Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"From Barriers to Bridges: Understanding IEMRTs’ Experiences with Canadian Certification and Integration","authors":"Lisa Wallace,&nbsp;Charlene Song,&nbsp;Arya Joshi,&nbsp;Alyssa Manalo,&nbsp;Mikki Campbell","doi":"10.1016/j.jmir.2026.102409","DOIUrl":"10.1016/j.jmir.2026.102409","url":null,"abstract":"<div><h3>Purpose</h3><div>Explores certification journeys of internationally educated MRTs (IEMRTs) who achieved Canadian certification to inform co-design of a national experiential bridging program.</div></div><div><h3>Methods</h3><div>Semi-structured focus groups (n = 12) and interviews (n = 2) conducted Dec 2024–Feb 2025 with IEMRTs certified 2022–2024; inductive thematic analysis.</div></div><div><h3>Results</h3><div>Peer support and mentorship were critical across credential assessment, exam preparation, and workforce integration. Access to Canadian experience varied. Employment pathways were non-linear; barriers included immigration uncertainty and recognition of prior practice.</div></div><div><h3>Conclusion</h3><div>A holistic approach combining peer support with system-level coordination is essential to sustainably integrate IEMRTs into the Canadian workforce; insights informed the co-design of a national experiential bridging program.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102409"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Imaging and Dosimetry after Radiotheranostics Lutathera Treatment for Neuroendocrine Tumours","authors":"Zaynab Muraj,&nbsp;Caroline Marr,&nbsp;Tara Rosewall,&nbsp;Rebecca Wong,&nbsp;Brandon Driscoll,&nbsp;Ivan Yeung,&nbsp;Judy Gabrys,&nbsp;Ibrahim Alrekhais,&nbsp;Aruz Mesci,&nbsp;Yat Man Tsang,&nbsp;Andrea Shessel","doi":"10.1016/j.jmir.2026.102408","DOIUrl":"10.1016/j.jmir.2026.102408","url":null,"abstract":"<div><h3>Purpose</h3><div>Post-treatment SPECT imaging is essential for assessing radiopharmaceutical uptake and informing dose calculations to tumours and organs. The objective of this study was to investigate patients’ understanding of individualized dosimetry and SPECT imaging post radiotheranostics treatments.</div></div><div><h3>Methods</h3><div>Quality improvement study using semi-structured telephone interviews with patients treated with Lutathera (2022–2024). Interviews explored SPECT attendance, purpose, communication, familiarity with “dosimetry,” expectations, and additional information needs. Transcripts analyzed using Braun and Clarke’s reflexive thematic analysis by two reviewers.</div></div><div><h3>Results</h3><div>Interviews with ten participants reached information saturation. Most felt well-informed but noted inconsistencies in SPECT duration and flow. “Dosimetry” was unfamiliar to many, but participants understood imaging assessed treatment uptake. Some connected results to decisions (dose escalation or discontinuation). Radiation safety concerns emerged, suggesting the need for proactive communication and support.</div></div><div><h3>Conclusion</h3><div>As radiotheranostics evolve, effective knowledge translation to patients is essential. Patients understood the rationale for post-treatment imaging and highlighted areas for better communication and support.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102408"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Healthcare Design Thinking to Redesign Tertiary Care Head and Neck Cancer Triaging","authors":"Jeeun An,&nbsp;Charlie Wang,&nbsp;Nikhil Uppal,&nbsp;Mankeert Dhillon","doi":"10.1016/j.jmir.2026.102371","DOIUrl":"10.1016/j.jmir.2026.102371","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Delays in head and neck (H&amp;N) cancer triaging at tertiary care centers are frequently driven by incomplete diagnostic imaging at the time of referral, resulting in prolonged referral holds, workflow inefficiencies, and increased patient anxiety. Clinical challenges and imaging-related bottlenecks were identified through frontline practice in a Clinical Specialist Radiation Therapist (CSRT) role, informing an interdisciplinary eHealth design project. This practice innovation initiative aimed to redesign the H&amp;N triaging workflow using a healthcare design thinking approach to improve imaging acquisition processes, enhance triage efficiency, and support timely access to specialist consultation and treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A clinician-led healthcare design methodology was applied through an eHealth lens. Current-state workflow mapping identified variability and pressure points across referral pathways from community-based specialists. Persona and empathy mapping captured the experiences of patients, referring providers, and triaging staff, informing a redesigned workflow