Training activity information
Details
Undertake a treatment plan adaption strategy for at least one patient and critically appraise its efficacy and impact on the patient
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Off-line or on-line adaption
- Assessment of target or normal tissue changes triggering a re-plan
- Plan-of-the-day adaptive planning
- MRI or other image-guided on-line plan adaption
- Reconciliation of any changes to planned dose by accumulation or other strategy
- Patient centred care and support
- Patient safety and treatment efficacy
- Communication of recommendations to clinical colleagues and treatment staff
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 are the reasons for adapting a treatment plan?
- What are different adaptation strategies?
- What data is required to inform the adaptation?
- How will the efficacy and impact on the patient be appraised?
- Have you discussed the specific patient case and potential adaptation strategies with relevant staff?
- How will you assess its efficacy and impact?
- What challenges might you encounter?
- How do you feel about critically appraising a treatment strategy and its impact on a patient?
In action
- What imaging modalities are being used to inform the adaptation?
- What specific changes are being made to the treatment plan parameters?
- How are you assessing the efficacy of the adaptation in terms of target coverage and OAR sparing?
- What considerations are you taking regarding the impact on the patient (e.g., treatment duration, potential side effects)?
- What metrics are you using to evaluate the adaptation?
- Are you able to effectively implement the necessary changes in the treatment planning system?
- Is the adapted plan achieving the desired dosimetric goals?
- Are you observing any potential issues with the adapted plan or its delivery?
- If the initial adaptation strategy is not achieving the desired outcomes or if unexpected issues arise, what alternative adaptation approaches are you considering?
- Are you consulting with experienced colleagues or reviewing relevant literature?
- How are you communicating the changes and their rationale to the clinical team and the patient?
On action
- What were the reasons for considering treatment plan adaptation? What imaging or other data triggered the need for adaptation? What were the steps involved in adapting the treatment plan? How was the efficacy of the adaptation assessed (e.g., target coverage, OAR sparing)? What was the perceived or reported impact of the adaptation on the patient?
- What did you learn about your understanding of adaptive radiotherapy principles, your ability to implement plan modifications using treatment planning systems, and your skills in critically evaluating the outcomes of plan adaptations? Did you identify any limitations in your knowledge of different adaptive strategies or evaluation methods?
- How will this enhance your understanding of adaptive radiotherapy principles and techniques? How will this improve your ability to contribute to the development and implementation of adaptive strategies? What further learning or experience in different adaptive radiotherapy workflows would be beneficial?
Beyond action
- Looking back at the treatment plan adaption you undertook, what have you learned about the process and its impact on the patient that you might apply differently now?
- How has this experience since shaped your understanding of the role and complexities of adaptive radiotherapy?
- Have you been involved in other treatment plan adaptations since this activity? How did your reflections on this initial experience influence your subsequent actions?
- How has your experience with treatment plan adaptation since contributed to your current practice in implementing and evaluating adaptive radiotherapy strategies?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Generate, adapt and evaluate treatment plans using complex techniques. |
| # 4 |
Outcome
Critically appraise the application of radiotherapy treatments and techniques and make recommendations considering safety, efficacy, outcomes and the suitability and impact on the patient. |
| # 5 |
Outcome
Evaluate the application of novel and evolving techniques and treatments in radiotherapy. |
| # 7 |
Outcome
Assess the quality of practice and make recommendations for improvements. |
| # 8 |
Outcome
Practice effectively as part of a multidisciplinary team to provide safe, patient centred radiotherapy treatments. |