Part VIII:Medical Exposures in Radiotherapy Lecture 2 : Scope and Responsibilities – Training of staff IAEA Post Graduate Educational Course on Radiation Protection and Safe Use of Radiation Sources Module 1 Scope and Responsibilities

Slide 2VIII.1.2 : Scope and Responsibilities – Training of staff Objective Appreciate the need for training of the staffAppreciate the need for training of the staff Understand the method of organising a training program for staffUnderstand the method of organising a training program for staff Appreciate and understand the need for updating the training programsAppreciate and understand the need for updating the training programs Able organise refresher trainingAble organise refresher training

Slide 3VIII.1.2 : Scope and Responsibilities – Training of staff Professional to be trained Radiation Oncologists Medical Physicists Radiotherapy Technologists Nurses Equipment maintenance Engineers

Slide 4VIII.1.2 : Scope and Responsibilities – Training of staff Education and Training Are essential for a StaffAre essential for a Staff As part of a the implementation of a Radiation Protection Programme (IAEA TecDoc 1040, 2.2.1): “Early in the process a decision should be made about additional training required for the hospital staff…”As part of a the implementation of a Radiation Protection Programme (IAEA TecDoc 1040, 2.2.1): “Early in the process a decision should be made about additional training required for the hospital staff…” The relevant plan should include who, where and when shall be trained.The relevant plan should include who, where and when shall be trained.

Slide 5VIII.1.2 : Scope and Responsibilities – Training of staff Responsibility of the licensee BSS 2.30.: “Provision shall be made for reducing as far as practicable the contribution of human error to accidents and other events that could give rise to exposures, by ensuring that:BSS 2.30.: “Provision shall be made for reducing as far as practicable the contribution of human error to accidents and other events that could give rise to exposures, by ensuring that: (a)all personnel on whom protection and safety depend be appropriately trained and qualified so that they understand their responsibilities and perform their duties with appropriate judgement and according to defined procedures;”

Slide 6VIII.1.2 : Scope and Responsibilities – Training of staff In practice training is required for both: Staff on whom radiation protection depends - typically radiotherapy professionals and service staffStaff on whom radiation protection depends - typically radiotherapy professionals and service staff Persons who could be subject to irradiation: staff (module VIII), patients (module IX) and public (module XVII) - in the latter case the education may be limited to information sheets and/or warning signsPersons who could be subject to irradiation: staff (module VIII), patients (module IX) and public (module XVII) - in the latter case the education may be limited to information sheets and/or warning signs

Slide 7VIII.1.2 : Scope and Responsibilities – Training of staff Education All staff in radiotherapy must have appropriate education to perform their duties…All staff in radiotherapy must have appropriate education to perform their duties… For radiation protection purposes this affects particularly:For radiation protection purposes this affects particularly: –Radiation Protection Officer –Physician –Qualified Expert (Medical Physicist) –Radiotherapy Technician –Maintenance staff

Slide 8VIII.1.2 : Scope and Responsibilities – Training of staff IAEA TecDoc …provides specific information on the role of the physician ( ) and medical physicist ( ) - the skills and competencies identified there determine the education and training requirements.…provides specific information on the role of the physician ( ) and medical physicist ( ) - the skills and competencies identified there determine the education and training requirements.

Slide 9VIII.1.2 : Scope and Responsibilities – Training of staff Qualifications and Training of others There should also be a process in place which ensures that outside contractors on whom radiation protection may depend (eg service engineers) are appropriately trained and qualified. This is typically reflected in a license of the contractor of which a copy should be available in the radiotherapy facility.There should also be a process in place which ensures that outside contractors on whom radiation protection may depend (eg service engineers) are appropriately trained and qualified. This is typically reflected in a license of the contractor of which a copy should be available in the radiotherapy facility.

Slide 10VIII.1.2 : Scope and Responsibilities – Training of staff BSS: Education is part of Management Requirements In radiotherapy, these requirements will be fulfilled by the requirement for a qualified expert in radiotherapy physics. Qualified radiation safety expertsQualified radiation safety experts –Licencee shall arrange for qualified radiation safety experts to provide observance to the Regulations –The qualifications of the radiation safety experts shall include appropriate academic knowledge and professional experience

Slide 11VIII.1.2 : Scope and Responsibilities – Training of staff Regulations – Management requirements Continuous education and training in radiation protection shall be provided to meet with changes in equipment, instrumentation, practice, monitoring methods, recommendations and regulations A transition period should be provided for those already involved in the delivery of radiation exposure in order to meet the requirements of training

