Amanda Bolderston

The scholarly radiation therapist. Part one: charting the territory

As radiation therapy practice evolves with advancing treatment and planning technologies, merging of imaging modalities, changing working models and the advancement to higher education, radiation therapists are frequently finding themselves on the frontline of translating new knowledge into practice. To a large degree, this growing involvement in self-directed original research, with associated dissemination of completed results, has led to an increasing number of therapists being encouraged to pursue an academic path in addition to a clinical career. In Canada, radiation therapists are being appointed as faculty to university departments for the first time. It is heartening that such opportunities are increasing; therapists are able to play a profound role in developing an evidence-based professional body of knowledge while at the same time being recognised for scholarly endeavours. However, despite these many positive steps, barriers and challenges to the development of a scholarly culture for radiation therapists still exist. Part one of this two-part series explores the history of the profession and the subsequent development of a scholarly culture.

The scholarly radiation therapist. Part two: developing an academic practice—the Princess Margaret Hospital experience

Part two of this two-part series presents the results of a departmental initiative implemented in 2003 at a large urban cancer centre, Princess Margaret Hospital (PMH) in Toronto, Ontario, Canada. This new model for radiation therapists was called Advanced Integrated Practice (AIP) and was developed, in part, to encourage and promote scholarship within radiation therapy. The AIP model incorporated integrated clinical specialty roles designed to blend exemplary clinical practice with focused academic activities. This paper discusses an evaluation of the AIP model undertaken to obtain a formal measure of how the model had evolved, how the radiation therapists and other stakeholders were responding to the new model, whether the initial outcomes were realized and to create plans for further development of the design. The evaluation utilized a mixture of traditional qualitative research methodologies such as focus groups, quantitative surveys and a variety of other available measurable outcomes. Outcomes from the model included increased opportunities for diverse roles that incorporated an element of academic practice and augmented career choice and scope for radiation therapists. In addition, academic output and research work also increased within the department. Lessons learned from the implementation and evaluation of the model are shared, and the authors offer some suggestions to increase scholarly activity within the profession.

Maintaining competence: a holistic view of continuous professional development

Continuous professional development (CPD) is regarded as an essential component of working life for radiation therapists and is increasingly being used by professional associations to ’prove’ the competence of their members. In the past, CPD activities have primarily been viewed as an individual responsibility, and have focused on maintaining a professional knowledge base and, subsequently, hands-on competency through didactic learning. However, there are drawbacks associated with this model; and concentrating on only one facet of learning ignores other theoretical areas of knowledge acquisition. This article explores several areas of social and organisational theories of learning including social networks, communities of practice, learning organisations, knowledge management, knowledge translation and research utilisation. It is concluded that maintenance of competence after graduation is multilayered and should be viewed in a holistic manner to incorporate some of the relevant elements of the concepts discussed. This article also offers some suggestions for the individual wanting to maximise their educational opportunities beyond traditional models of CPD.

Encouraging reflection: Do professional development workshops increase the skill level and use of reflection in practice?

Reflection is a way of evaluating best practice and challenging existing norms, while at the same time, considering one’s personal values and assumptions in our personal and professional lives. However, many health practitioners may lack the skills to do this effectively. Through participation in a series of three workshops, practitioners in the Radiation Medicine Program at Princess Margaret Hospital have learned and acquired new skills to encourage reflection and reflective practice in themselves, their colleagues as well as with their students. A pre- and post-course survey was used to ascertain their level of knowledge of reflection and reflective practice. An additional survey at 3 months assessed the frequency of use and ongoing comfort level with reflective practice. Results of the evaluation indicate that the participants’ knowledge of reflective practice has improved their understanding of reflection in clincal practice. They recognize the importance of reflection and anticipate increasing their use of reflection in/on practice. As well, participants have been able to sustain the positive momentum 3 months after the course was delivered.