S2841
RTT - RTT education, training, and advanced practice
ESTRO 2026
Competency assessment included bolus design review, treatment plan evaluation, clinical judgment, and on-treatment bolus application. Per departmental policy, the APRT was authorized to perform custom bolus placement for all nine attending physicians. For each patient, the APRT conducted a pre-verification review of bolus design and collaborated with the dosimetrist and physician as needed. During treatment verification, the dosimetrist remained present while the APRT assumed the physician’s in- room role; physicians remained available for consultation. Verification photographs were uploaded to the electronic medical record to confirm accuracy and safety. At this institution, physicians typically dedicate approximately 25 minutes per patient to bolus placement. Results: From January 1, 2024, to November 7, 2025, APRT-led custom bolus placement was performed for 42 patients, including 23 head and neck, 5 abdomen, 4 skin and soft tissue, 3 breast, 3 thorax, 3 pelvis, and 1 extremity prescription. All bolus placements were verified as accurate, with no treatment delays, replans, or safety incidents. In two head and neck cases, the APRT identified bolus discrepancies and escalated concerns to the physician, resulting in immediate corrective action. Radiation oncologists reported improved workflow efficiency, reduced interruptions during clinical tasks, and high confidence in APRT-led
feedback will indicate areas to improve for PCC and inform initiatives for increasing resilience. Keywords: Radiotherapy, resilience, students References: [1] Porritt, BM. “The Lived Experience of the Student Therapeutic Radiographers When Caring for Patients with Cancer in the Clinical Placement Setting….” University of Salford, UK; 2023. See www.proquest.com/dissertations-theses/lived- experience-student-therapeutic- radiographer/docview/3171104292/se- 2?accountid=12117[2] Campbell-Sills, L and Stein, MB. “Psychometric analysis and refinement of the Connor- Davidson Resilience Scale (CD-RISC): validation of a 10- item measure of resilience” J Trau Stress 20(6):1019- 1028, 2007[3] Alberta Health Services (AHS). “The Voice of Patients: Patient Experience/Satisfaction Surveys Core Questions” 2011. See https://albertahealthservices.ca/assets/info/res/if- res-rpi-patient-experience-core-questions.pdf Digital Poster 5034 Integrating an APRT in Custom Bolus Placement: A Feasibility and Workflow Optimization Study clodagh A Starrs, Maria Dimopoulos, Kunal SIndhu Radiation Oncology, Mount Sinai Hospital, New York, USA Purpose/Objective: Advanced Practice Radiation Therapists (APRTs) increasingly assume clinical responsibilities traditionally performed by radiation oncologists, supporting efficient, high-quality radiation oncology care. Custom bolus placement—typically completed by physicians during treatment verification—is one such task-shifted activity (1,2) that can disrupt clinical workflow and redirect physician time away from other responsibilities. With targeted clinical training, APRTs possess the technical expertise in immobilization, patient orientation, laser alignment, and treatment reproducibility required to perform this procedure safely and effectively. This study evaluates the feasibility, safety, and workflow impact of APRT-led custom bolus placement following structured training and competency validation. Material/Methods: A pilot APRT program was implemented at a high- volume U.S. academic radiation oncology department. Training included disease-specific anatomy, treatment intent, tumor and nodal considerations, and technical principles of bolus fabrication and application. The APRT completed 15 supervised clinical cases across three competency levels—direct supervision, autonomous practice with retrospective review, and independent practice—with each case reviewed and approved by a supervising radiation oncologist.
procedures Conclusion:
Integration of an APRT for custom bolus placement demonstrates a safe, feasible, and efficient workflow model that preserves treatment accuracy while reducing physician interruptions. This task-shifted approach enhances multidisciplinary collaboration, optimizes resource utilization, and supports sustainable radiation oncology practice Keywords: Advanced Practice, Clinical work optimization References: .Duffton A, Harnett N, McNair H, Tsang Y. RTT advanced practice and how it can change the future of radiotherapy. Radiography (Lond). 2024;30(1)World Health Organization; PEPFAR; UNAIDS. Task shifting: rational redistribution of tasks among health workforce teams – global recommendations and guidelines. Geneva, Switzerland: World Health Organization; 2007.
Proffered Paper 5174
A multi-Phase, mixed-methods methodology for establishing advanced practice radiation therapist global preparation standards
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