Innovative Education Method for a More Effective, Faster, and Valued Training in Radiation Therapy Treatment Planning

ObjectivesDue to radiotherapy automation, competencies of radiation technologists (RTTs) change, and training methods are challenged. This study aims to develop, and pilot test an innovative training method based on lean management principles.MethodsA new training method was developed for lung cancer treatment planning (TP). The novelty is summarized by including a stable environment and an increased focus on the how and why of key decision making. Trainees have to motivate their decisions during TP process, and to argue their choices with peers. Six students and six RTTs completed this training for lung cancer TP. Effects of the training were measured by 1) quality of TP, using doses in organs at risk and target volumes, 2) perceived experiences (survey), measured at baseline (T0); after peer session (T1); six months later (T2). Finally, training throughput time was measured.ResultsAt T0, RTTs showed a larger intragroup interquartile range (IIR) (2,63Gy vs 1,51Gy), but lower mean doses to heart and esophagus than students (6,79Gy vs 8,49Gy; 20,87Gy vs 24,62Gy). At T1, quality of TPs was similar between RTTs and students (IIR: 1,39Gy vs 1,33Gy) and no significant differences in mean dose to heart and esophagus (4,48Gy vs 4,69Gy; 17,75Gy vs 18,47Gy). At T2, students still performed equal to RTTs (IIR: 1,07Gy vs 1,45Gy) and achieved lower maximum dose to esophagus (44,75Gy vs 46,45Gy). The training method and peer sessions were experienced positive: at baseline (T0): 8 score on a scale 1-10, directly after the peer sessions (T1): 8 by the students and 7 by the RTTs, after nine months (T2): 9 by the students and 7 by the RTTs. Training throughput time decreased from twelve to three months.ConclusionsThis training method based on lean management principles was successfully applied to training of RTTs for lung cancer TP. Training throughput time was reduced dramatically and TP quality sustained after six months. This method can potentially improve training efficiency in diverse situations with complex decision-making. Due to radiotherapy automation, competencies of radiation technologists (RTTs) change, and training methods are challenged. This study aims to develop, and pilot test an innovative training method based on lean management principles. A new training method was developed for lung cancer treatment planning (TP). The novelty is summarized by including a stable environment and an increased focus on the how and why of key decision making. Trainees have to motivate their decisions during TP process, and to argue their choices with peers. Six students and six RTTs completed this training for lung cancer TP. Effects of the training were measured by 1) quality of TP, using doses in organs at risk and target volumes, 2) perceived experiences (survey), measured at baseline (T0); after peer session (T1); six months later (T2). Finally, training throughput time was measured. At T0, RTTs showed a larger intragroup interquartile range (IIR) (2,63Gy vs 1,51Gy), but lower mean doses to heart and esophagus than students (6,79Gy vs 8,49Gy; 20,87Gy vs 24,62Gy). At T1, quality of TPs was similar between RTTs and students (IIR: 1,39Gy vs 1,33Gy) and no significant differences in mean dose to heart and esophagus (4,48Gy vs 4,69Gy; 17,75Gy vs 18,47Gy). At T2, students still performed equal to RTTs (IIR: 1,07Gy vs 1,45Gy) and achieved lower maximum dose to esophagus (44,75Gy vs 46,45Gy). The training method and peer sessions were experienced positive: at baseline (T0): 8 score on a scale 1-10, directly after the peer sessions (T1): 8 by the students and 7 by the RTTs, after nine months (T2): 9 by the students and 7 by the RTTs. Training throughput time decreased from twelve to three months. This training method based on lean management principles was successfully applied to training of RTTs for lung cancer TP. Training throughput time was reduced dramatically and TP quality sustained after six months. This method can potentially improve training efficiency in diverse situations with complex decision-making.