Slide 12VIII.1.2 : Scope and Responsibilities – Training of staff Continuing Education Technology in radiation therapy is fast developingTechnology in radiation therapy is fast developing It is essential for all staff to have regular updates on radiation protection aspects (eg. consider the introduction of HDR brachytherapy)It is essential for all staff to have regular updates on radiation protection aspects (eg. consider the introduction of HDR brachytherapy) Continuing education must be documentedContinuing education must be documented

Slide 13VIII.1.2 : Scope and Responsibilities – Training of staff BSS: There is also a role for the regulatory authority  The Regulatory Authority should encourage medical authorities, universities and professional organizations to design and implement training programmes in radiation protection for: –radiation oncologists –qualified experts in radiotherapy physics –radiotherapy technologists –dosimetrists –maintenance personnel

Slide 14VIII.1.2 : Scope and Responsibilities – Training of staff Education & Training The Regulatory Authority should establish training curricula for (for example) :The Regulatory Authority should establish training curricula for (for example) : –RPOs –members of the RSC –relevant physicians –medical physicists –laboratory staff

Slide 15VIII.1.2 : Scope and Responsibilities – Training of staff Education and Training (cont) –Nurses working with radioactive patients –maintenance staff –radiation technologists –other relevant staff eg. cardiologists who need to use x-rays

Slide 16VIII.1.2 : Scope and Responsibilities – Training of staff Content of the Training Programme Training in radiation protection for radiotherapy should cover: –radiation modalities –facility design –characteristics of safety features of sources and source realeted equipment –dosimetry and instrument calibration –treatment planning –radiactive waste disposal –accident prevention and emergency procedures (+ lessons learned from past accidents)

Slide 17VIII.1.2 : Scope and Responsibilities – Training of staff How to achieve Education and Training for staff? As well as ensuring that specialist radiation workers (eg. radiographers) have the necessary training, the employer should also provide local trainingAs well as ensuring that specialist radiation workers (eg. radiographers) have the necessary training, the employer should also provide local training This could be basic safety training for new employees such as nurses and lab. staffThis could be basic safety training for new employees such as nurses and lab. staff Training should include the local rulesTraining should include the local rules

Slide 18VIII.1.2 : Scope and Responsibilities – Training of staff The Regulatory Authority should also have an audit system to ensure that training is of an appropriate standardThe Regulatory Authority should also have an audit system to ensure that training is of an appropriate standard The use of licenses to use radiation is one method of ensuring complianceThe use of licenses to use radiation is one method of ensuring compliance How to achieve Education and Training for staff?

Slide 19VIII.1.2 : Scope and Responsibilities – Training of staff Education and Training If the number of professionals is too small to justify setting up a training course, then international co-operation programs may be usedIf the number of professionals is too small to justify setting up a training course, then international co-operation programs may be used Distance learning programs may be usefulDistance learning programs may be useful A course such as the present may play an important role...A course such as the present may play an important role...

Slide 20VIII.1.2 : Scope and Responsibilities – Training of staff Summary A radiation protection program is an essential requirement for every radiotherapy facilityA radiation protection program is an essential requirement for every radiotherapy facility The radiation protection officer and the radiation safety committee plays an important role in the implementation of the programThe radiation protection officer and the radiation safety committee plays an important role in the implementation of the program Education and training of staff and all other persons who may be in ocntact with radiation is essentialEducation and training of staff and all other persons who may be in ocntact with radiation is essential

Slide 21VIII.1.2 : Scope and Responsibilities – Training of staff Typical elements of a RPP Assignment of responsibilitiesAssignment of responsibilities The Radiation Protection OfficerThe Radiation Protection Officer Designation of radiation areasDesignation of radiation areas Local rulesLocal rules Education and trainingEducation and training Planning for accidents and emergenciesPlanning for accidents and emergencies Health surveillance and monitoringHealth surveillance and monitoring Review and auditReview and audit System of recording and reportingSystem of recording and reporting

Slide 22VIII.1.2 : Scope and Responsibilities – Training of staff References Basic Safety StandardsBasic Safety Standards –Safety series No 115 IAEA publication Lecture Material of Lee Collins prepared for IAEALecture Material of Lee Collins prepared for IAEA Design and implementation of a radiotherapy programme: clinical, medical physics, radiation protection and safety aspects - IAEA Tec Doc 1040