Radiation therapists’ perspectives about barriers to continuing education in medical

dosimetry.
April Hardman, BS, RT(R)(N)(CNMT); Jessica Pagan, BS; RaeLyn Iacobo, MSHS, RT(R)(T)
(MR)(CT), Nishele Lenards, PhD, CMD, RT(R)(T), FAAMD; Ashley Hunzeker, MS, CMD;
Sabrina Zeiler, MS, CMD, RT(T)

I. Abstract
II. Introduction
A. PI: Radiation oncology has progressed rapidly leading to changes in job
responsibilities. (References: Robinson,1 Cagle,2)
B. PII: Historically, the traditional route to medical dosimetry has been to become a medical
dosimetrist has been to complete on-the-job training (OJT) with the option to sit
for the Medical Dosimetry Certification Board exam (MDCB). In 2017, MDCB
changed the requirements to include a minimum of a bachelor’s degree and
graduation from an accredited medical dosimetry program. (References: Pursey,3
AAMD,4)
C. PIII: There are only 15 accredited programs that offer education and training for
medical dosimetry. Eight of the available programs offer a bachelor’s or master’s
degree. (References: JRCERT,5)
D. PIV: According to the AAMD Education & Research Foundation, the competition
for student acceptance into Joint Review Committee on Education in Radiologic
Technology (JRCERT) accredited medical dosimetry programs is high.6 In 2009
one program reported 99 applicants for 16 positions.6 (Announcments,6 AAMD,4)
E. PV: Barriers to post-secondary and higher education is extensively researched in
several fields, but not medical dosimetry. (Vandelannote,7 Smith,8 Sabio,9) The
problem is that barriers for radiation therapists to pursue an education in medical
dosimetry may have a significant impact on future workforce demands. The
purpose of this study is to identify barriers to pursing an education in medical
dosimetry from the perspectives of radiation therapists. (Vandelannote,7 Smith,8
Sabio,9)
 1. Problem: The problem is that barriers for radiation therapists to
pursue an education in medical dosimetry may have a significant
impact on future workforce demands.
2. Purpose: The purpose of this study is to identify barriers to
pursing an education in medical dosimetry from the perspectives of
radiation therapists.
3. Research Questions: Research questions used to guide the study
were (Q1) what are the external barriers and, (Q2) internal barriers
to pursing an education in medical dosimetry for radiation
therapists?
III. Materials and Methods
A. PI: Survey Selection
1. Qualtrics XM Program
2. Email
B. PII: Study Design
1. First 2 Questions
1. provided a consensus of interest in the field and
eliminated participants that were not relevant to the research study
2. questions focused on the internal and external barriers to pursuing
an education in medical dosimetry (Internal and External barriers to
effective communication,10)
1. External Barrier Questions
2. Internal Barrier Questions
C. PIII: Study Population
1. Survey tested for validity with pilot study.
1. 70 participants
D. PIV: Data Collection
1. Online survey distributed through ASRT membership database
2. Data extracted from Qualtrics
E. PV: Statistical Analysis
 1.  Survey used a mixed method approach of multiple-
choice questions, Likert Scale for order and ranking, and open-
ended responses for choices not mentioned in the options
IV. Results
A. PI: General result information (Table 1 Pie Chart of # of responses vs
nonresponses)
1. Number of responses (n values)
2. Response rate
B. PII: Demographics of respondent population (Table 2 Pie Chart on years of
experience)
1. Years of experience
C. PIII: (Research Question 1) What are the external barriers to pursing an education
in medical dosimetry for radiation therapists? (Bar graph 3 on responses to all
external, Table Graph 4 on top 3 results)
1. Top 3 common external barriers for experienced Radiation
therapists
2. Top 3 common external barriers for entry level Radiation
therapists
D. PIV: (Research Question 2) What are the internal barriers to pursing an education
in medical dosimetry for radiation therapists? (Bar graph 5 on responses to all
internal, Table Graph 6 on top 3 results)
1. Top 3 common internal barriers for experienced Radiation
therapists
2. Top 3 common internal barriers for entry level Radiation therapists
V. Discussion
VI. Conclusion
 References
1. Robinson GF, Mobile K, Yu Y. The radiation oncology workforce: A focus on medical
dosimetry. Med Dosim. 2014;39(2):197-200.
http://doi.org/10.1016/j.meddos.2014.02.001.
2. Cagle S, Sullivan C. The Changing Face of The Medical Dosimetrist: How This Will
Affect Your Department. In: AAMD Annual Meeting; 2015. (PPT Presentation).
https://www.roswellpark.org/sites/default/files/changing-face-medical-dosimetrist.pdf.
3. Pusey D, Smith L, Zeman EM, Adams R. A history and overview of the certification
exam for medical dosimetrists. Med Dosim. 2005;30(2):92-96.
http://doi.org/10.1016/j.meddos.2005.03.001.
4. American Association of Medical Dosimetrists. 2020 AAMD Workforce Study Reports.
Salary and Workforce Surveys - American Association of Medical Dosimetrists.
https://www.medicaldosimetry.org/publications/salary-and-workforce-surveys/. Updated
June 1, 2021. Accessed June 21, 2021.
5. Joint Review Committee on Education in Radiologic Technology.
https://portal.jrcertaccreditation.org/accredited-educational-programs/search. Accessed
June 21, 2021.
6. Announcements. AAMD Education & Research Foundation/ AAPM Medical Dosimetry
Accreditation Grant Program.
https://aapm.org/announcements/AAMDFoundationAccreditationGrant.asp. Accessed
May 5, 2021.
7. Vandelannote I, Demanet J. Unravelling socioeconomic school composition effects on
higher education enrollment: the role of students’ individual and shared feelings of
futility and self-efficacy. Soc Psychol Educ. 2021;24(1):169-193.
https://doi.org/10.1007/s11218-021-09608-z.
8. Smith AN, Boyd LD, Rogers CM, Le Jeune RC. Self-perceptions of value, barriers, and
motivations for graduate education among dental hygienists. J Dent Educ.
2016;80(9):1033-1040. http://doi.org/10.1002/j.0022-0337.2016.80.9.tb06185.x.
9. Sabio C. Associate degree nursing students’ perceived barriers to baccalaureate nursing
education and intentions to enroll in a baccalaureate-only nursing environment. Teach
Learn Nurs. 2019;14(1):9-14. http://doi.org/10.1016/j.teln.2018.08.004.
10. Internal and external barriers to effective communication: And how to overcome them!
https://www.seekhle.com/2018/07/barriers-to-effective-communication.html. Updated
July 7, 2018. Accessed July 26, 2021.
 Appendix A
Survey Introduction
Dear Radiation Therapists,

