title: Radiographer-led plan selection for bladder cancer radiotherapy: initiating a training programme and maintaining competency.
abstract: OBJECTIVE
  The implementation of plan of the day selection for patients receiving radiotherapy (RT) for bladder cancer requires efficient and confident decision-making. This article describes the development of a training programme and maintenance of competency.
  
  
  METHODS
  Cone beam CT (CBCT) images acquired on patients receiving RT for bladder cancer were assessed to establish baseline competency and training needs. A training programme was implemented, and observers were asked to select planning target volumes (PTVs) on two groups of 20 patients' images. After clinical implementation, the PTVs chosen were reviewed offline, and an audit performed after 3 years.
  
  
  RESULTS
  A mean of 73% (range, 53-93%) concordance rate was achieved prior to training. Subsequent to training, the mean score decreased to 66% (Round 1), then increased to 76% (Round 2). Six radiographers and two clinicians successfully completed the training programme. An independent observer reviewed the images offline after clinical implementation, and a 91% (126/139) concordance rate was achieved. During the audit, 125 CBCT images from 13 patients were reviewed by a single observer and concordance was 92%.
  
  
  CONCLUSIONS
  Radiographer-led selection of plan of the day was implemented successfully with the use of a training programme and continual assessment. Quality has been maintained over a period of 3 years.
  
  
  CONCLUSIONS
  The training programme was successful in achieving and maintaining competency for a plan of the day technique.
authors.affiliation: 1 Department of Radiotherapy, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
authors.forename: H A
authors.initials: HA
authors.lastname: McNair
authors.forename: S
authors.initials: S
authors.lastname: Hafeez
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.forename: S
authors.initials: S
authors.lastname: Lalondrelle
authors.forename: F
authors.initials: F
authors.lastname: McDonald
authors.forename: V N
authors.initials: VN
authors.lastname: Hansen
authors.forename: R
authors.initials: R
authors.lastname: Huddart
mesh_terms: D002983:Clinical Competence; D054893:Cone-Beam Computed Tomography; D003657:Decision Making; D019583:Dose Fractionation, Radiation; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D006801:Humans; D011785:Quality Assurance, Health Care; D011871:Radiology / Q000193:education*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*