APRT(T) Oral Exam

The objective of the oral exam is to evaluate candidates on their advanced practice competence in solving their patients’ radiation therapy related problems at a level commensurate with the clinical, technical and professional standards set by the CAMRT.

The prospect of sitting for the oral exam can be a little intimidating. To prepare, there are key steps which can be taken to ensure full preparation for the high-stakes online testing experience. It is important to review the following information in detail and well in advance of the exam, to obtain and confirm the necessary skills for such tests.

Advantages of Oral Exams

Direct personal contact
Assessing problem solving and reasoning of realistic scenarios
Recognition of safe and competent individuals
Assessing professionalism and ethics
Opportunity to probe depth of knowledge
Flexibility in moving from one topic to another
Feedback on knowledge, skills and judgement
The ability of the panel to tailor questions to the candidate
The ability of the candidate to tailor questions to the panel

Step 1 – Oral Exam Process

Phase III Process

Consult with Advisor
Thoroughly review this webpage
Review Oral Exam Resources (in Step 2)
Submit fee two months prior to exam date
Complete an online oral exam with 5-6 panelists (3-4 hours)
If successful (candidate passes), the APRT(T) credential is issued

The above process is a simplified version of the steps within the APRT(T) Oral Exam process to obtain, ultimately, certification. It is important for an APRT(T) candidate to recognize that the high-stakes oral exam is similar to defending a master’s level thesis, a resident responding to physician knowledge-testing questions within a clinical case, and procedurally similar to oral exams in other health professions such as that for doctors and graduate-level nurses. As some APRT(T) candidates will come to certification without having direct experience with oral exams, it is prudent to recognize that the skills required to complete this should not be overlooked. To help prepare candidates, CAMRT has compiled some useful resources and detailed information. The exam panelists expect a candidate has reviewed and reflected upon this material, in addition to material found by the candidate independently.

Important Steps

Review the APRT(T) Certification Policies and Procedures Handbook.
Review this webpage in detail and refer to it again as you progress through the steps.
Identify the date of your oral exam and create a learning plan to reach your goal.
- CAMRT strives to identify an exam date within four weeks of the formal notification letter for successful completion of Phase II.
- The date will be mutually agreed upon by both examiners and examinee.
- The examinee should be prepared to request leave from work and other obligations to participate in the oral exam.
- The exam date must be within the candidate’s two-year certification process period. The date considered must take into account time available for a re-sit, should it be required.
Submit the oral exam fee [payment form] two months prior to the exam date.

Step 2 – Understanding the Oral Exam

Physical Space

The oral exam is conducted via a remote internet videoconferencing platform (e.g., GoToMeeting) with yourself and the exam panel. The computer and associated technology needs of the exam will be set up prior to your arrival. You will access the exam from this secure site and will be under the supervision of an invigilator for the entire exam.

You will be able to see the panel and they will be able to see you while in the exam room. Everyone will be in secure and quiet spaces.

A PowerPoint presentation slide deck will be shown on the screen with the exam questions and relevant information.

The panel Moderator will be identified to you. This individual will control the movement of the slide deck and coordinate the exam.

You will be allowed to bring scrap paper, pen/pencil and a non-programmable scientific calculator into the exam room; any other material or personal effects must be safely stored outside the room or given to the invigilator for the duration of the exam.

Accommodations

If you require an accommodation for a disability this must be identified to the CAMRT in writing at the time of your exam payment submission, and must include relevant medical documentation to support the request. Accommodation requests that will not impact the integrity of the exam process or provide an unfair advantage, and are supported by medical documentation, will be considered. Decisions regarding accommodations are at the discretion of the CAMRT and are not open to appeal.

Exam Format

There is a standard structure to the exam format, however, it will be tailored to a specific area of specialization (e.g., palliative, breast, head and neck, etc.). Questions will span the entire trajectory of the patient care path.

An applicant’s self-declared area of practice must be consistent with the applicant’s training, education and supervised experience submitted within the certification process.

The exam time is structured:

One hour prior to exam – locate exam room
Thirty minutes prior to exam – Go on video conference line for debrief with Moderator
Exam lasts approximately 3 – 4 hours

Questions will not ask for reiteration of the content a candidate provided during Phase I and II of the certification process. Instead, the candidate should focus on the practical application of the skills, knowledge and judgement associated with the activities described in the submitted content.

The clinical and technical domains will be addressed through integrative, case-based scenario questions based on the candidate’s chosen specialty.
The professional competencies will be addressed through a set of questions that can be related to the candidate’s experience as outlined in their portfolio submission.

