Establishment of Learning Milestones for Medical Radiation Therapists Using a Multi-modal Consensus Approach




Shu-Yu Wen;Chao-Yuan Tu;Chiao-Ling Tsai;Tzu-Jie Huang;Wen-Tao Huang;Kuo-Ming Huang;Chun-Yuan Tu;Chih-Wei Yang

Key Words

learning milestone ; radiation therapist ; nominal group technique ; modified delphi method ; focus group method


Journal of Medical Education

Volume or Term/Year and Month of Publication

26卷1期(2022 / 03 / 01)

Page #

21 - 33+ap1-20

Content Language


Chinese Abstract

Purpose: Relevant processes and outcomes of utilizing milestones framework in the training of non-physician therapists are seldom reported. This study aimed to construct learning milestones for radiation therapists (RTTs) through a stringent multi-modal consensus-based approach and explored its impacts. Methods: The nominal group technique (NGT), modified Delphi Method (MDM), and focus group method were integrated into the consensus development. After finalizing the consensus, qualitative and quantitative questionnaires were distributed to the participants to explore the impacts of the process. Medical educator's feedback was assessed with a Likert 5-point scale, which focused on: (1) Self-assessed comprehension of the 5 core competencies of RTTs; (2) Effectiveness of the consensus methods; and (3) Benefits of milestones framework on clinical education and promotion of professional identity. Results: Twenty-nine expert educators from medical institutions across Taiwan participated in the consensus development. Through the process, 13 sub-competencies and 115 milestones were developed. The self-assessed comprehension of core competencies significantly increased after the consensus development. All three consensus methods were deemed effective (the average scores for NGT, MDM, and focus group were 4.79, 4.66, and 4.62, respectively). The development process was considered beneficial to the clinical education of RTTs (4.79), the willingness to adopt the learning milestones (4.66), and the promotion of professional identity (4.66). Conclusions: The stringent multi-modal consensus development approach was feasible in establishing learning milestones for RTTs. Moreover, medical educator training was facilitated through the process. Comprehension of the five core competencies and professional identity were promoted by participating in the process.

Topic Category 醫藥衛生 > 醫藥總論
社會科學 > 教育學
  1. Frank JR, Mungroo R, Ahmad Y, et al.: Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach 2010;32:631-7.
  2. Swing SR. ACGME Launches Outcomes Assessment Project. JAMA 1998;279:1492.
  3. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach 2007;29:648-54.
  4. Schneider SM, Chisholm CD. ACGME outcome project: phase 3 in emergency medicine education. Acad Emerg Med 2009;16:661-4.
  5. LaMantia J. The ACGME core competencies: getting ahead of the curve. Acad Emerg Med 2002;9:1216-7.
  6. Green B, Jones M, Hughes D, et al.: Applying the Delphi technique in a study of GPs' information requirements. Health Soc Care Community 1999;7:198-205.
  7. Keeney S, Hasson F, McKenna HP. A critical review of the Delphi technique as a research methodology for nursing. Int J Nurs Stud 2001;38:195-200.
  8. Scotland GS, Bullough CH. What do doctors think their caseload should be to maintain their skills for delivery care? Int J Gynaecol Obstet 2004;87:301-7.
  9. van Teijlingen E, Pitchforth E, Bishop C, et al.: Delphi method and nominal group technique in family planning and reproductive health research. J Fam Plann Reprod Health Care 2006;32:249-52.
  10. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68-78.
  11. Wareing A, Buissink C, Harper D, et al. Continuing professional development (CPD) in radiography: A collaborative European meta-ethnography literature review. Radiography (Lond) 2017;23 Suppl 1:S58-63.
  12. Adleman J, Gillan C, Caissie A, et al. Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study. Int J Radiat Oncol Biol Phys 2017;98:428-37.
  13. Giuliani ME, Gillan C, Milne RA, et al.: Determining an imaging literacy curriculum for radiation oncologists: an international Delphi study. Int J Radiat Oncol Biol Phys 2014;88:961-6.
  14. Turner S, Seel M, Trotter T, et al. Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study. Radiother Oncol 2017;123:331-6.
  15. John-Matthews JS, Wallace MJ, Robinson L. The Delphi technique in radiography education research. Radiography (Lond) 2017;23 Suppl 1:S53-7.
  16. Benstead K, Lara PC, Andreopoulos D, et al. Recommended ESTRO Core Curriculum for Radiation Oncology/Radiotherapy 4th edition. Radiother Oncol 2019;141:1-4.
  17. McGaghie WC, Miller GE, Sajid AW, et al.: Competency-based curriculum development on medical education: an introduction. Public Health Pap 1978:11-91.
  18. Frank JR. The CanMEDS 2005 physician competency framework: The Royal College of Physicians and Surgeons of Canada; 2005.
  19. Dreyfus HL, Dreyfus SE, Athanasiou T. Mind over machine : the power of human intuition and expertise in the era of the computer. New York: Free Press; 1986.
  20. Kohn LT, Corrigan JM, Donaldson MS. To Err is Human: Building a Safer Health System. National Academies Press. 2000.
  21. Huang CC, Chen CH, Wei JW, et al.: The origin and development of effectiveness assessment of radiation therapist training. Journal of Healthcare Quality 2016;10:55-8.
  22. Jones J, Hunter D. Consensus methods for medical and health services research. BMJ 1995;311:376-80.
  23. Morgan DL. Focus groups as qualitative research / David L. Morgan. 2nd ed. Thousand Oaks, Calif.: Sage Publications; 1996.
  24. White RW. Ego and reality in psychoanalytic theory; a proposal regarding independent ego energies. New York,: International Universities Press; 1963.
Times Cited
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  2. Ya-Hui Chang;Shao-Chin Chiang;Chih-Wei Yang(2022)。Establishing Core Competencies of Taiwanese Pharmacists Using the Nominal Group Technique。Journal of Medical Education。26(4)。69-78。