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Introduction:The onset of the COVID-19 pandemic halted inperson activities in universities and caused disruption in the usual iteration of the semesters. When the clinical environment resumed student placement, the potential health risks caused additional anxiety to the students and clinical faculty. This paper aims to examine the measures implemented to support the radiation therapy students during their first clinical placement during the COVID-19 pandemic. Background:The 2nd year radiation therapy students' first clinical placement was organized around pandemic restrictions that required new activities to support student safety and wellness. The clinical faculty team redesigned the clinical course to integrate enhanced communication, additional safety measures and mental wellness sessions, as well as making COVID-19 related resources available during the week-long orientation and throughout the semester.Methods: Registered students were asked to participate in a 9-item survey questionnaire to gather their perspective on the effectiveness of the orientation and clinical activities during the pandemic. The responses were tabulated and independently analyzed for emergent themes by the clinical faculty. Discussion:The students reported that the combination of activities, workshops, exposure to the treatment unit and feedback from both clinical faculty and learning mentors provided the support needed for physical safety and wellness in the clinic. Identified challenges included communication with continuous masking, the timeliness of communicating evolving clinical safety protocols, and the need for enhanced coordination of interprofessional education. Conclusion:The COVID-19 pandemic brought new challenges and opportunities for students and clinical faculty at the University of Alberta's Radiation Therapy department. The results of the quality improvement survey highlighted the importance and effectiveness of the redesigned clinical course, which integrated COVID-19 related activities, enhanced communication strategies, safety, wellness resources and check-ins throughout the course.

rapher). Contours were defined on T2-weighted three-dimensional turbo spin echo sequences, reconstructed axially (T2w 3D Tra) acquired on the MRL. To assess the guide's utility, 9 radiographers with varying MRL experience contoured 5 MRI scans in the Monaco treatment planning system, from 5 different patients (n = 25). Each radiographer contoured the prostate, seminal vesicles, bladder, and rectum on each data set before and after the introduction of the atlas. The 'after' contours were generated >21 days following the 'before' contours to minimise the effects of repetition. In addition to DICE coefficients and descriptive statistics, inter-observer contour variations, time to contour and observer contouring confidence was determined prior to and following the introduction of the atlas utilising a 5-point Likert scale (observers score confidence 1 not confident to 5 extremely confident). Results: The contouring atlas has been agreed by the multidisciplinary team incorporating locally defined gold-standard contours and RTOG guidance. Five sets of images from 5 different patients have been acquired on the MRL (T2w 3D Tra) and to date the 'before' contours have been completed. Mean contouring time without the atlas for all contours was 54 minutes with the rectum and prostate contouring taking the greatest amount of time, a mean time of 15 minutes each. Contour confidence levels varied between participants greatly. Minimum contour variability between the observers was for the bladder contour, with the maximum range being 22.0cm3. This corresponded with the participants scoring the bladder contour with the higher confidence level rates (majority scoring ≥ 3). Prostate and rectum structures had the greatest contour variability between observers with the maximum range being 32.6cm3 and 36.1 cm3 respectively. Confidence levels also corresponded with this large variation with majority of observers scoring ≤ 2. The same radiographers will repeat the process with the aid of the contouring atlas. Conclusion:It is anticipated that the new atlas for contouring prostate and surrounding OAR anatomy during both online and offline radiotherapy planning scenarios will reduce inter-observer variability, uncertainty and the time needed to contour. This will be of particular benefit in future adapt to shape pathways.

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