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I. Abstract:

II. Introduction:

A. Medical dosimetrists come from a wide variety of educational and professional

backgrounds.
1. Historically, dosimetrists were classified as physics personnel who were mainly
responsible for performing dose calculations and creating dose distribution maps.
2. The field of radiation oncology has experienced many technological advances
and, consequently, designing treatment plans has become increasingly complex.
3. As a result, the Medical Dosimetrist Certification Board (MDCB) requires a
bachelors degree and graduation from a Joint Review Committee on Education in
Radiologic Technology (JRCERT) accredited program as prerequisites to
certification.
4. The training a student receives from elected programs affects their confidence and
success as a new dosimetrist.
B. Assessing factors that contribute to a graduates level of preparedness will aid in
developing better ways of both teaching and learning.
1. Development in areas that graduates feel ill-equipped in improves effectiveness of
dosimetry programs.
2. Knowing the training background of the most successful dosimetry graduates will
help prospective students plan their clinical and didactic pathways.
C. Currently, there is a lack of published data concerning how the training a dosimetry
student receives affects their degree of readiness when entering the workforce.
1. Baker et al5 report the need for investigations concerning the relationship of
previous work experience as a radiation therapist and its effect on success of a
dosimetry student.
2. A survey conducted by Mills6 acknowledges that sufficient training in both the
academic and clinical setting is crucial for dosimetrists, but does not explore the
factors that influence this training.
3. Lenards7 paper has evidence supporting the need for student confidence at the
completion of a dosimetry program.
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D. The University of Wisconsin- La Crosse (UWL) offers a masters degree in medical

dosimetry and was the fourth program in the nation to receive accreditation from the
JRCERT.
1. Admissions into the program considers candidates from two tracks; Track A for
registered radiation therapists with a bachelors degree and Track B for bachelors
degree recipients without prior radiation therapy experience.
2. Each student has a unique clinical experience because they are separated into
individual internship sites.
3. Annual surveys from a pool of past graduates were utilized to provide insight into
factors that affect a new dosimetrists confidence level.

III. Methods and Materials:

A. The population examined included the medical dosimetry graduates of the University of
Wisconsin La Crosses Master of Science degree program.
1. Classes of 2012-2015
2. Total sample size of 50-55 people
3. Larger cohorts of people as years progress and program grew
B. Responses from specific questions asked on a survey given to the previous students of the
UW La Crosse masters degree program after a designated length of time post-
graduation were analyzed.
1. BRIEFLY discuss why certain questions were asked and reviewed
2. Due to the fact that prior Radiation Therapy Technologist (RTT) experience was
not a question on each survey, this one factor will be reviewed in terms of
individual responses for certain years and as an overall number for the general
population.
3. We are to be given the number of RTT students per year can determine percent
of RTT students in the whole population

IV. Results:

A. Presentation of data graphs. Please see "Question Pages" document for the intermediate
time.
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1. At the top of each page there is a table stating each cohort and the number of
respondents from each cohort.
2. The names of the cohorts signify the graduation year and the length of time that
passed before the students were administered the survey.
i. For example, if the cohort graduated the medical dosimetry program in
2012 and filled out the survey 6 months post-graduation they would be
labeled as: 2015-6 months.
B. The majority of respondents, 37.21%, stated that they felt comfortable or trained in their
position after 1 month.
1. Over 90% of the population felt comfortable or trained within 6 months of
beginning their position
2. Therefore only 9.3% of the population (4 respondents) that took greater than 6
months to feel comfortable or felt that they were still not trained for the job.
C. Half of the individuals surveyed felt very well prepared for their job after graduation.
1. The number of responses per answer selection choice (i.e. Very well or
Adequately prepared) decreased in a linear fashion, terminating with no
responses of poorly prepared.
D. Of the 36 survey responses regarding current employment status, 33 responded that they
were currently working full time as a medical dosimetrist.
1. Within the remaining 3 responses, there was exactly one individual working in the
residual options of part time, per diem, or not in the field of medical dosimetry
respectively.
E. Within the graduating class of 2015, of the 16 students enrolled, 9 students had
previously worked as a radiation therapist.
1. The average number of year worked = 8.5.
2. The years of experience ranged from 20 years to 4 years.
F. Within the graduating class of 2015, of the 16 students enrolled, exactly half of the
students were employed by their clinical internship site upon graduation.
G. The average level of confidence for the competency procedures performed during clinical
internship resulted in 85.39% of respondents confident they could perform the designated
task.
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1. The procedure with the highest level of confidence, 95.19%, was prostate
Intensity Modulated Radiation Therapy (IMRT) planning.
2. The procedure with the lowest level of confidence, 29.21%. was brachytherapy
planning.
i. To be expected, not as readily available to all students and not a job
requirement for the majority of dosimetrists.
H. Within the graduating class of 2015, of the 16 students enrolled, 15 students were
currently treatment planning with the same treatment planning system as they had used
during their clinical internship.

