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Screenshot of MITIE showing room, patient, tube and bucky stand. MITIE, medical imaging training immersive environment.
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IntroductionA 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.MethodsA flexible agile development methodology was used to create the software rapidly and effective...
Context in source publication
Context 1
... systems were proposed to mimic clinical practice while allowing students to use the system without constant supervision. The proposed application comprised accurate 3D model of a digital radiography room, equipment and control area as seen in Figure 1. It was felt to be important that the software enabled students to image any patient position thus a fully adjustable and responsive patient model was constructed around a skeletal model. ...Citations
... Five studies, Bridge et al., 17 Sapkaroski et al., 18 Kato et al., 19 O'Connor et al., 20 and Rowe et al., 21 reported on student performance graded by an assessor. Results indicated that VR is advantageous compared to traditional practical skills training 17,20,21 and role play in a real clinical environment. ...
... Five studies, Bridge et al., 17 Sapkaroski et al., 18 Kato et al., 19 O'Connor et al., 20 and Rowe et al., 21 reported on student performance graded by an assessor. Results indicated that VR is advantageous compared to traditional practical skills training 17,20,21 and role play in a real clinical environment. 18 In the study by Bridge To practice radiographic projections using MITIE. ...
... The VR sessions need to be sufficiently long. In the study by Bridge et al., 17 the students received 2 h of VR training, and only 8 % reported that they wanted more time. However, in the study by O'Connor et al., 23 where the students were permitted to book four half-hour sessions each trimester, 75 % stated that the length of the VR learning sessions were not sufficient. ...
Introduction: The primary objective was to map the impact on confidence and performance on radio-graphic examinations among undergraduate radiography students utilizing virtual reality (VR). The secondary objective was to identify potential pitfalls to avoid in future VR implementation. Methods: A systematic review was conducted, which included comprehensive search in nine databases. The software Covidence was used for screening. Nine studies were included after quality assurance using the Critical Appraisal Skills Programme (CASP). Data extraction consisted of participant characteristics, study design, relevant statistical results, study limitations, and conclusions. Key findings were summarized in a systematic synthesis. Results: VR compared to traditional skills training provides an advantage in students' assessed performance in both equipment and patient positioning, as well as self-reported confidence within equipment positioning, selection of exposure parameters, and radiation safety. For successful outcome, factors to consider were the size of the VR room, VR tutorials, the length of the VR-session, a realistic VR environment , feedback from the VR system, and the opportunity to interact with patients, both verbally and palpatory. Conclusion: VR is a feasible tool, providing students with a safe, engaging, and controlled environment. Students may apply their theoretical knowledge into real-life scenarios, which develop students' clinical skills, critical thinking, and decision-making abilities. Implications for practice: Although VR has shown positive effects, VR alone does not guarantee increased performance and confidence in students. Research within this field is deficient, hence further research is needed to confirm the effect of VR, preferably caseecontrol or randomized studies.
... The participants reported satisfaction levels and perceived value of VR without having the possibility to outline either the factors affecting their enjoyment (or lack thereof) or the particular learning objectives where the potential usefulness of the software is highest and lowest. That might explain the ambivalence illustrated by the high percentage of neutral responses (30%), consistent with earlier findings [9]. ...
Introduction
Virtual reality (VR) has been increasingly recognised as a beneficial pedagogical tool in radiography education, particularly for skills training. This pilot study aims to gain insight into the viability of VR as a pedagogical instrument in a radiographic technique course within a Norwegian bachelor's programme in radiography by assessing users' experiences.
Methods
A cross‐sectional study was conducted involving all first‐year radiography students from a single bachelor programme in Norway. The study included a preliminary survey to gauge students' expectations prior to their first VR session and a main survey following the completion of the course. The surveys assessed demographics, prior VR experience, experiences with the use of VR as a learning tool and possible improvements. VR training was facilitated using Skilitics radiography simulation software across six stations equipped with Oculus Rift VR gear.