focused on earlier imaging acquisition and standardized referral processing. The proposed solution integrates two components. First, a revised triaging workflow introduces a proposed CSRT imaging medical directive to enable timely pre-ordering of diagnostic imaging when referrals are incomplete or imaging timelines are delayed, supported by partnerships with external imaging resources through an academic alliance. Second, a narrowly scoped AI-enabled virtual assistant supports triaging staff by flagging missing documentation, identifying imaging status, and prioritizing referrals based on urgency. The AI functions as decision support rather than autonomous clinical decision-making. A phased pilot using iterative Plan–Do–Study–Act cycles is proposed, beginning with workflow changes and medical directive use, followed by integration of the AI assistant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Key anticipated benefits include reduced referral hold times, improved triage consistency, decreased administrative burden for triaging staff, and earlier patient access to specialist consultation. The proposed redesign builds on established CSRT practice roles and existing clinical governance frameworks, with imaging medical directives envisioned as a future extension. Challenges include change management, alignment across multiple referral sources, and the need for careful governance of digital tools to ensure transparency, safety, and clinician trust.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Based on clinical workflow modelling, the redesigned triaging pathway is expected to reduce referral-to-consult delays and decrease triaging review time. Earlier imaging acquisition is anticipated to improve downstream readiness for treatment planning and reduce overall treatment wait times. This initiative demon","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102371"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Psychological Safety in Adaptive Radiotherapy: An Escalation of Concern Process","authors":"Fatima Hashmi,&nbsp;Enoch Kong,&nbsp;Renee Christiani,&nbsp;Stephen Russell,&nbsp;Stephen Breen,&nbsp;Darby Erler,&nbsp;Susan DeSousa","doi":"10.1016/j.jmir.2026.102345","DOIUrl":"10.1016/j.jmir.2026.102345","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Adaptive radiotherapy requires teams to adjust each patient’s treatment plan daily based on changing anatomy, demanding quick, and high-stakes decisions. After a significant safety event during a gastrointestinal (GI) case on the MR-Linac, incident analysis found that team members often hesitated to speak up and were unsure of how to escalate a concern or what to do if it wasn’t acknowledged. These findings highlighted gaps in psychological safety which is the shared belief that team members can speak up without fear of blame or judgment. The Quality Committee led the development of an Escalation of Concern (EOC) process to close that gap and provide a clear, structured method for voicing and resolving concerns before patient safety was at risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;The MR-Linac was chosen as the pilot site. The EOC process was developed in collaboration with MR-Linac medical radiation therapists (RTTs), medical physicists (MPs), and radiation oncologists (ROs). It adapted the Two-Step Challenge method from high-reliability industries. Staff first completed short online modules covering when to escalate, what language to use (“I am concerned...”), and common barriers. This built a shared foundation for open communication and psychological safety, which were some of the defined learning objectives of the program. Two pilot series were completed, each consisting of six one-hour simulation sessions. Each team member participated in one session within teams modeled after real MR-Linac groups, with ROs, MPs, and MRTs training together as they normally work. This structure made the learning realistic and directly transferable to practice. Sessions were co-developed and delivered with the Sunnybrook Canadian Simulation Centre. Each included structured debriefing and pre/post surveys to evaluate learning outcomes, confidence, and perceptions of psychological safety. The first pilot involved the MR-Linac GI team (seven MRTs, seven ROs, three MPs) to test workflow fit, and the second included three MPs and thirteen ROs to assess multidisciplinary communication and learning outcomes&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Pre- and post-training surveys demonstrated large educational benefits, with significant improvements in knowledge of the escalation process, standardized language, and the Two-Step Challenge (mean scores increased from 2.9 to 4.7, 2.2 to 4.6, and 2.5 to 4.6, respectively; all p &lt; .05). Confidence in identifying when escalation was appropriate also improved significantly (3.7 to 4.6, p &lt; .05). Psychological safety scores improved modestly. Qualitative feedback described the training as “eye-opening” and indicated that shared language reduced fear of sounding confrontational when speaking up. Challenges included small sample sizes and more limited gains in psychological safety, reflecting the complexity and time required for cultural change.