear of transmission, changes in PPE usage, and changes in staffing were reported as the most frequent work-related stressors. Themes related to working during the pandemic included: generalised anxiety; physical, emotional and cognitive symptoms of stress; and loneliness, as well as negative impact on health and quality of relationships. Survey findings from RT department managers in Canada (n = 12) and Norway (n = 13) suggest that the pandemic had an organisational impact on RT departments due to implemented infection control measures and changes in staffing. CONCLUSION: The COVID-19 pandemic has led to similar stressors amongst Canadian and Norwegian RTs but relatively higher levels of psychological impact among Canadian RTs. Findings demonstrate the importance of mental health support programmes in the workplace to mitigate the psychological impact of the COVID-19 pandemic on RTs.

Writing your first paper: An informal guide for medical radiation sciences professionals.

Writing and submitting a paper can be a daunting prospect, especially the first time. One of the more challenging aspects is knowing how to begin. Countless projects in the workplace never make it past local dissemination or conference presentation. This informal guide will help you take that next step and begin the peer-reviewed publication journey.

Improving Lesbian, Gay, Bisexual, Transgender, Queer and Two-Spirit Content in a Radiation Therapy Undergraduate Curriculum.

Lesbian, gay, bisexual, transgender, queer and two-spirit plus (LGBTQ2S+) people have distinct healthcare needs that may be unaddressed in many undergraduate healthcare curricula. The Radiation Therapy Program (RADTH) at the University of Alberta underwent a review of the three-year didactic curriculum using an online survey. The survey sought to ascertain if, where and how topics related to LGBTQ2S + healthcare are taught. Results indicated that out of 10 RADTH program faculty respondents, three teach related topics. The total time dedicated within the three-year curriculum was approximately three and a half hours. Other findings showed that faculty are interested in receiving more education in this area and would favour discussions about how to incorporate these themes into appropriate courses. This preliminary investigation demonstrated that there has been some initial work in this area, but there is more to be done.

Learning From Cancer Survivors as Standardized Patients: Radiation Therapy Students' Perspective.

INTRODUCTION/BACKGROUND: Healthcare programs have proven the benefits of standardized patients in educational activities, but limited scholarship exists on the involvement of cancer survivors in radiation therapy education. This innovative approach to simulation-based education in radiation therapy is the first to integrate cancer survivors as standardized patients in a high-fidelity environment. This research aims to examine the impact of cancer survivors on the students' learning during their simulation course. METHODS: This qualitative research used a phenomenological approach to gather data and analyze the students' view of their interactions with cancer survivors in the simulation course. The researchers conducted three focus group discussions with five of the eight radiation therapy students using a set of preformulated questions. RESULTS: The collected data were comparatively analyzed, and the research team identified four main themes: experience, teaching/coaching, patient-centeredness and gratitude. These represented the students' perspective on their experiences and the unique learning opportunities provided by the cancer survivors. FINDINGS/DISCUSSION: The simulation activities with the cancer survivors provided a safe and realistic experience for the students. This research highlighted the influence of the cancer survivors' oncology journey on the skills development of the radiation therapy students. CONCLUSION: The students benefited from the authentic patient perspective of the cancer survivors which helped build their confidence and develop their skills prior to clinical placement. This research demonstrated that incorporating cancer survivors as standardized patients in radiation therapy simulation education has added significant value to the students' learning.

Staffing Levels and Workload for Radiation Therapists in Canada.

