Improving radiation oncology providers' workload and performance: Can simulation-based training help?

Abstract

To help with ongoing safety challenges in radiation therapy (RT), the objective of this research was to develop and assess the impact of a simulation-based training intervention on radiation oncology providers' workload and performance during treatment planning and quality assurance (QA) tasks. Eighteen radiation oncology professionals completed routine treatment planning and QA tasks on 2 clinical scenarios in a simulation laboratory as part of a prospective institutional review board-approved study. Workload was measured at the end of each assessment/scenario using the NASA Task-Load Index. Performance was quantified based on procedural compliance (adherence to preset/standard QA tasks), time-to-scenario completion, and clinically relevant performance. Participants were then randomized to receive (vs not receive) simulation-based training intervention (eg, standardized feedback on workload and performance) and underwent repeat measurements of workload and performance. Pre- and postintervention changes in workload and performance from participants who received (vs did not receive) were compared using 2-way analysis of variance. Simulation-based training was associated with significant improvements in procedural compliance (P = .01) and increases in time-to-scenario completion (P < .01) but had no significant impact on subjective workload or clinically relevant performance. Simulation-based training may be a tool to improve procedural compliance of RT professionals and to acquire new skills and knowledge to proactively maintain RT professionals' preoccupation with patient safety.