Candidates may have access to select materials in hard copy and online.

Hardcopy materials for review may be provided to the candidate via the Invigilator, thirty minutes prior to the exam starting. Other material may be provided throughout the exam period. Examples of hard copy resources include pathology reports, CT images, DVHs, and CBCT match data.
Candidates may make notes using these materials and write on the material as needed. Any notes and the original material will be submitted to the invigilator at exam completion and prior to leaving the exam room for their secure return to CAMRT.

Review the exam assessment information and Keys to Success in the APRT(T) Certification Policies and Procedures Handbook.

Talk to your Advisor and other APRT(T)s about their exam experience and what tools helped them to prepare.

The oral exam questions are considered confidential during and after certification, and should not be directly discussed.

Oral Exam Question Examples

CLINICAL

Question: On Day 6 of treatment, you are called to the unit by the therapists who note the patient is complaining of esophagitis. How might you approach management with the patient?

Competencies Assessed:

Assess the patient’s physical condition
Formulate and implement an appropriate approach for medical management
Prescribe/dispense pharmaceutical from defined and approved formulary

TECHNICAL

Question: Describe technical considerations for planning simulation in the patient case presented.

Competency Assessed:

Provide interpretation and evaluation of technical and radiobiological information

PROFESSIONAL

Question: What is your philosophy on coaching and mentoring, and how did you come to build this perspective?

Competency Assessed:

Coach and mentor staff, students, other healthcare providers

Oral Exam Resources

Step 3 – Understanding the Exam Panel

Panel Structure

Exam panelists (examiners) are chosen because of their professional expertise in the specialty chosen by the candidate. All individuals have completed oral examiner training.

This training provides examiners with a copy of the exam, review of the scoring criteria and process in conjunction with the APRT(T) Competency Profile, and a review of the criteria for recusing oneself from the exam of a candidate known by the examiner.
In assigning exam panels to a candidate, efforts will be made to avoid conflict of interest, or the perception of a conflict of interest for both the panel members and the candidate.

You will not be made aware of who is on your panel prior to the exam.

All individuals, their professional title, and purpose for being on the panel will be identified for the candidate at the exam.

The panel composition includes (max 7 people):

Moderator (Chair or delegate from the APRT Committee)
At least one radiation therapist, APRT(T) preferred
At least one radiation oncologist
At least one medical physicist
Preference is given to those with prior APRT(T) certification or established expertise in the specific specialty.
Additional individuals may be present, including individuals who are shadowing (training). However, these individuals will play no role in the assessment of the candidate.

Panel Expectations

The panel Moderator will be identified to you when the exam begins. This individual will oversee the exam implementation, provide instructions, interact with the candidate if necessary and control the movement of the slide deck that guides the exam.

If you have any questions about the structure of the exam, need a slide changed or require clarification about information on a slide, you may direct these and other questions to the Moderator if another more suitable person is not identifiable.

During the exam, the panelists are expected to sit quietly and listen to your responses. They will also directly ask you questions associated with their professional expertise and the exam questions. You are expected to respectfully respond to the best of your abilities.

If you require more information, clarity regarding their question, or need a moment to pause and think of a response, it is appropriate to inform the panel of this.

In a virtual online setting, it may be hard to read the expressions and reactions of the panel. They may be more apt to maintain a stoic presence while you are talking rather than be highly animated. This is normal and expected behaviour of the panel.

You may notice a panelist writing notes for their evaluation purposes or using their keyboards to type. This is appropriate and expected behaviour of the panel.

If you find that the typing or an environmental noise is distracting, you may ask the Moderator to mute all microphones until a question is asked.

Presentation Resources

Step 4 – Preparing for the Exam

Consult with your advisor and other APRT(T)s
Research high-stakes oral defense exam skills
Practice oral defense exam skills
Reflect on experience and oral defense exam skills
Adjust learning plan

CAMRT highly recommends that candidates receive mentoring from an individual who has successfully completed their APRT(T) oral exam or has completed oral exams in general and is currently practicing within their specialty. This is in addition to consultation with their advisor.

