RESUMEN
BACKGROUND: The "resource therapist" supervisory radiation therapy roles at the British Columbia Cancer Agency were recently evaluated. METHODS: The process included interviews with resource therapists (n = 22) and an electronic survey of stakeholders including department managers (n = 5) and clinical radiation therapists (RTs) (n = 230). RESULTS: Themes from both sets of data included the ability and advisability of maintaining clinical expertise, role clarity and job creep, and the definition of leadership. The resource therapists were balancing an increasingly complex administrative workload that varied between provincial centres. The understanding of the role differed between stakeholders. Only 48% of the RTs agreed that they had a good idea of what resource therapists do and many desired the resource therapists to be more "hands on." CONCLUSIONS: In agreement with the literature, many resource therapists view themselves as clinicians first and managers second. There is also a marked difference in how the role is viewed between resource therapists and RTs. Role incumbents may benefit from access to more formal preparation, including job shadowing, training, and mentoring. There is also a need to increase understanding of the role across all stakeholder groups.
RESUMEN
BACKGROUND: Canadian radiation therapy departments usually have flat organizational structures, with relatively few administrative/managerial levels. The "unit supervisor" level is a typical job role that provides direct supervision of one or more treatment units with a mixture of clinical and administrative duties. METHODS: At the British Columbia Cancer Agency, the unit supervisor role was recently evaluated. One approach used as part of the evaluative process was a series of telephone interviews to examine similar roles across Canada (n = 9). RESULTS: Data indicated that departmental administrative tasks seem to be increasing significantly, and there is a move toward the addition of more administrative "middle" roles across the country to deal with these. Unit supervisor roles are subsequently becoming less clinical, but there is an emerging tension with moving away from solely clinical responsibilities and assuming more administrative work. CONCLUSIONS: The historic unit supervisor role was part of the team and did little administrative work. This model is becoming difficult to sustain, and tensions can arise in this new environment when using old organizational models. Focused departmental clinical expertise is important; however, balancing clinical and administrative expectations within the unit supervisor role can be problematic. Role expectations need to be examined, clarified, and communicated within departments. If unit supervisor roles are deemed clinical experts, then clinical time needs to be protected for expertise to be sustained.
RESUMEN
BACKGROUND: To be less resource intensive, we developed a template-based breast IMRT technique (TB-IMRT). This study aims to compare resources and dose distribution between TB-IMRT and conventional breast radiation (CBR). METHODS: Twenty patients with early stage breast cancer were planned using CBR and TB-IMRT. Time to plan, coverage of volumes, dose to critical structures and treatment times were evaluated for CBR and TB-IMRT. Two sided-paired t tests were used. RESULTS: TB-IMRT planning time was less than CBR (14.0 vs 39.0 min, p < 0.001). Fifteen patients with CBR needed 18 MV, and 11 of these were planned successfully with TB-IMRT using 6 MV. TB-IMRT provided better homogeneity index (0.096 vs 0.124, p < 0.001) and conformity index (0.68 vs 0.59, p = 0.003). Dose to critical structures were comparable between TB-IMRT and CBR, and treatment times were also similar (6.0 vs 7.8 min, p = 0.13). CONCLUSIONS: TB- IMRT provides reduction of planning time and minimizes the use of high energy beams, while providing similar treatment times and equal plans compared to CBR. This technique permits efficient use of resources with a low learning curve, and can be done with existing equipment and personnel.