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A Beginner's Guide to Mentoring CTRs
Mentoring blog

By Julie Bell, CTR, Quality Data Coordinator

Mentoring new Certified Tumor Registrars (CTRs) is more important than ever. We live in an everchanging world, with many different variables changing the industry every single day. Whether you have a few years under your belt or you’re a 20+ year veteran to the profession, mentoring is necessary for the next generation of CTRs. This article will briefly explore why mentoring is needed, how it is being done and some of the best practices for doing it – think of it as a beginner’s guide to mentoring CTRs, featuring the famous five Ws (who, what, where, when and why) and one H (how).

Who needs mentoring and who makes the best mentor?

If you have obtained your CTR in the last three years, you need a mentor. It doesn't matter how smart or ready you think you are. Anyone who knows about collecting cancer registry data recognizes that as the methods of diagnosis and treatment of cancer have evolved, so has the complexity of data that is collected in the cancer registry.  Thankfully, significant strides have been made in the standardization of registry codes. There are many free or inexpensive webinars available that clarify the codes and concepts. Without these webinars, believe me, we would all be lost!  Even so, it's difficult for someone new to this profession to accurately apply the “book knowledge” when abstracting. Without a mentor, wrong assumptions can be made, leading to coding errors and bad habits.

Who should the mentor be? Someone who has been a CTR for five years or more and is proficient at abstracting all sites. Their accuracy rate should be 95% or above.

What do the new registrars need help with?

The simplest answer is EVERYTHING.  If you have gone to school and successfully passed the CTR exam, you have learned quite a bit of knowledge. The college curriculum is comprehensive and encompasses all of the manuals that are used to abstract cases and run a cancer program at a hospital. So, what is missing? Experience!  Experience using the manuals. Experience reading and interpreting patient charts. Experience entering data into various registry software. These are just a few things. Experience is the way you develop the critical thinking that is required to interpret and apply the information contained in the manuals. Each individual’s needs will be different, of course, and each individual has a unique learning style.  However, there are several areas that everyone needs help understanding. For example:

  • Setting up resources (adding links in favorites for all of the manuals)
  • Dates: Diagnosis Date, Date of First Contact, Date of First Course Treatment
  • Class of Case
  • Histology
  • Staging (AJCC and SEER), EOD (for SEER hospitals)
  • Treatment
  • Facility specific information and how to abstract at a multi-hospital facility
  • Entering Information into a data base (each software is different)
  • Data utilizations/running reports

Where and how should mentoring be done?

Whether the registry is remote or located at a hospital, other than the logistics, the plan is the same. Start abstracting with a solid tumor site that is not too complex.  Thyroid, kidney, prostate are all good choices because they do not have a lot of SSDIs, there are not a lot of rules for determining multiple primaries, and the treatment is usually not complex.  Whichever site you choose as your starting point, make sure that you have 10-20 cases available to abstract. 

Before a new CTR begins abstracting, it’s a good idea to go over the primary site, staging, histology, treatment and any other facility specific nuances. The first case should be abstracted together. After that, the new CTR should abstract on their own. The mentor should review each case immediately after it is abstracted using a standardized form to tally the errors.  Immediate feedback is very important.  As soon as the mentor has reviewed the abstract, the errors found should be communicated to the new CTR so they learn not to repeat them.  Once the new CTR has abstracted more cases with very few errors — you set the parameters — they can move on to the next site. Abstracting by site gives the new CTR practice on one site rather than being overwhelmed by many sites with different rules, different data items and different challenges.  When they move on to a new site, make sure that they continue to abstract one or two cases of the site(s) that they have already practiced so they do not lose the skills they learned.

A win/win/win situation

What you end up with is a win/win/win situation.

The mentor wins because it is satisfying to help people learn and grow. Additionally, the mentor wins because at the same time they are learning and growing too.  Mentoring forces the mentor to become familiar with the manuals. Plus, the mentor’s abstracting will improve because of the repetition. A word of caution, however: It is never a good idea to have an inexperienced registrar or a registrar with poor accuracy rates as a mentor. A mentor who is not proficient and accurate may improve, but, it is a disservice to the new CTR to learn from someone who still has significant learning to do themselves.

The new CTR wins because someone has taken the time to help them become the best they can be. They will be more likely to stay employed at the company because of the relationships built while learning.

Finally, our profession wins because the mentor and the new CTR have worked together to ensure that the data is collected accurately. Remember, better data saves lives!

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