Results
Results indicated a significant difference between students' expectations and their actual experiences with VR in skills learning. While initial expectations were high, only 37% of students were content with VR training. Major issues highlighted included technical problems and limited pre‐session training. Students expressed a preference for more VR stations, teacher guidance and better software features.
Conclusion
Although VR holds potential as a supplementary tool in radiography education, the study identified several areas for improvement in the pedagogical approach. Pre‐session training, teacher assistance during the training sessions and feedback after the session are recommended to maximise the educational benefits of VR in radiography skills training.
... Risk-of-bias graph using a traffic light plot for different domains (D1 to D5) [22][23][24][27][28][29][30]32,34,35]. ...
... The studies used a wide range of VR software and hardware. Some of the studies used 3D simulation software packages displayed on 2D desktop computers [22,24,25,36], whereas others used headsets for an immersive VR environment [15,23,26,35,37]. The most used VR teaching software were the CETSOL VR Clinic software [33,35], Virtual Medical Coaching VR software [15,30,32], Projection VR (Shaderware) software [36], SieVRt VR system (Luxsonic Technologies) [37], medical imaging training immersive environment software [23], VR CT Sim software [25], VitaSim ApS software [26], VR X-Ray (Skilitics and Virtual Medical Coaching) software [27], and radiation dosimetry VR software (Virtual Medical Coaching Ltd) [31]. ...
... Some of the studies used 3D simulation software packages displayed on 2D desktop computers [22,24,25,36], whereas others used headsets for an immersive VR environment [15,23,26,35,37]. The most used VR teaching software were the CETSOL VR Clinic software [33,35], Virtual Medical Coaching VR software [15,30,32], Projection VR (Shaderware) software [36], SieVRt VR system (Luxsonic Technologies) [37], medical imaging training immersive environment software [23], VR CT Sim software [25], VitaSim ApS software [26], VR X-Ray (Skilitics and Virtual Medical Coaching) software [27], and radiation dosimetry VR software (Virtual Medical Coaching Ltd) [31]. ...
Background: In recent years, virtual reality (VR) has gained significant importance in medical education. Radiology
education also has seen the induction of VR technology. However, there is no comprehensive review in this specific area.
This review aims to fill this knowledge gap.
Objective: This systematic literature review aims to explore the scope of VR use in radiology education.
Methods: A literature search was carried out using PubMed, Scopus, ScienceDirect, and Google Scholar for articles relating
to the use of VR in radiology education, published from database inception to September 1, 2023. The identified articles were
then subjected to a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)–defined study selection
process.
Results: The database search identified 2503 nonduplicate articles. After PRISMA screening, 17 were included in the review
for analysis, of which 3 (18%) were randomized controlled trials, 7 (41%) were randomized experimental trials, and 7 (41%)
were cross-sectional studies. Of the 10 randomized trials, 3 (30%) had a low risk of bias, 5 (50%) showed some concerns,
and 2 (20%) had a high risk of bias. Among the 7 cross-sectional studies, 2 (29%) scored “good” in the overall quality and
the remaining 5 (71%) scored “fair.” VR was found to be significantly more effective than traditional methods of teaching in
improving the radiographic and radiologic skills of students. The use of VR systems was found to improve the students’ skills
in overall proficiency, patient positioning, equipment knowledge, equipment handling, and radiographic techniques. Student
feedback was also reported in the included studies. The students generally provided positive feedback about the utility, ease of
use, and satisfaction of VR systems, as well as their perceived positive impact on skill and knowledge acquisition.