V. Discussion:

A. Those who felt very prepared for a dosimetry job felt comfortable in a shorter amount of
time than those who felt unprepared.
1. Preparation includes competence in skills necessary for the job, meaning those
dosimetry students who felt prepared are therefore competent in dosimetric skills.
2. Competency is a result of practice and performance, so these students must have
experienced these while in training in order to become competent.
3. Katowa-Mukwato et al4 found that confidence (in medical students) directly
correlates with how often a skill has been performed/practiced.
4. Therefore, dosimetry students who were prepared well (became competent in
dosimetric skills during training) felt comfortable in a shorter amount of time than
those who felt unprepared (did not practice/perform the necessary dosimetric
skills/tasks).
B. Those very well prepared for their dosimetry jobs felt satisfied with the clinical
experience, and those satisfied with clinical experience felt comfortable in a dosimetry
position in a shorter amount of time than those who were somewhat satisfied with clinical
experience.
1. Florin et al1 suggested capability beliefs of nurses upon graduation are influenced
during their undergraduate studies, including both knowledge and skill obtained
training.
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2. This concept can be applied to other competency-based health education

programs such as UW- La Crosses Medical Dosimetry program.
3. Therefore, dosimetry students who felt they received adequate training (while in
school) will have higher capability beliefs (or confidence) upon graduation,
leading to comfort ability in the dosimetry profession in a relatively short time.
C. Those who received jobs at their internship sites felt comfortable with the position in a
shorter amount of time than those who received jobs elsewhere.
1. Already familiar with the attending physicians, treatment planning systems, and
work flow of the department.
2. Time frame to become comfortable would have been at the beginning of their
clinical internship and has already passed.
D. Those who had prior RTT experience felt comfortably trained as a dosimetrist after a
longer amount of time than those without RTT experience.
1. Prior RTT experience, for the purpose of this study, is being defined as the
individual holding a position as a radiation therapist for a given length of time.
Those with a valid RTT degree, but no clinical application of the degree, were not
included in this subset.
2. Mills6 reported that the majority of medical dosimetrists believe that entrants to a
medical dosimetry program should hold an RTT certification (as well as a
Bachelors degree).
3. Somewhat contradictory, Baker et al5 reported no statistical significance between
prior RTT experience and successful completion of a medical dosimetry program.
4. Radiation therapists are inherently meticulous and masters of their trade, and they
may apply this same desire to the field of medical dosimetry, therefore taking a
longer time to feel comfortable as a dosimetrist.
E. Those with prior RTT experience felt more prepared for their dosimetry jobs than those
without RTT experience.
1. Experienced RTTs have a solid foundational knowledge of radiation oncology.
2. Experienced RTTs understand the intricacies and workflow within a radiation
oncology department and are able to apply that knowledge to medical dosimetry.
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3. Experienced RTTs may ask questions or seek details from a therapists point of
view to in order to understand the reasoning behind dosimetric treatment planning
options/choices, therefore resulting in a more comprehensive learning experience
and preparation.

VI. Conclusion:

A. As seen in the comparative graphs within the discussion section, there are factors of a
students education that had a positive influence on their confidence as a newly employed
medical dosimetrist.
4. Those satisfied with their clinical experience felt comfortable in a dosimetry
position in a shorter amount of time than those who were somewhat satisfied with
clinical experience. (graph B)
5. High levels of clinical internship satisfaction also correlated to high levels of self-
perceived preparedness. (graph C)
6. Receiving a job at the site of their clinical internship made a student feel more
comfortable and trained in their position as a new medical dosimetrist compared
to those students that had to get acquainted with a new environment.
B. Prior RTT experience had a positive impact on a graduates perceived preparedness but
had a negative influence on the time that it took them to feel comfortable or trained in
their position.
1. Those with prior RTT took a longer amount of time to feel comfortably trained in
their position, however they felt more prepared compared to those without prior
RTT experience.
2. Perhaps they felt more prepared due to the fact that they had worked in the realm
of radiation oncology in the past therefore the environment of being in a hospital
setting was not new to them.
3. On the contrary, they were required to adapt to a new position within radiation
oncology therefore possibly leading them to need a longer amount of time to feel
comfortable in their new role.
C. The purpose behind this study was to help differentiate between the factors of a medical
dosimetry education that are positively, negatively, or neutrally influencing a newly
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graduated individual so as to help better the next generation of Certified Medical

Dosimetrists (CMD).
1. Assessing factors that contribute to a graduates level of preparedness will aid in
developing better ways of both teaching and learning.
2. Due to a lack of published data concerning how the training a dosimetry student
receives affects their degree of readiness when entering the workforce, we felt it
was important to gain this information from recent graduates.
D. Based on the results achieved from this survey, it is appropriate to conclude that further
research should be conducted once larger sample sizes are available.
1. Having a larger sample size that receives the same survey after the same amount
of time.
2. More in depth statistical analysis of the results and comparative aspects of the
factors.
3. Research to find out the reasoning behind why experienced RTTs took longer to
feel comfortable as a medical dosimetrist as compared to non-RTTs.
4. This study is a good starting point and basis for furthering the research.
5. Perhaps give a survey to other educational programs.
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2648.2011.05792.x
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2354-d714-51bb-b0082375ea52. Published April 2012. Accessed April 2017.
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Menomonie, WI: University of Wisconsin- Stout; 2007.