Abstract
The purpose of this scoping review is to examine the literature regarding the development, implementation, scope and extent of Advanced Practice Radiation Therapist (APRT) roles in Australia in peer reviewed journals, government reports, conference proceedings and reports. A search was undertaken of PubMed, Web of Science and CINAHL, the ASMIRT website and, and Google Scholar to identify relevant documents. Combinations of keywords with Boolean operators ((advanced practice) OR (advanced practitioner) OR (specialist)) AND ((radiation therapist) OR (radiation therapy)) were used. Online and physical searches were conducted between July 16 and 23 2017. Results were not date limited. The searches retrieved 352 after duplicates were removed with 46 remaining after filtering for eligibility criteria. Items consisted of journal articles, conference abstracts, presentation slides, online presentations, State government and ASMIRT reports. A number of potential and existing APRT roles were found in the identified articles, including image review, stereotactic, treatment review, breast localisation, palliative radiotherapy, brachytherapy, radiation engineering and urology. Despite reports indicating that radiation therapists in Australia have been concerned with professional directions since 2001, there is little evidence of formal progress towards defined APRT roles. Several centres have implemented roles in a number of practice areas. The success of APRT roles lies in the ability to demonstrate that implementation goals have been achieved and that patient care has improved. The literature suggests that this is occurring, however, the presented evidence is not compelling.
Highlights
The incidence of cancer in Australia is increasing with new diagnoses rising from 124,465 in 2013 to an estimated 134,174.1 Coupled with this, a growing number of people survive their initial cancer diagnosis, but “live with recurrent cancer, requiring ongoing monitoring, treatment, care and support”.2 This growing demand will put increased pressure on the health system, and in particular on cancer services
A search was undertaken of the databases PubMed, Web of Science and CINAHL to identify literature relating to Advanced Practice Radiation Therapist (APRT) roles in Australia
The 2006 Professional Advancement Working Party (PAWP) report delineates the difference between role extension and role expansion, noting that the former is “the acquisition of additional knowledge and skills as a direct result of the increasing demands made upon the professions”[39] whilst the latter refers to “formally and explicitly recognising enlargement of existing scope of practice into new tiers of practice accompanied by additional education, theory and practice”
Summary
The incidence of cancer in Australia is increasing with new diagnoses rising from 124,465 in 2013 to an estimated 134,174.1 Coupled with this, a growing number of people survive their initial cancer diagnosis, but “live with recurrent cancer, requiring ongoing monitoring, treatment, care and support”.2 This growing demand will put increased pressure on the health system, and in particular on cancer services. Radiation therapy is a safe, highly effective treatment for many types of cancer for both cure and palliation.[3] Traditionally, planning, delivery and quality assurance of radiation therapy in the radiation oncology department has been compartmentalised, where tasks are apportioned to radiation oncologists (RO), radiation therapists (RT) and radiation oncology medical physicists (ROMP), based on their specific areas of expertise. This could lead to gaps or delays in service meaning that patients may not receive care as efficiently as possible.
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