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102345"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Timeliness of Inpatient Palliative Radiation Therapy (PRT): A Retrospective Analysis to Inform Practice Improvements","authors":"Carrie Lavergne,&nbsp;Shawn Binda,&nbsp;Jenelle Abram,&nbsp;Brian Leung","doi":"10.1016/j.jmir.2026.102368","DOIUrl":"10.1016/j.jmir.2026.102368","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Palliative radiation therapy (PRT) is an effective intervention for symptom control in patients with advanced cancer. While most PRT is delivered in the outpatient setting, some patients require inpatient treatment due to symptom burden, functional status or social factors. At XXX hospital, non-urgent PRT is typically initiated within four days of CT simulation, and delivered on weekdays only. Anecdotally, many inpatients remain hospitalized for the duration of their PRT to support coordination of care and symptom management, yet are discharged on the day of or shortly after treatment completion. In alignment with the hospital’s 2025/26 corporate priority to reduce length of stay and improve patient flow, this project aimed to evaluate the current state of inpatient PRT delivery and identify opportunities to improve access, experience, and potentially reduce inpatient length of stay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Following Research Ethics Board approval, a retrospective review was conducted of all patients admitted to XXX Hospital who received PRT between January 1 and December 31, 2024. Patient data was extracted from the electronic medical record (EPIC) and merged with Activity Level Reporting (ALR). The dataset was refined to focus on singular treatment timelines (one simulation plus one course of treatment per admission). A treatment summary was generated using PowerQuery in Excel to calculate time-based intervals. Weekend treatment patterns were examined by identifying instances where patients remained inpatients over weekends during which PRT was not delivered.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The retrospective design of the study introduced data quality challenges, including multiple PRT courses within a single admission, re-simulations, and missing data elements. Despite these limitations, a cohort of 504 inpatients receiving PRT was identified. Of these, 143 patients (28.4%) were discharged on the day of or day following their final PRT fraction, suggesting that discharge timing was closely linked to treatment completion for over a quarter of inpatients. Notably, 80 of these patients (55.9%) remained hospitalized over a weekend during which no PRT was delivered, accounting for 172 potentially avoidable inpatient bed days in 2024. Analysis of the interval from CT simulation to PRT initiation is ongoing and will be presented at the RTI3 Conference.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;In Canada, the average cost of acute-care inpatient bed day is estimated at approximately $1,100. For patients awaiting discharge primarily to complete PRT, early initiation and completion of treatment may offer meaningful personal, financial and system-level benefits. Two key opportunities were identified to support the hospital objective of reducing inpatient length of stay for patients receiving PRT: (1) expanding access to weekend and holiday PRT, and (2) reducing the inter","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102368"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Oncologists’ Perspectives on Clinical Specialist Radiation Therapists Prescribing Medications and Ordering Imaging.","authors":"Maggie C. Huang,&nbsp;Marcia Smoke,&nbsp;Thomas Farrell,&nbsp;Jasleen Uppal,&nbsp;Krista McGrath","doi":"10.1016/j.jmir.2026.102390","DOIUrl":"10.1016/j.jmir.2026.102390","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;As the Clinical Specialist Radiation Therapist (CSRT) role continues to expand, standardizing advanced practices such as prescribing medications and ordering diagnostic imaging under medical directives remains an opportunity and a challenge. Considering the perspectives of Radiation Oncologists (ROs) is important in understanding the feasibility of implementing prescriptive and diagnostic