Factors Influencing Radiation Therapists' Perceptions of Performing Manual Monitor Unit Calculations in a...

Despite increased automation in the field of radiation therapy, the need to perform monitor unit calculations manually still exists for a small number of clinical situations. Challenges in maintaining the skill of performing infrequently occurring clinical tasks have been identified among other health professions, but no study has been performed for similar issues in radiation therapy. The aim of this study was to explore radiation therapists' (RT) perceived changes in comfort level to perform manual calculations (MC), an infrequently occurring clinical task, and to evaluate factors that may have influenced the change in comfort level.

The study sample consisted of RTs working within the radiation therapy department of a cancer hospital. A questionnaire soliticing RTs' comfort level with MC and potential influencing factors was sent to each participant. The difference in responses based on key study variables, including initial mastery of MC, ongoing exposure to MC, recent exposure to MC, and MC continuing education, was analyzed. In addition, a wave analysis was performed to determine whether the responses gathered with the questionnaire were representative of those who did not respond.

Fifty-one responses were obtained. The wave analysis suggested that our study results may reflect the views of those of RTs who were eligible to participate, but did not respond. Ninety percent of the participants reported that their comfort level in performing MC had decreased over the years. A significantly smaller proportion of participants reported being comfortable with orthovoltage MC (14%) compared to other types of MC (75-84%). Participants' years of work experience did not appear to influence their comfort level in performing MC. A higher proportion of participants that had recent or ongoing exposure to MC, including those that performed a MC within the last 12 months, worked in dosimetry, were engaged in on-call activities, or were engaged in continuing education on MC, reported being more comfortable in MC than those participants who did not engage in such activities (91%-92% vs. 47%-71%, P < .001).

Initial mastery and ongoing exposure were identified in the literature as important factors that influence practitioners' ability in performing clinical tasks. Although initial mastery was found to influence comfort level in performing MC, our study also revealed that ongoing exposure may be relatively more important. Lessons drawn from this study will become more important to the field of radiation therapy as more manually performed clinical tasks become less frequent over time. To address potential reduction in RTs' ability in performing this infrequent clinical task, individual radiotherapy departments have historically put in place effective strategies to assure accuracy. Yet, alternatives to performing MC should be explored in order to maximize safety, efficiency, and quality of patient care.