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How groups view themselves and each other is very important in order to promote effective work practices. These views can be tribal in nature and lead to stereotyping which may affect how we communicate and act with other groups. This study primarily aims to identify how student radiographers view their own and other radiographic profession.
Method:
A survey was undertaken using the Student Stereotypes Rating Questionnaire with all radiographic training sites in England. The questionnaire was given to radiography students training as either diagnostic radiographers or therapeutic radiographers. It asked students to rate four professions: doctors, diagnostic radiographers, therapeutic radiographers and nurses on nine characteristics.
Results:
The online survey was open between February and July 2019 and elicited 233 responses. Overall, the radiography students’ perceptions of their own profession and the other non-radiography professions were generally positive; however, each radiographic profession’s view on the other radiographic professions was less favourable, the scores being significantly lower than for other professions. The professions each identified unique attributes (interpersonal skills, being a team player and independent working) that separated the professions from each other. Differences and similarities in stereotypes appeared not to change with time, although gender differences for certain attributes did exist.
Conclusion:
Students appear to have preconceived positive stereotype of their own profession and a more negative stereotype of the other radiography profession that appears relatively stable during their training period and was unaffected by interprofessional education.
The aim of this study was to explore the experiences of radiotherapy students on clinical placement, specifically focussing on the provision of well-being support from clinical supervisors.
Materials and methods:
Twenty-five students from the University of the West of England and City University of London completed an online evaluation survey relating to their experiences of placement, involving Likert scales and open-ended questions.
Results:
The quantitative results were generally positive; however, the qualitative findings were mixed. Three themes emerged: (1) provision of information and advice; (2) an open, inclusive and supportive working environment; and (3) a lack of communication, understanding, and consistency.
Findings:
Students’ experiences on placement differed greatly and appeared to relate to their specific interactions with different members of staff. It is suggested that additional training around providing well-being support to students may be of benefit to clinical supervisors.
The impact of COVID-19 social restrictions on mental wellbeing of health professional students during placement is largely unknown. Conventional survey methods do not capture emotional fluctuations. Increasing use of smartphones suggests short message service (SMS) functionality could provide easy, rapid data. This project tested the feasibility and validity of gathering data on Therapeutic Radiography student mental wellbeing during clinical placement via emoji and SMS.
Methods:
Participants provided anonymous daily emoji responses via WhatsApp to a dedicated mobile phone. Additional weekly prompts sought textual responses indicating factors impacting on wellbeing. A short anonymous online survey validated responses and provided feedback on the method.
Results:
Participants (n = 15) provided 254 daily responses using 108 different emoji; these triangulated with weekly textual responses. Feedback concerning the method was positive. ‘Happy’ emoji were used most frequently; social interaction and fatigue were important wellbeing factors. Anonymity and opportunity to feedback via SMS were received positively; ease and rapidity of response engendered engagement throughout the 3-week study.
Conclusions:
The use of emoji for rapid assessment of cohort mental wellbeing is valid and potentially useful alongside more formal evaluation and support strategies. Capturing simple wellbeing responses from a cohort may facilitate the organisation of timely support interventions.
Direct observation in the radiotherapy clinic remains the primary method for the assessment of procedural skills. But with increasing automation and reductions in clinical placement time during the recent pandemic, the role of summative, simulation-based assessment is being revisited. The aim of this article is to share early experiences of using Virtual Environment for Radiotherapy Training (VERT) in the assessment of a palliative, parallel pair, external beam treatment delivery technique in a new pre-registration undergraduate programme.
Methods:
Eight first-year students completed a campus-based individual virtual assessment using virtual patient plans representing metastatic disease in the brain and pelvis and late-stage primary lung tumours. Performance was logged on a 25-item checklist for pre and post-procedure checks and treatment delivery tasks.
Results:
All eight students participated in the assessment with seven students (87·5%) achieving a pass grade at first attempt. The course team observed that participants demonstrated a range of skills and abilities and were able to compare and contrast individual approaches to patient positioning. Specific feed-forward action points were also highlighted as areas for students’ to focus on during their second placement. The project also identified logistical benefits for assessment teams.
