The evolving radiation therapist role in a multidisciplinary palliative radiotherapy clinic.

158 Background: Radiation therapists (MRTT) have been integrated in varying capacities into outpatient palliative radiotherapy (PRT) services across Canada for nearly two decades. We explored the experience of our centre's MRTTs who have developed an essential role over nine years, from supporting one half-day PRT clinic per week to five full days of clinical, technical, research, and administrative involvement.

METHODS: An electronic survey was distributed to all 12 MRTTs who contributed to the PRT program (2007-2016), which was later supplemented by in-person semi-structured interviews. Qualitative analysis of the responses was undertaken to discern common themes. These were contextualized within the operational changes to our multidisciplinary clinical model, from pilot to integrated service.

RESULTS: Among seven respondents (range of PRT-specific experience: 1-5 years), five answered all questions. From the narratives, three common themes emerged: responsibilities, challenges, and opportunities. Responsibilities identified included: PRT planning/delivery (cited 13 times), patient assessment (12), multidisciplinary collaboration (MDC) (8), research (8), navigation (7), clinic process innovation (5), administration (5), communication (4), and education (2). Challenges described included: lack of support (cited 10 times), lack of shared understanding (5), high workload (5), pushback from colleagues (3), and inadequate staffing (2). However, opportunities outnumbered challenges, in terms of evolution of involvement in MDC (cited 13 times), patient care (8), increased autonomy (6), professional growth (5), role variation (5), scope of practice expansion (2), and being the team's key contact for referrals (2). The range of MRTT experiences, responsibilities and challenges encountered reflected specific PRT clinical and operational conditions.

CONCLUSIONS: As our PRT service model has evolved from short-term pilot to fully integrated departmental service, so has the MRTT role. MRTTs contributing to PRT as part of a MDC model are supportive of advancing non-traditional involvement in the holistic palliative care of patients with advanced cancer.