Radionuclide Therapies —
Training activity: 1

Details

Perform personalised prior radiation risk assessments for individual radionuclide therapy patients and provide radiation protection advice including:

• Inpatient therapies
• Outpatient therapies

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Local and national radiation legislation
• Patient’s home/work circumstances
• Tailoring advice to individual circumstances
• Communication with patients
• Patient centred care and support
• Carers and comforters

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What does success look like?
  • Have you identified exactly what is expected of you in relation to this activity, and what is your understanding of what constitutes a successful personalised risk assessment and effective advice for both inpatient and outpatient scenarios?
  • How will you ensure that the advice you provide aligns with appropriate legislation (such as IRR and EPR) and your specific departmental procedures?
  • Have you discussed the particular patient scenario with your training officer to gain full clarity on the expectations for your performance in this instance?
• What is your prior experience of this activity?
  • Thinking about your prior experience, what is your current understanding of performing risk assessments for therapy patients, and have you had the opportunity to observe this activity or complete relevant academic study?
  • What possible challenges do you anticipate—such as patient anxiety, language barriers, complex family situations, or clinical factors like renal function—and how have you planned to handle these issues if they arise?
  • Do you clearly recognise your scope of practice, specifically knowing when you must seek advice or help from a supervisor, Radiation Waste Adviser (RWA), or senior colleague regarding complex cases or regulations?
  • How do you feel about embarking on this training activity—for example, do you feel confident, anxious, or technically prepared?
• What do you anticipate you will learn from the experience?
  • What specific skills do you want to develop through this activity, such as improving your communication techniques for sensitive information, your ability to apply regulations to individual circumstances, or your documentation skills?
  • What specific insights do you hope to gain, such as a deeper understanding of how patient-specific factors significantly influence the final radiation protection advice?
• What additional considerations do you need to make?
  • Have you consulted actions identified from your previous experiences of similar tasks to ensure you are focusing on the specific areas you previously noted for improvement?
  • Have you identified all the important information required before starting, such as the patient’s medical history, the radionuclide and activity to be administered, and the relevant national regulations and SOPs?

In action

• Are you noticing anything surprising or different from what you anticipate during the process of performing the risk assessment or providing advice?
  • Are you encountering situations such as:
    • Unexpected information arising from the patient’s history or living situation that complicates standard advice
    • Difficulty in assessing or communicating the risk effectively to the patient or their carers
    • Questions from the patient or staff that you are finding challenging to answer immediately
    • Discovering inconsistencies in available patient information
  • How does this experience compare with previous experiences of similar activities?
• How is this unexpected development impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to the assessment or advice? Is it affecting your ability to undertake the activity independently?
  • Consider the steps you are taking in the moment, such as:
    • Are you pausing the assessment or advice session?
    • Are you consulting procedures or guidelines?
    • Are you seeking clarification or advice from a supervisor or colleague?
    • Are you modifying the way you are presenting information?
  • How are you feeling in this moment? For example, are you finding it difficult to adapt? Is it affecting your confidence? Are you feeling positive you can reach a successful conclusion?
• How is any unexpected development being resolved as you progress during the activity?
  • How are you working within your scope of practice? Are you successfully managing the situation yourself, or do you need support because it is beyond your current scope?
  • What are you learning in this moment as a result of any unexpected development? For example, are you learning a new way to phrase advice or a key piece of information to look for in a patient’s history?

On action

• Begin by summarising the key points of the experience of performing the radiation risk assessment and providing advice.
  • Describe the specific steps you undertook, including gathering patient information and communicating with the patient.
  • Consider specific events, actions, or interactions that felt important during the activity, including your own feelings during the experience. This might include challenging questions from the patient or specific details of their circumstances that influenced the assessment.
  • Include any ‘reflect-in-action’ moments, where you adapted to the situation as it unfolded. Recall anything that felt surprising or different from what you anticipated (e.g., unexpected patient history, difficulty understanding the patient’s living situation relevant to restrictions), and how you reacted to that unexpected development in the moment.
• Identify what learning you can take from this experience. For example, what did you learn about gathering information for risk assessments, applying legislation to specific patient scenarios, or effectively communicating complex radiation protection advice and restrictions?
  • What strengths did you demonstrate during the activity? Were you effective in eliciting necessary information or explaining risks clearly to the patient?
  • What skills and/or knowledge gaps were evident? Was there anything you were unsure about regarding specific restrictions, legislation, or handling patient anxieties?
  • Compare this experience against previous engagement with similar activities (if any). Have any previously identified actions for development been achieved? Has your practice improved in performing risk assessments or providing advice?
  • Identify any challenges you experienced and how you reacted to these. Did these challenges affect your ability to deal with the situation? Were you able to overcome the challenges?
  • Identify anything significant about the activity. Did you need to seek advice or clarification from a supervisor or colleague regarding the assessment or advice? Or did you need to escalate something to ensure you were working within your scope of practice?
• Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learnt. This includes learning from any feedback you have received.
  • What will you do differently next time you perform a personalised radiation risk assessment or provide radiation protection advice? Will you approach information gathering or explanation differently?
  • Has anything changed in terms of what you would do if you were faced with a similar situation again, particularly regarding handling unexpected patient circumstances or questions?
  • Do you need to practise any aspect of the activity further?
  • Are there specific skills related to risk assessment, communication, or applying legislation you want to develop further, drawing upon this experience?

Beyond action

• Have you revisited your previous reflections (reflect-before-action, reflect-in-action, and reflect-on-action) for this specific activity (performing personalised prior radiation risk assessments and providing radiation protection advice)?
  • When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to assessing patient-specific risks or communicating advice effectively?
  • Have you completed these previously identified actions? If not, what are the barriers? If so, how did completing them impact your subsequent performance of this activity?
  • Are you ready to demonstrate this new learning confidently and consistently when performing this task?
  • Has discussing these experiences with others changed your view or understanding of patient risk assessment and communication in this context?
• Considering your cumulative experiences and reflections on this activity, how will the learning you have gained support you in preparing for relevant observed ‘in-person’ assessments for the module? For example, how does your improved ability to assess and communicate risk prepare you for an Observed Communication Event (OCE) like ‘Perform patient risk assessment for radionuclide therapy with a patient’ or a Case-based Discussion?
  • How has your practice related to performing radiation risk assessments and providing advice developed and evolved over time across multiple instances of undertaking this training activity?
  • Can you identify specific examples of improvement or increased confidence in handling complex patient situations or tailoring advice?
  • Based on your experiences, how has your ability to recognise when something related to a patient’s risk assessment or the required advice is beyond your scope of practice improved?
  • Do you have a clearer understanding of when and from whom (e.g., Radiation Protection Adviser (RPA), medical physics expert, supervisor) you need to seek advice or clarification?

Relevant learning outcomes

#	Outcome
# 2	Outcome Identify and explain the post-therapy behavioural radiation restrictions including the effective communication of risk to patients and personnel.
# 3	Outcome Apply and advise on, the principles of radiation safety associated with radionuclide therapies.