PURPOSE: The safe delivery of radiation therapy is dependent in part on the provision and organization of oncology professionals. General recommendations for staffing of radiation oncologists, medical physicists, and radiation therapists have been published, but most of these provide little detail, especially in the case of radiation therapists (RTs). In Canada, there are no guidelines or national standards for the staffing of RTs, and there is a paucity of Canadian data on the existing staffing levels of RTs and the models used to establish these levels. This project sought to identify and compare the staffing models used for Canadian RTs, and the staffing levels and workload resulting from these models. METHODS AND MATERIALS: In January 2016, a survey was sent to managers of the 46 radiation treatment centres in Canada. This survey sought information on a range of staffing and practice variables for the fiscal year 2014/2015. Respondents were requested to provide the staffing model used for RTs at each centre and enough additional information to calculate the staffing levels and workload resulting from their staffing model. The survey included further variables that had the potential to influence staffing levels and workload, and centres were compared to establish if these variables did indeed impact staffing. RESULTS: Of the 46 centres contacted, 37 centres responded, representing an 80.4% response rate. Survey results showed there are a variety of ways used to determine staffing across the country. Twenty of the 37 responding centres include some type of workload measurement in their staffing model, whereas 17 centres base staffing solely on historic levels or operating funds. There is a great deal of variation in the staffing levels and workload of RTs in Canada, with staff at some centres planning and treating twice the number of patients as RTs at other centres. Radiation therapist staffing levels at most radiation treatment centres in Canada are below the level recommended in recent publications. Differences in staffing levels or workload could not be accounted for by treatment complexity, number of specialty programs, use of relief staff, or number of RTs working in specialty nontreatment roles. CONCLUSIONS: A high degree of variability in staffing levels and workload exists for RTs in Canada, which is not explained by differences in patterns of practice. It is likely that workload for RTs exceed safe levels at some Canadian centres. It is recommended that treatment centres use an up-to-date staffing model for RTs and continue to review staffing levels at regular intervals.

The Education and Practice Environment for Medical Radiation Science Professionals Caring for Lesbian, Gay, Bisexual, and Transgender Patients: An Analysis of a #MedRadJClub Tweet Chat.

INTRODUCTION: The medical radiation sciences' (MRS) MedRadJournalClub attracts a global group of participants to monthly sessions to discuss selected journal articles. The September 2017 session explored the experiences of MRS professionals working with lesbian, gay, bisexual, and transgender (LGBT) patients. The aim of the chat was to establish staff educational preparation, how participants' organizations approached the issue, and what participants would do differently at work or at home in relation to this patient population after the chat. METHOD: Data were extracted using the Twitter advanced search function with #MedRadJClub from the 19th to 23rd September 2017. The data were reviewed and categorized for themes. Tweets related to shared LGBT resources were captured, verified, and counted separately. RESULTS: 44 participants took part in the September Twitter chat. After data cleaning, 127 tweets were included for analysis with a further 16 tweets sharing LGBT resources. Almost all of the participants disclosed that they had no undergraduate education or workplace training in the care of LGBT patients. Workplaces of a limited few participants had specific approaches to improve experiences for this patient population. Many participants were eager to advocate for changes in their workplaces after the Twitter chat. CONCLUSION: There is still work to be carried out to educate MRS professionals to enhance their LGBT patients' experience and improve workplaces. Positive changes in education and a more inclusive clinical environment will ultimately improve care for LGBT patients.

Patterns of Practice in Canadian Radiation Treatment Centres: Results of a National Survey.

PURPOSE: Radiation therapy has changed rapidly over the past decade due to the application of technological advances. A survey was conducted of radiation treatment centres in Canada to establish current patterns of practice across the country. Areas of inquiry included treatment techniques and image verification, as well as roles and responsibilities of radiation therapists (RTs). METHODS AND MATERIALS: In January 2016, a survey was sent to managers of the 46 radiation treatment centres in Canada. This survey sought information on a range of staffing and practice variables for the fiscal year 2014/2015. RESULTS: Of the 46 centres contacted, 37 centres responded, representing an 80.4% response rate. Survey results showed that the use of volumetric arc therapy and intensity-modulated radiation therapy is common across Canada for several anatomic sites, as well as the use of daily pretreatment image verification. A high degree of variability exists for imaging modality (two dimensional vs. three dimensional) for some sites, including brain, head and neck, and lung. RTs' responsibilities have expanded uniformly across the country, with RTs involved in organ-at-risk contouring and on-treatment image approval at the majority of centres. Despite this role expansion, specialty roles in areas of quality and applications expertise are still rare. CONCLUSIONS: Radiation therapy in Canada has transitioned to high-technology treatment techniques with relative consistency across the country. There is, however, variation in the imaging modality used for daily verification. Canada may benefit from consensus guidelines on the application of three-dimensional imaging for treatment verification. While RTs have expanded their responsibilities, role definition for RTs working in supervisory or supporting positions has not kept pace at many centres and it is unclear if RTs are supported in their expanded accountabilities.