imaging ordering authority for CSRTs across Ontario. The study intends to evaluate ROs’ perspectives on CSRTs prescribing medication, and ordering imaging, as well as on their perceived impact on workflow efficiency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Based on a literature review done by the authors and input from a panel of experts, a 14-question anonymous quantitative survey was developed on LimeSurvey using a 5-point Likert scale, along with multiple-choice and binary-response items. This was done to assess the ROs’ perceived confidence in workflow efficiency and care associated with CSRTs. The survey was reviewed by a RO before its distribution and was sent to 31 ROs across the Greater Toronto Area and Hamilton region; 13 responses were received. A statistical analysis of these responses were conducted using one-tailed and two-tailed sign tests, and a Kruskal-Wallis test identified any gender-based differences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The ROs did not express statistically significant (p &gt; 0.05) data on their perception of patient confidence in CSRTs prescribing medications. However, they agreed that having CSRTs prescribe medications (p=0.0001) and order images (p=0.0032) under medical directives would reduce their workload. Results showed statistically significant confidence (p &lt; 0.05) among ROs in having CSRTs prescribe analgesics, antiemetics, anti-diarrheals, antifungals, magic mouthwash, and Flamazine under medical directives. ROs also expressed confidence (p &lt; 0.05) in CSRTs ordering contrast and non-contrast imaging. However, confidence was not statistically significant (p &gt; 0.05) for higher-risk medications such as anxiolytics, coanalgesics, corticosteroids, opioids, and hydrocortisone. Interestingly, although not statistically significant, ROs showed more agreement in having CSRTs prescribe opioids than hydrocortisone, suggesting that familiarity and clinical context may influence prescriber confidence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Findings indicated high RO confidence in CSRTs prescribing lower-risk medications, aligning with literature on other advanced practice professions. Whereas variations in higher-risk prescribing suggest the need for continued professional development to strengthen interprofessional trust. These results highlight the importance of interprofessional collaboration in advancing and standardizing the CSRT role across cancer centres. While ROs recognize the workflow benefits of CSRT involvement, hesitancy in delegating comp","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102390"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Pedagogical Principles for APRT Graduate Education: Evidence from a Multi-Phase Global Study","authors":"Maria P. Dimopoulos,&nbsp;Samantha Skubish,&nbsp;Yat Tsang,&nbsp;Caitlin Gillan,&nbsp;Nicole Harnett","doi":"10.1016/j.jmir.2026.102354","DOIUrl":"10.1016/j.jmir.2026.102354","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>As advanced practice radiation therapist (APRT) roles continue to expand globally, there remains a lack of standardized, pedagogy-informed guidance for APRT education preparation. This study synthesized global evidence to identify core principles necessary to rationalize and establish APRT graduate programs.</div></div><div><h3>Methods/Process</h3><div>A multi-phase, mixed methods design was employed, including: a scoping review of education required for advanced practice competency in healthcare, comparative analysis of APRT degree programs, an international survey of APRTs, a SWOT analysis, and global multi-disciplinary focus groups. Analytic emphasis was placed on educational design features, including learning theory, competency progression, mentorship structures, and assessment strategies; and mapped these onto APRT role expectations. Methodological triangulation occurred during a two-day immersive workshop utilizing structured concept mapping.</div></div><div><h3>Results or Benefits/Challenges</h3><div>Data sources included 11,346 scoping review records (14 eligible studies), 56 submitted surveys (11 countries, 74.7% response rate), criteria of five APRT degree programs, and qualitative input from 33 participants across four focus groups (four administrators/MD leaders, nine APRTs, 10 educators, seven gatekeepers). Integrated analysis produced the APRT Global Preparation Standards (GPS) model, identifying six pedagogical principles underpinning effective APRT education: (1) hybrid, flexible delivery to support diverse learner needs; (2) experiential learning anchored in physician mentorship and competency-based assessment; (3) context-responsive curriculum adaptable to variable workforce demands; (4) master’s-level training reinforced with structured clinical immersion; (5) curriculum content aligned to clinical, leadership, education, and research domains; and (6) graduate outcomes tied to cognitive autonomy, advanced clinical reasoning, and professional identity formation. The model emphasizes competency progression, reflective practice, and skills acquisition pathways, providing a blueprint for implementation. The GPS model emphasizes competency progression, reflective practice, and deliberate skills acquisition pathways as essential mechanisms for advanced practice preparedness.