Conclusions:
While these experiences are a single snapshot, a VERT simulation-based summative assessment is feasible and identified benefits included controlled observation and structured feedback on individual performance and scheduling pressure reductions for clinical teams. However, more work is needed to determine the psychometric qualities and predictability of performance in more complex techniques.
Emotional intelligence (EI) is an increasingly important aspect of a health professional’s skill set. It is strongly associated with empathy, reflection and resilience; all key aspects of radiotherapy practice. Previous work in other disciplines has formed contradictory conclusions concerning development of EI over time. This study aimed to determine the extent to which EI can develop during a radiotherapy undergraduate course and identify factors affecting this.
Methods and materials
This study used anonymous coded Likert-style surveys to gather longitudinal data from radiotherapy students relating to a range of self-perceived EI traits during their 3-year degree. Data were gathered at various points throughout the course from the whole cohort.
Results
A total of 26 students provided data with 14 completing the full series of datasets. There was a 17·2% increase in self-reported EI score with a p-value<0·0001. Social awareness and relationship skills exhibited the greatest increase in scores compared with self-awareness. Variance of scores decreased over time; there was a reduced change in EI for mature students who tended to have higher initial scores. EI increase was most evident immediately after clinical placements.
Conclusions
Radiotherapy students increase their EI scores during a 3-year course. Students reported higher levels of EI immediately after their clinical placement; radiotherapy curricula should seek to maximise on these learning opportunities.
London South Bank University (LSBU) has successfully implemented Virtual Environment for Radiotherapy Training (VERT) across the therapeutic radiography training curricula and are now supporting the use of VERT for patient education in clinical departments. A number of publications have reported on the use of VERT in education and training; more recent literature has focused on the use of VERT for patient education.
Materials and methods
The successful introduction of VERT before students’ first clinical placements resulted in the development of a ‘Pre-Clinical week’ where students practice and improve their technical skills, using the hand controls without a patient present, leading to increased confidence in clinical practice. Other examples of VERT curriculum integration at LSBU focused on the use of VERT for anatomy teaching. The more recent innovation at LSBU relevant to VERT integration has been the design, development and implementation of collaborative research projects where the aims of the studies were to explore patients’ perceptions of VERT as an information giving resource before radiotherapy delivery.
Summary
The introduction of VERT as education tool has enabled academic staff to develop a range of teaching methods to embed virtual training into the traditional classroom setting, demonstrating innovation and collaboration.
Peer review of treatment plans has been used to improve planning consistency, decrease the need for replanning and improve quality of care through the safe delivery of high-quality radiotherapy plans. This narrative review summarises the clinical benefits and addresses the implementation of peer review of treatment plans in undergraduate medical dosimetry and radiation therapy training.
Discussion
There are encouraging results of peer review for advanced treatment planning techniques such as Stereotactic Body Radiation Therapy techniques in clinical practice. Peer review can be used as a tool to improve students’ knowledge of organ-at-risk contouring, treatment plan critique and quality assurance. These desirable treatment planning skills can be easily transferred to clinical settings. Moreover, there are several potential pedagogical benefits such as improvement in student engagement, better communication skills and provision of synchronous and asynchronous feedback that can positively impact student success and future employment. However, there are several challenges in facilitating its implementation in university settings.
Conclusion
Embedding skills in peer review of treatment plans at undergraduate teaching level can be a powerful tool to impart clinical treatment planning knowledge. This narrative review provides a basis on which to develop an exploratory study of structured peer review activities in a training environment.
This article describes a collaborative project that aimed to develop a patient-centred curriculum in radiotherapy. In the wake of the Francis report in 2013 and a call for compassion to be a central tenet of health programmes, the project was a timely opportunity to enhance the radiotherapy curriculum.
Methods:
Collaboration between university staff and patients and carers using the service improvement model Plan-Do-Study-Act was the method employed for the curriculum project. Two key discussion forums helped shape the curriculum plan, with module and course evaluation continuing to inform developments.
