Qualitative Study of Interprofessional Collaboration in Radiation Oncology Clinics: Is There a Need for Interprofessional Education?

Abstract

Interprofessional education (IPE) is gaining recognition as a means of improving healthcare delivery and patient outcomes. A primary goal of IPE is improved interprofessional collaboration (IPC). The multidisciplinary team in the radiation oncology clinic requires effective IPC for optimal delivery of radiotherapy. However, there are limited data on IPE and IPC in radiation oncology. This qualitative study aims to characterize IPC and IPE in radiation oncology. Semi-structured phone interviews with radiation oncologists, nurses, dosimetrists, radiation therapists, medical physicists, and medical students across a single academic medical center and affiliated network sites were performed from June to August 2019. Interviews were recorded, de-identified, and transcribed verbatim. Resulting transcripts were analyzed using constructivist grounded theory methodology. Seventeen interviews were performed with four radiation oncologists, two nurses, two dosimetrists, four radiation therapists, two medical physicists, and three medical students. Grounded theory analysis identified four themes: 1) Management of the radiation oncology clinic, 2) Current climate of interprofessional education in radiation oncology, 3) Potential impact of interprofessional training in radiation oncology, and 4) Creating an interprofessional training program in radiation oncology. Each theme elicited between 2-7 subthemes. From the analytical themes that emerged, it is hypothesized that misunderstanding radiation oncology health professionals’ roles can lead to communication breakdown, which creates less efficient clinic management and disorganized patient care. While other radiation oncology professionals shadow physicians during their training, physicians are not learning about these professions in the same way. Interviewees from each professional category recommend a formal shadowing program for radiation oncology medical trainees at the resident or medical student level. Having structured opportunities for IPE is important given competing demands of learners during residency and medical student rotations. This study suggests an unmet need for exposure of radiation oncology medical trainees to IPE with the ultimate goal of improving IPC in the radiation oncology clinic.