Ready for the Big Time: Provincial Formalization of an APRT(T) Class of Practice

Abstract

Purpose/Aim

The growth of advanced practice in radiation therapy requires pan-Canadian infrastructure to standardize, streamline, and incentivize related roles across the country. A national certification model that certifies advanced radiation therapy practice has been in place since 2017, administered by the Canadian Association of Medical Radiation Technologists (CAMRT). This confers the protected title of Advanced Practice Registered Technologist (Therapy), or APRT(T), on those meeting the requirements. The next logical step in solidifying safe and standardized advanced practice is to define a separate regulatory class for APRT(T)s in provinces where regulation of medical radiation technology (MRT) professions exists. The CAMRT convened a task group of radiation therapists with expertise in advanced practice and issues of self-regulation in Ontario, Alberta, British Columbia (BC), and Nova Scotia, to prepare the way for future action on extended class practice for APRT(T)s.

Methods/Process

The CAMRT APRT(T) Regulation & Legislation Task Group set out to accomplish three tasks: 1) Define the specific tasks and responsibilities that distinguish advanced practice from standard practice in radiation therapy, as it relates to formal regulated scopes of practice in each Ontario, Alberta, and Nova Scotia, and future regulation in BC. 2) Enlist the preliminary support of provincial regulatory bodies and other stakeholders for the Task Group work to define a separate regulatory class for APRT(T)s 3) Map provincial legislative and regulatory processes and prepare evidence and materials to formalize the new APRT(T) role Using the national APRT(T) competency profile, provincial legislation that defines controlled acts, restricted activities, and profession-specific regulations (depending on the province), and an inventory of medical directives and delegations held by currently certified APRT(T)s, the Task Group identified the areas where legislative and regulatory change would be required to formalize an APRT(T) class of practice. Following relevant guidance, documentation was prepared to initiate the process to create a separate class in each province.

Results or Benefits/Challenges

Recognizing a separate class of practice for APRT(T) will support consistent and sustainable implementation of this important role. APRT(T)s will be able to practice autonomously and to full scope without additional delegations, medical directives or support structures. A separate category of self-regulated practice may also incentivize centres to invest in new models of care that involve APRT(T)s. More importantly, in the interest of public safety, it will ensure that engagement in an advanced scope of radiation therapy practice is restricted to those formally confirmed to have the requisite knowledge, skills, and judgement through national certification. The differences in provincial legislation and regulation of practice, the modest number of APRT(T)s currently practicing in the country, and the ongoing challenges in socializing the relevant radiation medicine professional communities to the nature of advanced practice all present challenges that require expert attention to ensure the success of this initiative.

Conclusions/Impact

A collaborative and concerted approach to creating an advanced class of license for APRT(T)s where MRT practice is self-regulated in Canada will support efforts to advance this important role in cancer care.