title: Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study.
abstract: To develop an entry-to-practice quality and safety competency profile for radiation oncology residency.
  
  
  
  A comprehensive list of potential quality and safety competency items was generated from public and professional resources and interprofessional focus groups. Redundant or out-of-scope items were eliminated through investigator consensus. Remaining items were subjected to an international 2-round modified Delphi process involving experts in radiation oncology, radiation therapy, and medical physics. During Round 1, each item was scored independently on a 9-point Likert scale indicating appropriateness for inclusion in the competency profile. Items indistinctly ranked for inclusion or exclusion were re-evaluated through web conference discussion and reranked in Round 2.
  
  
  
  An initial 1211 items were compiled from 32 international sources and distilled to 105 unique potential quality and safety competency items. Fifteen of the 50 invited experts participated in round 1: 10 radiation oncologists, 4 radiation therapists, and 1 medical physicist from 13 centers in 5 countries. Round 1 rankings resulted in 80 items included, 1 item excluded, and 24 items indeterminate. Two areas emerged more prominently within the latter group: change management and human factors. Web conference with 5 participants resulted in 9 of these 24 items edited for content or clarity. In Round 2, 12 participants rescored all indeterminate items resulting in 10 items ranked for inclusion. The final 90 enabling competency items were organized into thematic groups consisting of 18 key competencies under headings adapted from Deming's System of Profound Knowledge.
  
  
  
  This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.
authors.affiliation: Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jenna
authors.initials: J
authors.lastname: Adleman
authors.affiliation: Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gillan
authors.affiliation: Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada; Saint John Regional Hospital, Saint John, New Brunswick, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Caissie
authors.affiliation: Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Cancer Centre, Halifax, Nova Scotia, Canada.
authors.forename: Carol-Anne
authors.initials: CA
authors.lastname: Davis
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Liszewski
authors.affiliation: Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: McNiven
authors.affiliation: Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Electronic address: Meredith.Giuliani@rmp.uhn.ca.
authors.forename: Meredith
authors.initials: M
authors.lastname: Giuliani
mesh_terms: D001315:Australia; D002170:Canada; D002983:Clinical Competence; D032921:Consensus; D003479:Curriculum; D003697:Delphi Technique; D003718:Denmark; D006804:Ergonomics; D005260:Female; D017144:Focus Groups; D006283:Health Physics; D006801:Humans; D007391:International Cooperation; D007396:Internship and Residency / Q000592:standards; D008297:Male; D009520:New Zealand; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D016730:Program Development; D018787:Radiation Oncology / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data; D012449:Safety; D006113:United Kingdom