ESTRO 38 Abstract book

S625 ESTRO 38

Results Nine RT departments were assessed during the course of this audit, representing a 75% response rate. The national mean level of compliance with current best practice was 67%, with overall compliance to the recommendations for environmental layout (65%), clinical practice (67%) and staff training (75%). Only the latter achieved the target level of compliance. Conclusion Improvement of areas such as environmental layouts, dementia-focused protocols and education, as well as establishing links with other healthcare professionals and departments, will enable centres to meet all current standards of best practice in the future. PO-1127 The development and initial evaluation of a simulated clinical radiotherapy training centre. S. Ketterer 1 , P. Bridge 1 1 University of Liverpool, Department of Radiotherapy- School of Health Sciences, Liverpool, United Kingdom Purpose or Objective While the radiotherapy clinical environment is a source of rich learning for therapeutic radiography students, workload pressure on clinical departments can impact on implementation and support of placements as well as restrict learning opportunities. Although evidence supports use of simulation for health profession training, much of this is based on students’ self-assessment of enjoyment and perceived learning. Simulation activities are also generally restricted to specific aspects of the role and rarely provide a realistic representation of the daily workload. This study aimed to determine the feasibility of developing and evaluating an integrated simulation placement capable of simulating a real radiotherapy department. The project also aimed to scope the potential to reduce the clinical training burden by directly replacing some clinical weeks with simulation. Material and Methods The project commenced with a scoping exercise that identified the range of activities, tasks and skills development expected from a first year student on their clinical placement. This was then mapped to existing and potential simulation equipment and activities. Realism was provided by “branding” of the facility as a virtual department, while actors and service users provided a range of patients for students to engage with. Students were randomised to simulation or clinical placement and then their assessment scores following placement were compared. Results A two-week integrated simulation placement was successfully developed and implemented within an academic department. The core simulation workspaces comprised a couch with alignment lasers, mould room water-bath, computed tomography scanner, virtual linear accelerator, radiotherapy planning consoles and virtual reality headsets. The placement was populated with academic and clinical staff, with actors and service users providing “patient” contact. Initial evaluation indicated that students valued the structured approach of the placement and the opportunity to gain familiarity with techniques in a safe unpressured environment. The ability to learn from mistakes was perceived to be particularly valuable. Comparison of assessment scores demonstrated equivalence of learning for the simulated placement. The integrated and prospectively designed learning experience of the simulation placement is targeted to the specific learning outcomes of the placement and in some cases led to improved learning compared to clinical placement. Conclusion Results from this study indicate that an integrated radiotherapy simulation placement can be undertaken successfully in a dedicated academic facility. The placement can be used to prepare students for more

adjuvant or neoadjuvant anthracycline and taxans based chemotherapy and 28 (70%) received adjuvant hormonal treatment. Thirty-six patients were treated with breast conserving surgery and 4 by mastectomy. All patients were treated with normofractionated radiotherapy with a dose of 50Gy to breast or chest wall and LN if indicated, and a dose of 63Gy to the boost volume in case of indication. There were 15 (45%) left side and 22 (55%) right side breast cancers. Median follow-up was 47 months. Among them, 27 patients (67.5%) received irradiation to regional LN including internal mammary chain (IMC). Every patient received optimal CTV and PTV coverage of 96-98%. The mean heart dose was: 8Gy (3.5-10.8). The mean lung V20Gy was 20.8% (7.2-29.2) to ipsilateral lung. The contralateral breast received mean dose of 4.7Gy (2.5- 6.1). The HT was well tolerated with grade 1 (67.5%) and 2 (30%) acute skin reactions and only 1 (2.5%) grade 1 acute esophagitis. Concerning late toxicities, we observed only 4 cases (10%) with grade 1 fibrosis. No cardiac toxicity was observed. At last follow-up, there was only 1 local recurrence, no regional LN recurrence and 3 (7.5%) metastatic progressions. Conclusion HT is useful for this very much selected group of PE breast cancer patients for whom the conventional radiation therapy techniques cannot ensure an optimal homogeneous dose distribution or cannot respect the constraints to the OAR. Longer follow-up is necessary to confirm and validate these results in this population of patients. PO-1126 Caring for Patients with Dementia Undergoing Radiation Therapy – A National Audit A. O'Donovan 1 , J. Flood 1 1 Applied Radiation Therapy ARTT research group, Discipline of Radiation Therapy- Trinity College Dublin, Dublin, Ireland Purpose or Objective The number of people with dementia is increasing in conjunction with the rapid growth of the older aged population in many countries worldwide. More people with dementia will also be diagnosed with cancer and may require radiotherapy at some stage of their disease trajectory. It is therefore necessary that care is taken to ensure that the Radiation Therapy (RT) department practice environment meets criteria for good practice in dealing with patients with dementia, in order to limit distress whenever practically possible. The primary aim of this national audit was to investigate Irish radiation therapy departments, with regard to dementia care in the areas of the department environment, clinical practice and staff training. Material and Methods The audit was conducted according to recommendations for best practice and universal design, particularly those of the Society and College of Radiographers (UK), the dementia friendly environment/dwelling guidelines and the King’s Fund. The audit took place between September and November 2017. The environmental assessment consisted of six standards encompassing orientation, mobility, security, continence, wellbeing, and meaningful interaction. Clinical practice consisted of four standards encompassed by patient rights, informed consent, holistic care, and patient autonomy. Staff education and training was divided into the standards of training and support. Poster: RTT track: Education and training/role development