Results:
The key outcome of the project is that it has shaped the 'care' theme evident in the current undergraduate programme. Co-production methods resulted in the development of a range of shared classroom activities that focus on experiences, care values and communication strategies. The new curriculum has evaluated positively and the impact of learning is demonstrated both in the classroom and clinical setting. The project team have also influenced recruitment processes and patient and carer involvement in programme approval is embedded.
Conclusion:
Working together, with patients and carers is an ideal method to enhance the curriculum and reflect the requirements in practice of current health and social care professions. Further developments in student assessment are planned.
The mandatory clinical radiotherapy department visit undertaken by potential applicants aims to provide understanding of the profession and therefore reduce attrition. Increasing pressure on clinical departments makes visits a logistical challenge. This additional step may also present as an unnecessary barrier to applicants. With no evidence relating to visits, this study aimed to explore the perceptions of both students and clinical educators concerning potential benefits and challenges.
Method
A focus group interview method was used to gather in-depth qualitative data concerning the clinical department visit experiences from first-year undergraduate students and clinical educators.
Results
Three themes emerged from the student focus groups: the perceived purpose of the clinical visit, the visit content and the outcomes and impact arising from the visit. Clinical educator data also followed these themes in addition to ‘logistical impact’ theme.
Conclusion
The clinical visit has value to applicants in affirming their decision to study radiotherapy. There is variation in expectation and content for these visits and they are logistically challenging. Nationally agreed guidelines for visit structure and content could improve visit efficiency and effectiveness. A national clinical visit form may reduce workload for educators and applicants.
Student experience on clinical placement is not well captured with traditional program evaluation tools. This study aims to complete a qualitative analysis of the reflective clinical journals completed during professional placement by radiation therapy (RT) students in order to uncover the issues that affect students on placement and how these change as the student's progress through the program.
Materials and methods
A qualitative descriptive analysis (QDA) was undertaken on the descriptive content of student journals completed by 97 students over 3 consecutive years while undertaking professional placement in Radiation Oncology Treatment Centres within Australia. Two coders used a QDA sourcebook specifically designed for the research to independently analyse the descriptive content of the reflective journals for four main categories and 18 subcategories.
Results
The result revealed a statistically significant increased tendency to discuss clinical environment and a decreased tendency to discuss the patient, 92·9–12·5% (coder 1) and 85·7–18·8% (coder 2), as they progressed through the program.
Conclusions
The results of this study showed some similarities with studies completed in other health professions; however, the breadth of issues explored within the content of these RT student journals demonstrates the true diversity of the RT student experience on professional placement.
In many countries, there is a skills gap in proton therapy with many staff unprepared to work with the new technology. The new Virtual Environment for Radiotherapy Training (VERT) proton module provides learners with a simulated proton machine 3D environment. This project aimed to evaluate the role of VERT in training the radiotherapy workforce for the future use of protons.
Methods:
A practical teaching session using VERT was deployed after a traditional teaching session had provided basic knowledge. A questionnaire deployed before and after VERT enabled comparison of knowledge while a combination of Likert and open questions gathered participant feedback concerning the initiative.
Results:
A total of 38 students provided evaluation of the session. Overall, there were high levels of satisfaction and enjoyment with 35 participants reporting enjoyment and 36 indicating that the event be repeated.
Discussion:
Participants felt that they had learned from the experience, although quantitative data lacked statistical significance to demonstrate this. All participants agreed that VERT had provided improved understanding of proton dose deposition arising from visualisation of beams and dose deposition. Most participants agreed that the simulation was realistic and that it had improved their understanding. Feedback in relation to future sessions concerned smaller group sizes, more patient cases, more time and additional clinical datasets.
Conclusion:
A proton simulation module has been shown to be an enjoyable teaching tool that improves students’ confidence in their knowledge of the underpinning theory and clinical usage of the modality. Learners felt better prepared to encounter protons in clinical practice. Future work will build on these findings using smaller group work and a more robust assessment tool to identify long-term impact of the training.
