ESTRO 2023 - Abstract Book

S365

Sunday 14 May 2023

ESTRO 2023

Kingdom; 6 Buckinghamshire New University, School of Health Care and Social Work, Buckinghamshire, United Kingdom; 7 The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Radiotherapy, Surrey, United Kingdom Purpose or Objective The study aims to explore perceptions of the four pillars of Advanced Practice (AP): clinical practice, education, research, leadership and management in the current practice and education of Radiation Therapists (RTTs) across Europe from stakeholders' perspectives. Materials and Methods A qualitative descriptive study was conducted using individual semi-structured interviews (online). Purposive and convenience sampling was used to recruit stakeholders across Europe (advanced practitioners, RTTs, managers, educators, postgraduate students, professional associations representatives and regulatory bodies representatives). Interviews (n=33) were conducted between June and early September 2022 (average: 47 minutes). Full verbatim independently transcriptions were checked by both interviewer and interviewees. Four researchers independently coded the transcriptions using inductive thematic analysis. The COREQ guideline guided the study process. Results The interviewees' in-depth insights were from 16 European countries. Most stakeholders valued all pillars of AP. However, gaps in the research pillar on the current practice of advanced practitioners were highlighted, and a lack of leadership and management content in the AP programmes was noted. Sub-themes related to AP challenges were common between countries and included staff recruitment and retention issues, lack of postgraduate education specific to AP in radiotherapy, AP clarity and standardisation at national and European levels, lack of recognition of “advanced practitioner” profile and regulation, educational and training needs for specific AP roles, etc. Conclusion Efforts should be made to enhance the pillars of research, leadership and management in the practice and education of RTTs. Standardisation of the AP level is recommended for the sustainability of this workforce transformation demanded in the European agenda. A legal framework including the four pillars of AP is urgently needed to support the education and practice of AP roles amongst RTTs in the current and future radiotherapy landscape. This study provides a sound basis for radiotherapy advanced practice research whereby future research should include other stakeholders, such as other healthcare professionals from the interprofessional teams, policymakers, patients, and the public. OC-0462 Using the right tools to do the job right; evaluating a RTT decision-making framework in gynae IGRT J. Rodgers 1 , A. Booth 1 , C. Triffitt 1 , L. Barraclough 2 , A. Fatimilehin 2 , K. Haslett 2 1 The Christie NHS Trust, Radiotherapy, Manchester, United Kingdom; 2 The Christie NHS Trust, Clinical Oncology, Manchester, United Kingdom Purpose or Objective IGRT in gynaecological cancer treatment can be challenging due to the complexities presented by variations in target and OAR position. Referral online to departmental IGRT advanced practitioner radiographers (IGRT APRTT) represents an initial escalation when issues are detected by treatment RTTs. Decision making by IGRT APRTTs can be subjective and introduces a level of uncertainty during the online IGRT process. The most important decision is whether to stop the treatment workflow and intervene or continue to treat. The clinical gynaecological team within the authors department acknowledged this and wanted to provide robust protocols that would aid decision making for IGRT APRTTs in online scenarios. The aim of this audit was to evaluate the effectiveness of the developed framework. Materials and Methods 30 consecutive radically planned cervix and endometrial patients were selected for retrospective review. Departmental protocol is to image daily. All relevant XVI images, defined as when the treatment workflow was halted and patient taken off the treatment couch, were reviewed by the clinical gynaecological team to consider if the intervention was necessary or whether treatment should have continued. Based on their judgements thematic trends were categorised and a decision making framework was constructed to cover common scenarios with recommended actions dependent on thresholds and established action levels based on severity: • Green - proceed to treat

• Amber- proceed to treat with intervention offline

• Red - do not treat. The framework was introduced to the IGRT APRTT team after stakeholder approval. Once established a further 30 consecutive patients were sampled to assess the effect of implementation of repeat imaging. No further changes within the department were made that might influence IGRT review.