title: Hazards and incidents: Detection and learning in radiation medicine, a comparison of 2 educational interventions.
abstract: OBJECTIVE
  Interprofessional, educational live simulations were compared with group discussion-based exercises in terms of their ability to improve radiation medicine trainees' ability to detect hazards and incidents and understand behaviors that may prevent them.
  
  
  METHODS
  Trainees and recent graduates of radiation therapy, medical physics, and radiation oncology programs were recruited and randomized to either a simulation-based or group discussion-based training intervention. Participants engaged in hazard and incident detection, analysis, and a discussion of potential preventive measures and the concept of the "highly reliable team." A video examination tool modeled on actual incidents, using 5-minute videos created by faculty, students, and volunteers, was created to test hazard and incident recognition ability before and after training. Hazard and incident detection sensitivity and specificity analyses were conducted, and a survey of the participants' and facilitators' perceptions was conducted.
  
  
  RESULTS
  Twenty-seven participants were assigned to the simulation (n = 15) or discussion group (n = 12). Hazard and incident-detection sensitivity ranged from 0.04 to 0.56 before and 0.04 to 0.35 after training for the discussion and simulation groups, respectively. The pre- and posttraining difference in sensitivity between groups was 0.03 (P = .75) for the minimum and 0.33 (P = .034) for the maximum reaction time. Participant perceptions of the training's educational value in a variety of domains ranged from a mean score of 6.58 to 8.17 and 7 to 8.07 for the discussion and simulation groups, respectively. Differences were not statistically significant. Twenty-six of the 27 participants indicated that they would recommend this event to a colleague.
  
  
  CONCLUSIONS
  Participants' ability to detect hazards and incidents as portrayed in 5-minute videos in this study was low both before and after training, and simulation-based training was not superior to discussion-based training. However, levels of satisfaction and perceptions of the training's educational value were high, especially with simulation-based training.
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Thompson
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Yilan
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Michener Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Potvin
authors.affiliation: Michener Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Holmes
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Di Prospero
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Keller
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Ewa
authors.initials: E
authors.lastname: Szumacher
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Liszewski
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Pamela
authors.initials: P
authors.lastname: Catton
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Meredith
authors.initials: M
authors.lastname: Giuliani
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Bethany
authors.initials: B
authors.lastname: Pitcher
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Melania
authors.initials: M
authors.lastname: Pintilie
authors.affiliation: Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Techna Institute, Toronto, Ontario, Canada. Electronic address: jean-pierre.bissonnette@rmp.uhn.ca.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bissonnette
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D018787:Radiation Oncology / Q000193:education*; D018788:Radioactive Hazard Release; D000066908:Simulation Training / Q000379:methods*