Advanced practice in radiotherapy across Europe: stakeholders' perceptions of implementation and evolution.

Area of Science:

• Radiotherapy workforce development
• Healthcare professional advancement
• European healthcare systems

Background:

• Workforce innovation through skills-mix and task-shifting optimizes radiotherapy services.
• Advanced practitioners (APs) operate beyond initial registration across clinical practice, leadership, education, and research.
• Limited research exists on advanced therapeutic radiographers/radiation therapists (TR/RTTs) in Europe.

Purpose of the Study:

• To investigate European radiotherapy stakeholders' perceptions of current and future advanced practice (AP).

Main Methods:

• Online semi-structured interviews were conducted with 33 stakeholders from 16 European countries (June-September 2022).
• Interviews were transcribed verbatim and analyzed thematically using NVivo, guided by Braun and Clarke's seven steps.

Main Results:

• Participants identified research as a neglected AP pillar due to lack of time, skills, funding, and competing clinical priorities.
• Key themes included AP drivers, challenges, enablers, and the journey to becoming an AP.
• Stakeholders emphasized the need for consistent job titles, harmonized education, defined AP requirements, and integrated support for all AP pillars.

Conclusions:

• The profession and education of TR/RTTs are not harmonized across Europe, impacting advanced practice.
• Advanced TR/RTTs should encompass all four pillars, with research and leadership integrated into master's programs.
• A significant policy gap exists in the education and practice of APs in radiotherapy.