At Queensland University of Technology, student radiation therapists receive regular feedback from clinical staff relating to clinical interpersonal skills. Although this is of great value, there is anecdotal evidence that students communicate differently with patients when under observation.
Purpose
The aim of this pilot was to counter this perceived observer effect by allowing patients to provide students with additional feedback.
Materials and methods
Radiotherapy patients from two departments were provided with anonymous feedback forms relating to aspects of student interpersonal skills. Clinical assessors, mentors and students were also provided with feedback forms, including questions about the role of patient feedback. Patient perceptions of student performance were correlated with staff feedback and assessment scores.
Results
Results indicated that the feedback was valued by both students and patients. Students reported that the additional dimension focused them on communication, set goals for development and increased motivation. These changes derived from both feedback and study participation, suggesting that the questionnaires could be a useful teaching tool. Patients scored more generously than mentors, although there was agreement in relative grading.
Conclusions
The anonymous questionnaire is a convenient and valuable method of gathering patient feedback on students. Future iterations will determine the optimum timing for this method of feedback.
This study aimed to determine the potential role and guidelines for implementation of skill-based peer mentoring for radiotherapy planning education.
Methods
After four weekly mentoring sessions, both Year 3 mentors (n=9) and Year 2 mentees (n=9) were invited to complete a short online questionnaire relating to the impact of the initiative. The tool contained a mixture of Likert-style questions concerning student enjoyment and perceived usefulness of the initiative as well as more qualitative open questions that gathered perceptions of the peer mentoring process, implementation methods and potential future scope.
Results
Several key discussion themes related to benefits to each stakeholder group, challenges arising, improvements and potential future directions. There were high levels of enjoyment and perceived value of the mentoring from both sides with 100% of the 18 respondents enjoying the experience. The informal format encouraged further learning, while mentors reported acquisition of valuable skills and gains in knowledge.
Conclusions
Peer mentoring has a valuable and enjoyable role to play in radiotherapy planning training and helps consolidate theoretical understanding for experienced students. An informal approach allows for students to adopt the most appropriate mentoring model for their needs while providing them with a free space to engender additional discussion.
Radiation oncology information systems (OIS) play a crucial role in radiation therapy by ensuring accurate and safe delivery of treatment. A MOSAIQ OIS system is currently used to support undergraduate radiation therapist training at Queensland University of Technology. This review addresses the rationale for implementation and integration in teaching environments and explores the pedagogical benefits supported by educational theory.
Discussion
A review of MOSAIQ functionality shows potential to transform learning through the development of authentic and engaging learning tasks. It provides students with an opportunity to learn two-dimensional image matching through the use of digitally reconstructed radiographs and electronic portal images as well as three-dimensional image matching using computed tomography (CBCT) data in a safe learning environment without clinical time pressures. In addition, this provides the students with knowledge of quality assurance (QA) checks through the verification of treatment parameters and the transfer of information from the planning system to the treatment units. However, there are several potential challenges and practical considerations that need to be overcome.
Conclusion
The application of MOSAIQ OIS could potentially transform teaching and learning strategies for student radiation therapists. Increased knowledge and hands-on skills at undergraduate levels in areas such as image matching and QA can be powerful tools to drive the standards of practice a step further.
This report discusses the approach to teaching undergraduate radiation therapy students in New Zealand using the Virtual Environment for the Radiotherapy Training (VERT) system. In conjunction with VERT being used to teach clinical skills, integration of conceptual knowledge occurs across all 3 years of the programme; this report gives examples of how this is achieved in practice.
Patient involvement in health profession student training is becoming more common and includes clinical case studies, informing curriculum development and active teaching in dedicated patient experience sessions. Despite a growing evidence base supporting patient involvement, there is little published data concerning motivation for involvement. A qualitative study was performed to provide narrative relating to patient experiences in expert patient sessions on an undergraduate radiation therapy course.
Methods
A phenomenological approach utilised semi-structured interviews with two expert patients from different backgrounds. A common set of questions were used for each participant. Interviews were digitally recorded and transcribed before thematic coding.
