Pete Bridge

The development and evaluation of a virtual radiotherapy treatment machine using an immersive visualisation environment

Due to the lengthy learning process associated with complicated clinical techniques, undergraduate radiotherapy students can struggle to access sufficient time or patients to gain the level of expertise they require. By developing a hybrid virtual environment with real controls, it was hoped that group learning of these techniques could take place away from the clinical departments. This paper presents initial evaluation of the use of a three-dimensional immersive visualisation environment (IVE) to simulate a working radiotherapy treatment machine. A virtual patient complete with a range of different treatment sites was used to enhance learning and teaching of beam alignment in 3D. Pre- and post-questionnaires were used to evaluate the perceptions of 42-year 1 pre-registration students with regards to the learning that had taken place. 93% of students perceived an improvement in their understanding and confidence in their technical skills as a result of using the IVE. The mean overall improvement was 21.2% (p<0.00001), and this was positively correlated to perceived realism of the application. The application was reported to be both realistic and enjoyable. Feedback suggested it has a role to play in development of technical skills and also pre-clinical induction. More work with the application is ongoing to clarify that role and the potential benefits of this technology.

A comparison of electronic and paper-based assignment submission and feedback

This paper presents the results of a study evaluating student perceptions of online assignment submission. 47 students submitted assignments and received feedback via features within the Virtual Learning Environment Blackboard™. The students then completed questionnaires comparing their experience of online submission and feedback with traditional methods. Results indicated that 88% of students reported a time saving and many reported financial benefits using online submission. 93% of students preferred having their feedback available online rather than printed and handed to them. Overall, students preferred online assignment management to postal or physical hand-in. The main disadvantage of electronic submission appeared to be student distrust of the receipt system. The use of online assignment submission and management is recommended for use in Higher Education establishments where students may be remote. It is most suitable for assignments that do not require inclusion of many images.

System failure: A comparison of electronic and paper-based assignment submission, marking, and feedback

Introduction The myriad of procedures associated with traditional assignment submission and management presents many problems to academic and clerical staff particularly where cohort size is large. Students also face problems, especially if they are remote to the university and rely on postal services. Online assignment submission and management (OASM) offers potential benefits in this respect, and there has been a considerable degree of interest in its use although experience of its implementation at Sheffield Hallam University is limited.

A snapshot of radiation therapy techniques and technology in Queensland: An aid to mapping undergraduate curriculum

Undergraduate students studying the Bachelor of Radiation Therapy at Queensland University of Technology (QUT) attend clinical placements in a number of department sites across Queensland. To ensure that the curriculum prepares students for the most common treatments and current techniques in use in these departments, a curriculum matching exercise was performed.

Practice patterns of radiation therapy technology in Australia: results of a national audit

This article presents the results of a single‐day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice.

The development and evaluation of a medical imaging training immersive environment

A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory.

MO‐D‐230A‐02: An Immersive Virtual Environment for Training of Radiotherapy Students and Developing Clinical Experience

Purpose:Radiotherapy equipment and techniques are rapidly developing and so efficient training is invaluable. However, the demands on clinical systems and the lack of trained personnel make it difficult to achieve. As an alternative approach we have developed virtual reality training tools, fully interactive and operating on a life size scale these can provide valuable experience for students and staff. We designed a study for 42 first year therapist students to investigate the usefulness of our training environment for learning a clinical technique that typically causes problems. Method and Materials: We have created a virtual environment that simulates an actual radiotherapy treatment machine, controlled via an actual handheld control pendant. The study was developed to simulate a “skin apposition” electron beam treatment. A virtual patient, based on the visible human female dataset, complete with rectangular markings for a range of different treatment sites, provided a range of treatment scenarios. At the Hull Immersive Visualization Environment (HIVE) we are able to project our graphics display onto a 5.3 m by 2.5 m ‘Power Wall’ utilizing stereoscopic visualization enabled via LCD shutter glasses. Such immersive interaction techniques (including the use of the Linac hand pendant) add to the users sense of reality. To provide feedback, we have implemented a ‘scoring algorithm’ to assess how well the user has set up the beam/ patient. Results: The students reported the training environment to be realistic and following its use 93% perceived an improvement in their understanding of this clinical technique and 69% found the control system easy to master. Conclusion: Having implemented such training software and hardware we are beginning to perform academic studies to assess the impact of its use in the educational forum. We wish to understand which areas of multi‐discipline training will benefit from such an approach.

The virtual portfolio: from conception to reality

The rapid growth in web technologies illustrates how global attitudes to paper are changing. The world of radiotherapy is responding to this by steadily replacing paper-based systems with digital equivalents. In this time when the world is swapping thousands of years of dependence on ink and paper for pixels and screens, representing professional development in a large file of paper may soon seem incongruous. This paper aims to introduce the concept of a “virtual portfolio” along with the rationale for using it. In the context of radiotherapy professional practice, the virtual portfolios function mirrors that of a conventional portfolio, but uses electronic media to collate and present the evidence. Potential advantages and disadvantages of the virtual portfolio are presented, along with a brief overview of the software tools that can assist with the transition away from paper. Since a portfolio is ultimately a very individual expression of personal and professional development, it is obvious that the virtual portfolio will not be suitable for everyone. It can be seen that electronic media offer some useful tools to the portfolio developer, but ultimately it is the content and use of the portfolio rather than the format that is of importance.

Achieving waiting time targets: at what cost?

Staffing and equipment levels in the UK are impacting heavily on waiting times for radiotherapy. This paper presents the results of financial and organisational interventions on the radiotherapy waiting list at the Derbyshire Royal Infirmary. Efficacy of these interventions was assessed using audits before and after their application. The interventions included working extended days and weekends, employment of agency staff and “out-of-hours” machine servicing and maintenance. A Waiting List and Data Quality radiotherapist was appointed to streamline the radiotherapy referral system. A waiting list database application was developed to book patients in the correct order of priority and within target waiting times. The resulting increase in radiotherapy workload was achieved over a 3-month period at an approximate cost of £30,000, albeit with several implications. Staff felt that the pace of work was unsustainable, although sickness rates did not increase. After the interventions were removed, and waiting times increased, staff morale dropped. Extended working hours impacted on the reliability of the machines, causing more unscheduled interruptions than normal. This indicated the need for additional maintenance or servicing sessions. This paper shows that full compliance with RCR guidelines for waiting times is achievable, given sufficient financial and organisational assistance.

Development and initial evaluation of a novel 3D volumetric outlining system

The novel three-dimensional (3D) radiotherapy interactive outlining tool allows volumes to be created from a handful of points within axial, sagittal and coronal planes. 3D volumetric visualisation allows users to directly manipulate the resulting volume using innovative-sculpting tools. This paper discusses the development and initial evaluation of the software ahead of formal clinical testing. User feedback was collated as part of the software development phase to ensure clinical suitability, define user training strategies and identify best practice. A loosely structured format was adopted with leading descriptive questions aiming to generate suggestions for improvements and initiate further discussion. The four participants reported great satisfaction and value in being able to use all three planes for outlining, although orientation in 3D was evidently a problem. All participants felt that the software was capable of producing acceptable outlines rapidly and that the multi-planar capability allowed for improved outlining of the prostate apex. Mesh generation from a small number of points placed on a range of planes is a rapid and effective means of target delineation. Multi-slice volume sculpting and 3D orientation is challenging and may indicate a need for a paradigm shift in anatomy and computed tomography training.