</div></div><div><h3>Conclusions/Impact</h3><div>his study contextualizes global evidence to establish pedagogically grounded educational principles for APRT preparation. The GPS model supports graduate-level APRT pedagogy and provides a foundation for building scalable, academically rigorous education programs across North America.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102354"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Practice Paradox: Radiation Therapists’ Perspectives of Person-Centred Care","authors":"Caroline Marr,&nbsp;Michael Velec,&nbsp;Yat Man Tsang","doi":"10.1016/j.jmir.2026.102347","DOIUrl":"10.1016/j.jmir.2026.102347","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Person-centred care (PCC) involves treating patients as partners in their own care by being responsive to their individual goals, values, and preferences. When PCC is practiced by radiation therapists (RTTs), patient satisfaction has increased, psychological distress has decreased, anxiety has reduced, and technical understanding has enhanced. Yet the prevalence of PCC practices among RTTs remains unknown. This study aimed to address this gap by assessing the level of PCC practiced and exploring RTT perspectives on care delivery across Canada.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A national cross-sectional survey of RTTs was conducted across Canada. Eligible participants were practicing RTTs who were currently practicing in Canada. The questionnaire was developed and pilot-tested with RTTs for clarity and relevance. It was also reviewed with a patient with lived experience going through radiation therapy. The 18 questions included: 1) demographics; 2) levels of PCC practice measured using the validated Person-Centred Care Assessment Tool (P-CAT); 3) frequency of performing key PCC practices endorsed by a provincial guideline, and 4) open-ended questions about perspectives on PCC. The survey was distributed via email and flyers by the Canadian Association of Medical Radiation Technologists (CAMRT) and radiation therapy managers. Descriptive statistics were performed in RStudio (Version 2025.05.1+513). Qualitative analysis of the open-ended questions was conducted in NVivo (Version 15) using Braun and Clarke’s thematic analysis to identify prevalent themes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;From July to September 2025, 318 RTTs completed the survey. RTTs were of a mean age of 39.7 ± 11.3 years, predominantly female (82.4%) with a college or bachelor’s degree (84.9%). The median (range) P-CAT score was 43 (18-57), out of a possible 65, with higher scores indicating greater PCC. The frequency (%) of RTTs performing the five PCC practices “very often” were practicing the essential requirements of care (53.1%), having continuity of care and timely communication (38.4%), tailoring radiation therapy to the patient (29.9%), knowing the patient as an individual (29.9%), and enabling patients to actively participate in their care (22.0%). Qualitative analysis identified five common themes regarding RTT’s perspectives of PCC: 1) supporting patient participation, 2) collaborative, trusting relationship, 3) understanding the person holistically, 4) systemic and structural barriers, and 5) tailoring care to the person.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;This is the first multi-centre study exploring PCC practices within the RTT scope. Canadian RTTs self-report delivering moderate-to-high PCC, based on PCAT. However, despite the importance of supporting patient participation, only a minority report performing this often, revealing a significant gap between values and reported practices.","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102347"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Radiation Therapist Roles in Adaptive Radiation Therapy: A Pan-Canadian Assessment and Upskilling Framework","authors":"Winnie Li,&nbsp;Amanda Moreira,&nbsp;Michael Velec,&nbsp;Jennifer Dang,&nbsp;Nicole Harnett,&nbsp;Patricia Lindsay,&nbsp;Peter Chung,&nbsp;Yat Tsang,&nbsp;Tara Rosewall","doi":"10.1016/j.jmir.2026.102403","DOIUrl":"10.1016/j.jmir.2026.102403","url":null,"abstract":"<div><h3>Purpose</h3><div>Adaptive radiation therapy (ART) is a closed-loop process that modifies treatment plans based on anatomical changes observed during therapy. While ART is increasingly recognized as a key advancement in precision radiation therapy, its implementation across Canada remains variable. This study explores the current status of ART nationally and examines the evolving roles and training needs of Radiation Therapists (RTTs) to inform recommendations for a competency framework supporting advanced image-guided ART.