1. Rhode Island Cancer Registry Internship Training Program David Rousseau, BS Director, CIS Hospital Association of Rhode Island Rhode Island Cancer Registry June 24, 2010 Quebec City, Quebec NPCR/CDC Grant Number 5U58DP000830-0

2. Background The Rhode Island Department of Health contracts the Hospital Association of Rhode Island to maintain the official statewide cancer incidence database The Rhode Island Department of Health contracts the Hospital Association of Rhode Island to maintain the official statewide cancer incidence database John Fulton, PhD at Rhode Island Department of Health John Fulton, PhD at Rhode Island Department of Health

3. Presentation Outline Identify the problem Identify the problem Evaluate solutions Evaluate solutions Develop a plan of action Develop a plan of action Develop Internship Training Program Develop Internship Training Program Institute Internship Training Program Institute Internship Training Program Evaluate Internship Training Program Evaluate Internship Training Program Summary & Conclusions Summary & Conclusions

4. The Problem There is a well documented nationwide shortage of Certified Tumor Registrars There is a well documented nationwide shortage of Certified Tumor Registrars Many of the current Certified Tumor Registrars are nearing retirement age Many of the current Certified Tumor Registrars are nearing retirement age The field of Cancer Registration is relatively unknown The field of Cancer Registration is relatively unknown The path to certification is difficult and getting more difficult The path to certification is difficult and getting more difficult The work is getting increasingly more complex The work is getting increasingly more complex

5. Evaluate Solutions College curriculum College curriculum Small number of openings Small number of openings Only college level course in the area closed because of lack a of students Only college level course in the area closed because of lack a of students Train candidates selected by reporting facilities in the hospital setting Train candidates selected by reporting facilities in the hospital setting Hospitals needed someone immediately Hospitals needed someone immediately Complexity of cancer registration not understood Complexity of cancer registration not understood

6. Evaluate Solutions We then decided to examine how the existing workforce entered the field We then decided to examine how the existing workforce entered the field Identify prospective cancer registrars through the Rhode Island cancer registry community and provide them with class room training and clinical experience that provides them with the experience needed to decide if they want to follow the path to certification Identify prospective cancer registrars through the Rhode Island cancer registry community and provide them with class room training and clinical experience that provides them with the experience needed to decide if they want to follow the path to certification

7. Rhode Island Cancer Registry Internship Training Program Identify candidates with existing interest and understanding of cancer registration through cancer registry community Identify candidates with existing interest and understanding of cancer registration through cancer registry community Restrict participation to hospital staff or people in allied health fields Restrict participation to hospital staff or people in allied health fields Provide flexibility to allow for varied work schedules Provide flexibility to allow for varied work schedules

8. Develop Internship Program Develop internship curriculum and materials Develop internship curriculum and materials Introduction to Cancer Registration Introduction to Cancer Registration Basic anatomy Basic anatomy Case finding, abstracting, coding and staging Case finding, abstracting, coding and staging CoC Standards CoC Standards 2 days a week for 8 weeks 2 days a week for 8 weeks Generous homework assignments Generous homework assignments

9. Develop Internship Program Clinical Experience Clinical Experience Review case finding audit materials from reporting hospitals and pathology labs Review case finding audit materials from reporting hospitals and pathology labs Create partial abstract using Abstract Plus Create partial abstract using Abstract Plus Conduct case finding audits and create partial abstract using real medical records Conduct case finding audits and create partial abstract using real medical records

11. Evaluate Internship Program We expected to conduct the program 1 time with 7 to 10 interns but due to the response we had to schedule a second class for a total of 19 interns We expected to conduct the program 1 time with 7 to 10 interns but due to the response we had to schedule a second class for a total of 19 interns Developed an advanced program that involved more extensive abstracting, CS and T-N-M staging Developed an advanced program that involved more extensive abstracting, CS and T-N-M staging

13. Evaluate Internship Program 7 of the 19 interns or 36% are currently involved in cancer registration 7 of the 19 interns or 36% are currently involved in cancer registration 2 are abstracting in a CoC approved hospital 2 are abstracting in a CoC approved hospital 3 are involved with case finding and follow-up 3 are involved with case finding and follow-up 1 is training to become the registrar at the Rhode Island VA 1 is training to become the registrar at the Rhode Island VA 1 has filled open part time position at RICR 1 has filled open part time position at RICR 3 interns are actively following the path to certification 3 interns are actively following the path to certification

14. Summary The internship program was not designed to train cancer registrars. The internship program was not designed to train cancer registrars. The internship program was designed to provide people with an interest in cancer registration with a understanding of what the field truly involves through class work and clinical experience so that they can decide if they wish to follow the path to certification The internship program was designed to provide people with an interest in cancer registration with a understanding of what the field truly involves through class work and clinical experience so that they can decide if they wish to follow the path to certification

15. Conclusions Just as in the past there are people from allied healthcare fields who have displayed an interest in cancer registration Just as in the past there are people from allied healthcare fields who have displayed an interest in cancer registration When provided with an understanding of cancer registration through class work and clinical experience there are people who will follow the path to certification When provided with an understanding of cancer registration through class work and clinical experience there are people who will follow the path to certification

16. Special Thanks Rhode Island Cancer Registry Community Rhode Island Cancer Registry Community Ruth Maranda, LPN, CTR Ruth Maranda, LPN, CTR Mary Lewis, CTR Mary Lewis, CTR

17. RICR Internship Training Program Training Materials Contact: Contact: DavidR@HARI.org DavidR@HARI.org DavidR@HARI.org RuthM@HARI.org RuthM@HARI.org