As medical dosimetry graduate students at the University of Wisconsin La Crosse, we invite you
to complete this survey regarding barriers to continuing education in Medical Dosimetry from
the perspective of radiation therapists. We are reaching out to you because you have been
identified as a radiation therapist or are currently enrolled in a radiation therapy program.
Barriers for radiation therapists to pursue an education in medical dosimetry may
significantly impact future workforce demands. The researchers of this study aim
to identify barriers that contribute to radiation therapists not enrolling in medical dosimetry
programs.  

This survey is composed of 7 questions. Completing this survey should take < 4 minutes. The
survey is anonymous, and your identity will remain confidential. Your participation is
completely voluntary. Clicking on the survey link implies consent to participate in the study.

If you have any questions or concerns, please contact our research advisor, Nishele Lenards, at
nlenards@uwlax.edu.

This survey is best suited for completion on a desktop, as some of the questions may not be
mobile friendly. Please click here; or copy and paste this URL into your internet
browser:https://uwlax.ca1.qualtrics.com/jfe/form/SV_ai99mueJRqHakAu

We thank you in advance for your participation.  

If you decide to participate in this survey, please submit the survey before (deadline date).  

Thank you,  

RaeLyn Debner (debner4390@uwlax.edu)  

April Hardman (hardman5150@uwlax.edu)  

Jessica Pagan (pagan7749@uwlax.edu)  

 Appendix B
Questions and Answers to Barriers of Radiation Therapists to pursuing education in Medical
Dosimetry. We greatly appreciate your participation in this survey. This survey should take <4
minutes to complete.
Survey Questions   
1. How likely are you considering furthering your education in a medical
dosimetry program?      
a. Extremely Likely   (skips to #3)  
b. Likely    (skips to #3) 
c. Undecided    (skips to #3) 
d. Unlikely (skips to #2) 
e. Very Unlikely (skips to #2) 
2. Based on your prior answer, is your decision to not further education in medical
dosimetry due to challenges or barriers you may have encountered?  
a. Yes (skip to #3) 
b. No (this choice will auto exit survey with a custom message: “Thank you
for participating in the survey. There are no additional questions applicable to
you”) 
(Q1) What are the external barriers to pursing an education in medical dosimetry for
radiation therapists?  
3. External barriers correspond to limitations outside of us, including people and
environment around us. Please identify the external barriers that would prevent you from
going to medical dosimetry school.  
 Lack of clinical sites in preferred location    
 Lack of familiarity in the program applications    
 Lack of financial support (e.g. scholarships, loans)  
 Loss of employment (income and benefits)    
 Length of most medical dosimetry programs    
 Lack of patient interaction    
 Ergonomic: too much sitting    
 Difficulty of the board exam  
 Lack of flexibility in school enrollment status (part-time options) 
 Lack of flexible schooling format (hybrid or online options) 
 Personal responsibilities    
 Job responsibilities in medical dosimetry  
 Other (please specify) [text entry box]  
 There are no external barriers (skip to question #5) 
4. If applicable, please rank your prior choices of external barriers from most significant (1)
to least significant.  (Use the drag and drop feature to order your choices) 
(This question will carry forward their choices from #3 and allow them to order only those
they selected in #3.) 
(Q2) What are the internal barriers to pursing an education in medical dosimetry for
radiation therapists? 
5. Internal barriers correspond to limitations inside of us, including: our thinking,
attitude, perceptions, and communication. Please identify the internal barriers that would
prevent you from going to medical dosimetry school. 
 Lack of confidence in succeeding   
 Preference to obtain more work experience.    
 Perception about the difficulty level of medical dosimetry education    
 Perception that the job will be boring     
 Perception that I am not in an ideal age range 
 Perception that there would be insufficient support from faculty 
 Perception that job will be stressful 
 Other (please specify)  [text entry box ] 
 There are no internal barriers (skip to question #7) 
6. If applicable, please rank your prior choices of internal barriers from most significant (1)
to least significant.  (Use the drag and drop feature to order your choices) 
 
(This question will carry forward their choices from #5 and allow them to order only those
they selected in #5.) 
 
7.  Demographics: How many years of Radiation Therapy Experience do you have? (post-
graduation)    
a. 0-5    
b. 5+