Investigating opinions of, and perceptions to, advanced practice radiation therapist roles.

Introduction: The demand for cancer services is growing due to increased incidence and the number of people who survive their initial diagnosis but require ongoing therapy. One method of increasing capacity in radiation oncology is to delegate tasks from one professional group to another. In the last ten years there has been increasing interest in advanced practice radiation therapist (APRT) roles. The majority of the Australian literature relates to metropolitan radiation oncology centres with a paucity of information from regional or rural settings. This study sought to explore the knowledge of, and attitudes to APRT roles of members of three professional groups in public radiation oncology centres in Tasmania.

Method: Data was collected through a self-reported online survey from radiation oncologists (RO), radiation oncology medical physicists (ROMP) and radiation therapists (RT) working in Tasmanian public radiation oncology services regarding their knowledge and understanding of APRT roles, acceptance and support for the roles and where APRTs could contribute to improving patient care. The survey incorporated a combination of five point Likert scale, Yes/No/Don't know and Yes/No/Not Applicable choices. The survey was reviewed by a professional panel of RT, RO and ROMP from mainland Australian radiation oncology centres.

Results: At the time of survey invitation, there were 52 RTs, 7 ROs, and 7 ROMPs working in the identified departments. The survey had an overall response rate of 48.5%with profession specific response rates of 48.1% (RT), 42.9% (RO) and 57.1% (ROMP). General agreement was found amongst survey respondents with regards to understanding of APRT roles having themes of clinical expertise, leadership, communication, collaboration and teaching. Where participants were offered a list of tasks to choose those appropriate to APRT roles, the highest agreement was with "Contour organs at risk per protocol", "Image review - soft tissue online decision making/adaptive RT" and "Principal investigator in clinical research. The notion of establishing ARPT roles was well supported, as strong agreement was found with the statements related to improvement in job satisfaction, opportunities, recruitment and retention for RTs, and that APRTs could be used to relieve workload of other professionals.

Conclusion: This exploratory study found that the respondents were generally in favour of APRT roles, but that they were not clear about the tasks to be performed by APRTs. It was identified that patients, ROs, ROMPs, RTs and the department would benefit from the implementation of APRT roles. Sseveral areas of practice were identified by respondents which they perceived would improve the quality of patient care.