Virtually Certified: Development of an Online Oral Examination Phase for a National Advanced Practice Certification Model for Radiation Therapists in Canada.

Following development of a framework to establish the scope of advanced practice for radiation therapists (APRTs), a Canadian certification process was built. This involved three independently-assessed phases: professional portfolio, case submission, and oral examination. The oral examination was to test the candidate's knowledge and capacity for decision-making. Development and piloting involved 3 elements: 1) content development, including relevant case selection, with accompanying high-fidelity imaging and resources; 2) harnessing of technology and ensuing logistics, given the desire to offer the examination online, maximizing accessibility and minimizing resources; and 3) examiner recruitment and preparation, involving a national call for interprofessional examiners, to assess across the spectrum of competencies. Each element was approached systematically, with modifications made iteratively. Three overarching challenges required ongoing attention and consideration: resource-intensiveness of building and validating cases, ensuring applicability and relevance of case content and "answers" across practice environments, and preparation of non-radiation therapist (oncologist and physicist) examiners regarding APRT standards. The resultant examination model is thought to be a robust assessment tool, well-regarded by candidates and examiners as fair and transparent, and complementary to the other certification phases. A consultatory pilot process supported establishment of a robust framework that is believed to be defensible and preliminarily valid.

A Canadian Survey of the Management of Radiation-Induced Skin Reactions.

INTRODUCTION: Radiation therapy skin reactions are one of the most common side effects and can cause patient distress. In some cases, a severe radiation-induced skin reaction may limit delivered dose and potentially compromise treatment outcomes. There are some established best practices, but approaches and patient advice appear to have changed little over the years and are often based on tradition, not evidence. Canadian radiation therapy departments use different skin care products and approaches, and there has been little previous work to examine national practice patterns. MATERIALS AND METHODS: This study used a 42-item electronic survey based on a questionnaire designed by the UK Society and College of Radiographers. Practice data were collected related to assessment and prophylactics, interventions for prevention and management, and use of tools and guidelines. The final survey version was distributed to an identified radiation therapist-registered nurse dyad at each radiation therapy department in Canada (n = 44). RESULTS: Thirty-three departments responded (75% response rate). Results suggest a variation in national management. A number of departments continue to advise patients not to wash or use deodorant/antiperspirant despite having evidence to the contrary. There are also unnecessary restrictions on the use and timing of application of lotions as well as conflicting postradiotherapy skin care instructions regarding sun exposure. CONCLUSION: The study demonstrated variation in practice across Canadian radiation therapy departments. National interprofessional guidelines could improve uptake of best practices. Where there is little evidence, a stress-reduction approach with more collaborative decision-making should be used to minimize patient disruption.

Smoothing the Way: The Perception of Unit Supervisor Radiation Therapist Roles at the British Columbia Cancer Agency.

BACKGROUND: The "resource therapist" supervisory radiation therapy roles at the British Columbia Cancer Agency were recently evaluated. METHODS: The process included interviews with resource therapists (n = 22) and an electronic survey of stakeholders including department managers (n = 5) and clinical radiation therapists (RTs) (n = 230). RESULTS: Themes from both sets of data included the ability and advisability of maintaining clinical expertise, role clarity and job creep, and the definition of leadership. The resource therapists were balancing an increasingly complex administrative workload that varied between provincial centres. The understanding of the role differed between stakeholders. Only 48% of the RTs agreed that they had a good idea of what resource therapists do and many desired the resource therapists to be more "hands on." CONCLUSIONS: In agreement with the literature, many resource therapists view themselves as clinicians first and managers second. There is also a marked difference in how the role is viewed between resource therapists and RTs. Role incumbents may benefit from access to more formal preparation, including job shadowing, training, and mentoring. There is also a need to increase understanding of the role across all stakeholder groups.