Results
Both participants identified areas of similarity as well as key difference in their experiences. Both had different levels of public speaking experience as well as different levels of knowledge relating to radiation therapy treatment. Both found the initial session emotional but ultimately enjoyed the process and found it cathartic.
Conclusion
The patients enjoyed this experience and identified clear value of the teaching for themselves and the students. Previous public speaking or clinical experience seemed to have limited impact on patient experience and suggested the vulnerability of the situation. Both had different perspectives of their fellow patients and their role in the healthcare partnership. These findings indicate the value of ensuring students have access to a range of perspectives from different patients.
To explore student therapeutic radiographers’ understanding of obesity and cancer and to identify if student therapeutic radiographers believe that radiographers should have a role within weight management.
Materials and Methods:
This study used a self-completed online questionnaire (google forms) to collect data from Radiotherapy and Oncology students, studying at one Higher Education Institution, to gain an understanding of their current knowledge of weight management. A retrospective margin of error calculation was carried out, showing a 9% margin of error with a 90% confidence level.
Results:
In total 57 responses were received, n = 50 BSc students and n = 7 pre-registration MSc students. Three key barriers to openly discussing weight loss management with service users emerged from the questionnaire data; these were a lack of time, lack of clear guidelines and lack of confidence. These barriers could potentially be addressed by improving education and training, making it easier for therapeutic radiographers to openly discuss weight management with service users.
Findings:
Awareness of guidelines was suboptimal, with 82% (n = 47) of respondents unaware of any guidelines. In addition to this, the majority of students identified a lack of confidence as a barrier to them providing weight management advice. Despite this, 54·4% of respondents agreed that radiographers should have a role in providing weight management advice, with 22·2% of respondents being unsure. Findings suggest that behaviour change is required amounts both students and staff members, so that healthcare professionals are more inclined to have healthy weight management discussions. Perhaps more specialist roles need to be developed, so that healthy weight management discussions can become a norm.
Studies have investigated the prevalence of compassion satisfaction and compassion fatigue in various healthcare professions. However, the majority of evidence is linked to the nursing profession and little is known about paramedical professions such as radiography and even less is known about its prevalence in students. The purpose of this study was to describe the levels of compassion satisfaction and compassion fatigue in the student population and how they varied in time.
Methods
Students undertaking radiotherapy training at the researcher’s host sites were surveyed using the Professional Quality of Life questionnaire at the end of each final clinical block in each year of their training.
Results and conclusion
During the 3 years of training compassion satisfaction falls and burnout increases in the student population, although the change is not significant. Secondary traumatic stress increases significantly during the 3 years of training, F=5·725, p=0·005. Considerable variation also exists in the three scores dependent on the student’s clinical training site. Relationships are also observed between some personality traits, particularly conscientiousness and neuroticism and compassion scores.
Pre-registration teaching of radiotherapy planning in a non-clinical setting should allow students the opportunity to develop clinical decision-making skills. Students frequently struggle with their ability to prioritise and optimise multiple objectives when producing a clinically acceptable plan. Emerging software applications providing quantitative assessment of plan quality are designed for clinical use but may have value for teaching these skills. This project aimed to evaluate the potential value of automated feedback to second year BSc (Hons) Radiotherapy students.
Materials and methods
All 26 students studying a pre-registration radiotherapy planning module were provided with automated prediction of relative feasibility for left lung tumour planning targets by planning metrics software. Students were also provided with interim quantitative reports during the development of their plan. Student perceptions of the software were gathered using an anonymous questionnaire. Independent blinded marking of plans was performed after module completion and analysed for correlation with software-assigned marks.
Results
In total, 25 plans were utilised for marking comparison and 16 students submitted feedback relating to the software. Overall, student feedback was positive regarding the software. A ‘strong’ Spearman’s rank-order correlation (rs=0·7165) was evident between human and computer marks (p=0·000055).
Conclusions
Automated software is capable of providing useful feedback to students as a teaching aid, in particular with regard to relative feasibility of goals. The strong correlation between human and computer marks suggests a role in benchmarking or moderation; however, the narrow scope of assessment parameters suggests value as an adjunct and not a replacement to human marking.