Depth and breadth of knowledge: Candidates should exhibit a high degree of depth and breadth of knowledge for their area of specialization. As an example, if a case was on topic A, questions that may be asked, but are not limited to, include:
1. What types of topic A problems might be encountered in a person who has disease B?
2. If a case report was submitted which involved the co-management of a patient who had condition C, how is complication D and E managed and why?
Professional skills: You should be able to describe your accomplishments and contributions to your profession. However, a reiteration of what you accomplished is not enough. Remember to focus on the process of how you accomplished it, your thinking associated with this process (how it worked and how it could be improved with future projects), the skills and tools used to create change, and how these might be applied in the future.
Know what others know: It is not enough to say another profession “does something” or you would refer the matter to another profession. Think deeper – ensure you can explain the processes used in interdisciplinary practice, reasons for referral and possible outcomes for the patient, and the rationale for established patient care pathways. When you don’t know the information, it is best to state so and how you would find the information out.
Be prepared: Candidates should be prepared for questioning that will probe their ability to think and support their philosophy of practice. Basic knowledge and high standards of care are required for certification in advanced practice.
Realistic Expectations: High achievers tend to focus on what to do right and they forget to acknowledge that everyone does something wrong sooner or later. The oral exam panelists do not expect you to be perfect. Take a moment to understand your mental strength and identify skills to be worked on.

APRT(T) Oral Examination Preparation Exercise

Building Mental Strength Resources

Step 5 – Day of the Exam

Items to bring to the exam

You must bring a valid piece of government-issued Photo ID with valid expiration date and visible signature (e.g., drivers license, passport, etc.) to confirm your identity.

You will also be allowed to bring into the exam room:

Water/juice/coffee/drink in a clear spill-proof container with no label
Scrap paper and pens/pencils
Non-programable scientific calculator

Any other material or personal effects, including cell phones and/or electronic devices, food (for the break), must be safely stored outside the room or given to the invigilator for the duration of the exam.

Hour before your exam is scheduled:

Identify the room and meet the invigilator – you may be asked to present your photo ID to confirm your identity.

Confirm with the invigilator they have checked that the computer and internet connection are working.

Identify where the washroom is and any other relevant locations important to you.

Find a spot close by to consume any drinks or snacks you need. Take a moment to reflect on what you have learned and review your notes.

Review the oral exam Keys to Success section in the APRT(T) Certification Policies and Procedures Handbook and refresh yourself with these vital points.

Thirty minutes before exam is scheduled:

Arrive back to the exam room. If you arrive late to the exam room, you will not be provided with additional time.

All electronic devices should be turned off (cell phones, digital/smart watches) and will be collected by the invigilator. Wallets, keys and other loose belongings will also be collected. All other personal belongings, such as purses, bags and suitcases, can be placed in a location within the exam room by the invigilator. Please note that study materials are not permitted in the exam room with you after you have entered.

All personal belongings will be returned to you upon completion of the exam.

Your workspace will be clear of all material not required for the exam. Place your allowed items down and make your spot comfortable.

Allowed items: scrap paper, pens/pencils, non-programable scientific calculator

The invigilator will provide you with some initial information and ensure your computer is properly set up.

For example, you will not be allowed to use the Chat Room in the videoconferencing program during the exam.

The invigilator will provide you access to the videoconferencing program. You will be connected to the Moderator who will provide you with an introduction, some grounds rules and answer any questions you may have prior to the exam starting.

Upon completion of the discussion with the Moderator, your computer screen will be turned off and the invigilator will promptly provide you with any hard copy material you may review prior to the exam. Take this time to review the documents and make notes.

Five minutes prior to the exam starting, the invigilator will ensure the computer screen is turned on and the appropriate connection is made to the exam panel.

Your exam will begin promptly with the Moderator starting the conversation.

During the exam

You are able to ask for a break during the exam if you need one. You will not be allowed to take exam items or electronic devices out of the room.

You are allowed to ask the Moderator or any panelist for clarity on any question, case or exam material during the exam.

You may request that the Moderator show you a specific PowerPoint slide on your computer if you need to see the information again.

You should ask for a moment to think about your response and write down notes.

The panelists expect there to be silence during these moments. It is best to identify your actions explicitly to ensure there is not a misunderstanding of your intent.

Remember to identify your thinking process in all responses.

You should expect the examiners to ask additional questions (probes and prompts).

Probes help a candidate explore, investigate, or further extrapolate on their response, and are necessary for some exam questions; for example: a question is presented to the candidate but the answer requires more information than the original question describes. Probes are considered as part of the exam questioning.
Prompts lead a candidate toward what they should answer as part of an exam question, or when an adequate probe wasn’t sufficient in obtaining an appropriate answer from the candidate.; for example: the exam question directly states that an answer is required for a specific topic and the candidate misses this topic as part of their answer. Prompts are considered as part of the scoring dimensions.