</div></div><div><h3>Methods</h3><div>A multi-phase, mixed-methods approach was employed. Phase 1 involved a national survey of all Canadian cancer centers (n=48) to assess ART adoption, RTT involvement, and training practices. Phase 2 mapped online ART workflows for MR-guided and CT-guided systems and compared them to existing competency frameworks. Phase 3 used a Modified Delphi process with subject matter experts from five centers practicing online ART to identify tasks requiring upskilling beyond entry-level competencies.</div></div><div><h3>Results</h3><div>Thirty-two centers responded (67%), with 25 reporting offline ART and 5 reporting online ART. Offline ART was widely practiced, while online ART adoption was limited by technical and resource constraints. RTTs were integral to both workflows, performing 50% of offline and 58% of online ART tasks, with target delineation emerging as a significant role expansion. Training approaches varied, relying on in-house methods for offline ART and vendor-led sessions for online ART. Expert consensus identified four critical upskilling areas: structure propagation and contouring, target volume verification, plan modification, and dosimetric evaluation. These tasks, along with treatment decision-making, were deemed essential for safe and effective online ART delivery.</div></div><div><h3>Conclusion</h3><div>ART implementation in Canada is evolving, with RTTs assuming expanded responsibilities. However, training remains inconsistent and insufficient for advanced ART workflows. A national adaptive competency framework is recommended to standardize education, support RTT upskilling, and enable broader ART adoption.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102403"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We Say Inclusive, But Are We Ready? The Hidden Gap in Clinical Education Accommodations","authors":"Samantha Moraes","doi":"10.1016/j.jmir.2026.102442","DOIUrl":"10.1016/j.jmir.2026.102442","url":null,"abstract":"<div><h3>Purpose</h3><div>Health professions education increasingly emphasizes inclusive learning environments; however, evidence remains limited regarding the implementation of accommodations within clinical settings, where learning is complex, high-acuity, and practice-based. This study aimed to examine how clinical educators are supported in facilitating accommodations for learners with disabilities and to identify gaps between policy and practice.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using MEDLINE and CINAHL. A total of 955 records were identified, with 11 studies meeting inclusion criteria following screening and full-text review. Studies across health professions were analyzed using thematic analysis to identify patterns related to accommodation implementation, educator roles, and system-level challenges.</div></div><div><h3>Results</h3><div>Six interrelated themes were identified: conceptualizations of disability; the academic-clinical translation gap; educator preparedness and role ambiguity; attitudinal and cultural barriers; disclosure and communication challenges; and structural constraints within clinical environments. While accommodations are well established in academic contexts, their implementation in clinical settings remains inconsistent. Clinical educators report limited training, ambiguous expectations, and competing clinical demands. Barriers extend beyond logistical constraints to encompass cultural assumptions regarding safety and competence, as well as systemic conditions that limit flexibility.</div></div><div><h3>Conclusion</h3><div>These findings highlight a disconnect between inclusive education policies and their enactment within clinical environments. The persistence of variability, role ambiguity, and structural constraints suggests that current approaches rely heavily on individual educators rather than coordinated systems. Advancing inclusive clinical education will require institutionally supported strategies that embed clear guidance, shared responsibility, and context-responsive implementation within clinical practice.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102442"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}