Interprofessional Image Verification Workshop for Physician and Physics Residents: A Multi-Institutional Experience


      Verification of patient position through pretreatment setup imaging is crucial in modern radiation therapy. As treatment complexity increases and technology evolves, physicist-physician collaboration becomes imperative for safe and successful radiation delivery. Despite the importance of both, residency programs lack formal interprofessional education (IPE) activities or structured training for image verification. Here we show the impact of an interprofessional image verification workshop for residents in a multi-institutional setting.


      The workshop included a lecture by the attending physicist and physician, and hands-on image registration practice by learners (medical physics residents, MP; and radiation oncology residents, RO). All participants filled out pre- and postactivity surveys and rated their comfort from 1 to 10 in (A) selecting what type of imaging to order for a given case and (B) independently assessing the setup quality based on imaging. A paired 1-tailed t test (α = 0.05) was used to evaluate significance; Spearman rank correlation coefficient was used to assess correlation of ratings and RO postgraduate year (PGY). Surveys had free-response questions about IPE and image verification activities in residency.


      A total of 71 residents from 7 institutions participated between 2018 and 2020. Pre- and postsurveys were completed by 50 residents (38RO, 12MP) and showed an increase in (A) from 5.5 ± 2.2 to 7.1 ± 1.6 (P < .001) and in (B) from 5.1 ± 2.3 to 6.8 ± 1.5 (P < .001), with significant increases per subgroup (AΔ, RO = 1.8 ± 1.7, P < .001; BΔ, RO = 1.9 ± 1.8, P <. 001; AΔ, MP = 1.1 ± 1.4, P = .012; BΔ, MP = 1.2 ± 1.6, P = .016). RO confidence scores moderately correlated with PGY. Survey responses indicated that image verification training is mostly unstructured, with extent of exposure varying by program and attending; most with little-to-no training. Time constraints were identified as the main barrier. IPE was noted as a useful way to incorporate different perspectives into the process.


      Formal image verification training increases resident comfort with setup imaging review and provides opportunities for interprofessional collaboration in radiation oncology residency programs.
      To read this article in full you will need to make a payment
      ASTRO Member Login
      ASTRO Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features.
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gillespie EF
        • Panjwani N
        • Golden DW
        • et al.
        Multi-institutional randomized trial testing the utility of an interactive three-dimensional contouring atlas among radiation oncology residents.
        Int J Radiat Oncol Biol Phys. 2017; 98: 547-554
      1. Elekta ProKnow. Solutions for radiation oncology residency programs. Available at: Accessed August 17, 2021.

        • Nabavizadeh N
        • Elliott DA
        • Chen Y
        • et al.
        Image guided radiation therapy (IGRT) practice patterns and IGRT's impact on workflow and treatment planning: Results from a national survey of American Society for Radiation Oncology members.
        Int J Radiat Oncol Biol Phys. 2016; 94: 850-857
        • Padilla L
        • Dault J
        • Fields E
        Image registration and verification workshop: A pilot study.
        Pract Radiat Oncol. 2020; 10: e461-465
        • Winter IP
        • Ingledew PA
        • Golden DW
        Interprofessional education in radiation oncology.
        J Am Coll Radiol. 2019; 16: 964-971
        • van Buuren S
        Flexible Imputation of Missing Data.
        2nd ed. Chapman and Hall/CRC Interdisciplinary Statistics, Boca Raton, FL2018
        • Jimenez RB
        • Johnson A
        • Padilla L
        • et al.
        The impact of an introductory radiation oncology curriculum (IROC) for radiation oncology trainees across the United States and Canada.
        Int J Radiat Oncol Biol Phys. 2020; 107: 408-416
        • Brower JV
        • Chen S
        • Ritter A
        • et al.
        Comfort level of US radiation oncology graduates: assessment of transition to independent clinical practice.
        J Cancer Educ. 2021; 36: 278-283
        • Marks LB
        • Adams RD
        • Pawlicki T
        • et al.
        Enhancing the role of case-oriented peer review to improve quality and safety in radiation oncology: Executive summary.
        Pract Radiat Oncol. 2013; 3: 149-156
      2. Wang MH, Loewen SK, Giuliani M, et al. Clinical learning, didactic education, and research experiences of radiation oncology resident physicians in Canada [E-pub ahead of print]. J Canc Educ. doi: 10.1007/s13187-020-01799-x, accessed August 17, 2021.

        • Moideen N
        • de Metz C
        • Kalyvas M
        • et al.
        Aligning requirements of training and assessment in radiation treatment planning in the era of competency-based medical education.
        Int J Radiat Oncol Biol Phys. 2020; 106: 32-36
        • Schultz OA
        • Hight RS
        • Gutiontov S
        • et al.
        Qualitative study of interprofessional collaboration in radiation oncology clinics: Is there a need for further education?.
        Int J Radiat Oncol Biol Phys. 2021; 109: 661-669


      Commenting Guidelines

      To submit a comment for a journal article, please use the space above and note the following:

      • We will review submitted comments as soon as possible, striving for within two business days.
      • This forum is intended for constructive dialogue. Comments that are commercial or promotional in nature, pertain to specific medical cases, are not relevant to the article for which they have been submitted, or are otherwise inappropriate will not be posted.
      • We require that commenters identify themselves with names and affiliations.
      • Comments must be in compliance with our Terms & Conditions.
      • Comments are not peer-reviewed.