Radionuclide Therapies —
Training activity: 4

Details

Perform contamination monitoring and decontamination of a treatment room post radionuclide therapy administration

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 SOPS
• Choice of appropriate monitor
• Appropriate use of contamination monitor
• Decontamination of surfaces
• Determining radiation level at which the room can be released to the ward or restrictions that need to be used

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?
  • What is your understanding of what constitutes successful contamination monitoring (systematic, thorough, and accurately documented) and effective decontamination for this specific treatment room?
  • How will you ensure that you correctly identify any contamination, reduce it to acceptable levels, and confirm the room is safe for subsequent use while strictly applying radiation safety principles?
  • Have you discussed these expectations with your training officer to gain full clarity on the specific requirements for monitoring and potentially decontaminating this room after therapy?
• What is your prior experience of this activity?
  • Thinking about your prior experience, have you observed this activity before, and how has your work in other areas (such as dose preparation) prepared you to use the necessary monitoring equipment and decontamination techniques?
  • What possible challenges do you anticipate—such as identifying low-level contamination or dealing with difficult-to-remove spills—and how have you planned to handle these while managing your own exposure risk?
  • Do you clearly recognise your scope of practice, specifically knowing when contamination levels are beyond your ability to manage independently and at what point you must stop to seek help from a supervisor or Radiation Waste Adviser (RWA)?
  • How do you feel about embarking on this specific training activity?
• What do you anticipate you will learn from the experience?
  • What specific skills do you want to develop, such as improving your technique for systematic coverage, your ability to interpret results accurately, or your documentation of the clearance process?
  • What specific insights do you hope to gain, such as identifying common areas where contamination occurs or evaluating the effectiveness of different decontamination agents?
• What additional considerations do you need to make?
  • Have you consulted the actions for improvement identified from your previous observations of room clearances or contamination incidents?
  • Have you reviewed all critical information before starting, including the radionuclide used, the activity administered, the required detector types, necessary PPE, and the relevant departmental SOPs for room clearance?

In action

• Are you noticing anything surprising or different from what you anticipate during the monitoring or decontamination process?
  • Are you encountering situations such as:
    • Higher than expected contamination levels
    • Finding contamination in unexpected areas
    • Difficulty decontaminating a specific surface or type of contamination
    • Equipment failure or inconsistent readings from monitoring equipment
    • Discovering contamination outside the immediate treatment area
    • Running low on decontamination supplies or waste containers
  • How does this experience compare with previous experiences of similar activities?
• How is this impacting your actions? For example, are you responding to the situation appropriately?
  • Are you adapting or changing your approach to monitoring or decontamination? Is it affecting your ability to undertake the activity independently?
  • Consider the steps you are taking in the moment, such as:
    • Are you immediately stopping the process and reassessing?
    • Are you changing your monitoring technique or pattern?
    • Are you switching decontamination agents or methods?
    • Are you reinforcing control measures (e.g., cordon off area)?
    • Are you seeking advice from a supervisor, RPA, or health physics staff?
  • 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 contamination within standard procedures, or does the situation require escalation to someone with greater authority or expertise (e.g., declaration of a significant spill or incident)?
  • What are you learning in this moment as a result of any unexpected development? For example, are you learning the most effective way to decontaminate a particular surface or the importance of double-checking monitoring equipment calibration?

On action

• Begin by summarising the key points of the experience of performing contamination monitoring and potentially decontamination.
  • Describe the specific steps you undertook, including using monitoring equipment and decontamination materials.
  • Consider specific events, actions, or interactions that felt important during the activity, including your own feelings during the experience. This might include challenges with performing the monitoring correctly, identifying contamination, or the decontamination process itself.
  • 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., finding unexpected levels of contamination, difficulty decontaminating an area), 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 effective contamination monitoring techniques, applying decontamination procedures, or ensuring radiation safety in the treatment environment?
  • What strengths did you demonstrate during the activity?
  • Were you effective in performing thorough monitoring, following decontamination protocols, or applying radiation protection principles?
  • What skills and/or knowledge gaps were evident?
  • Was there anything you were unsure about regarding specific monitoring points, decontamination agents, or safety precautions?
  • 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 monitoring and decontaminating rooms?
  • Identify any challenges you experienced (beyond unexpected events already noted) 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 monitoring results or decontamination steps? Or did you need to escalate something (e.g., persistent high contamination) 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 contamination monitoring and decontamination? Will you change your monitoring pattern or decontamination technique?
  • Has anything changed in terms of what you would do if you were faced with a similar situation again, particularly regarding handling unexpected contamination findings or difficulties with decontamination?
  • Do you need to practise any aspect of the activity further? Are there specific practical skills related to monitoring equipment or decontamination procedures 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 contamination monitoring and decontamination of a treatment room)?
  • When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to monitoring technique, interpreting results, selecting appropriate decontamination methods, or adhering to safety protocols?
  • 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 the importance of thorough monitoring, effective decontamination techniques, or emergency procedures?
• 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 skill in monitoring and decontamination prepare you for a DOPS like ‘Monitor and decontaminate a room post radionuclide therapy’?
  • How has your practice related to contamination monitoring and decontamination developed and evolved over time across multiple instances of undertaking this training activity?
  • Can you identify specific examples of improvement or increased confidence in identifying contamination, performing decontamination efficiently, or documenting procedures?
  • Based on your experiences, how has your ability to recognise when something related to contamination levels, the extent of decontamination required, or dealing with a significant spill is beyond your scope of practice improved?
  • Do you have a clearer understanding of when and from whom (e.g., RPA, supervisor) you need to seek advice or clarification?

Relevant learning outcomes

#	Outcome
# 3	Outcome Apply and advise on, the principles of radiation safety associated with radionuclide therapies.
# 4	Outcome Perform monitoring measurements to determine a radionuclide therapy patient’s point of release and follow appropriate decontamination procedures.