Conclusions: The evidence from this review shows that the use of VR had significant benefit for students in various aspects of
radiology education. However, the variable nature of the studies included in the review reduces the scope for a comprehensive
recommendation of VR use in radiology education
... Of these 78 papers, 4 full-texts could not be found, while the remaining 74 fulltext articles were evaluated for eligibility. After the full-text examination, another 55 full-text articles were removed; 19 experimental studies were included in this systematic review (Engum et al. 2003;Bridge et al. 2014;Kucuk et al. 2016;Ekstrand et al. 2018;Aebersold et al. 2018;Lorenzo-Alvarez et al. 2019;Gnanasegaram et al. 2020;Lebdai et al. 2021;Ulrich et al. 2021;Smith et al. 2021;Copson et al. 2021;Han et al. 2021;Birrenbach et al. 2021;Behmadi et al. 2022;Gray et al. 2022;Chang et al. 2022;Pickering et al. 2022;Chao et al. n.d. ). ...
... Among the ninteen studies identified, four were quasi-experimental trials Behmadi et al. 2022;Chang et al. 2022;, one was quasi-RCT (Pickering et al. 2022) and fourteen were RCT (Engum et al. 2003;Bridge et al. 2014;Kucuk et al. 2016;Ekstrand et al. 2018;Aebersold et al. 2018;Lorenzo-Alvarez et al. 2019;Gnanasegaram et al. 2020;Lebdai et al. 2021;Ulrich et al. 2021;Beulens et al. 2021;Copson et al. 2021;Han et al. 2021;Birrenbach et al. 2021;Gray et al. 2022;Chao et al. n.d.) (Table 1). ...
... Rights reserved. (n = 7) (Engum et al. 2003;Bridge et al. 2014;Aebersold et al. 2018;Lorenzo-Alvarez et al. 2019;Smith et al. 2021;Birrenbach et al. 2021;Chao et al. n.d.), anatomy (n = 5) (Kucuk et al. 2016;Ekstrand et al. 2018;Gnanasegaram et al. 2020;Copson et al. 2021;Pickering et al. 2022) ( Table 1). The XRs used in the experimental group are summarized in Table 2. Fifteen studies evaluated VR (Engum et al. 2003;Bridge et al. 2014;Ekstrand et al. 2018;Lorenzo-Alvarez et al. 2019;Lebdai et al. 2021;Ulrich et al. 2021;Smith et al. 2021;Copson et al. 2021;Han et al. 2021;Birrenbach et al. 2021;Behmadi et al. 2022;Gray et al. 2022;Chang et al. 2022;Chao et al. n.d.), three evaluated AR (Kucuk et al. 2016;Aebersold et al. 2018;Gnanasegaram et al. 2020), and one evaluated MR (Pickering et al. 2022). ...
Aim
Extended reality (XR) provides technologies that can create engaging and interactive learning resources easily updatable in line with the learning needs. This systematic review aimed to investigate the academic performance (AP), level satisfaction (LS), and acceptability (Ac) of XRs in university education students of medicine and health sciences.
Method
The Preferred Reporting Items for Systematic Reviews statement was applied.
Results
Nineteen experimental studies were included, which examined AP, 15 LS and 4 AC. No study was found that applies the Metaverse, 15 considered virtual reality (VR), 3 Augmented Reality (AR), 1 Mixed Reality (MR). Ten studies showed a statistically significant increase in AP in students who adopted XRs compared to traditional teaching methodologies. Six 5 studies showed a significant increase in LS after VR use. Two studies reported a high percentage of significant acceptability of XR use.
Conclusion
The review provides that Metaverse results still need to be implemented; VR was a valid tool to support the improvement of AP and LS of students; VR turns out to be more widespread than other XRs. There are several discrepancies in the studies that confirm the need to promote the understanding of VR simulation’s effects on the acquisition of skills.
... Significant training is required for radiation oncology professionals to transition from traditional threedimensional conformal radiation therapy to IMRT safely and effectively [6]. While educational resources ranging from paid online coursework to virtual simulators exist, far fewer target RT centers in LMICs transitioning to IMRT [7,8]. Such resources may be inaccessible due to high costs, variable foundational knowledge, and cultural barriers. ...
Purpose
To address a gap in radiation oncology education in low- and middle-income countries (LMICs), we sought to evaluate the effectiveness and generalizability of a refined curriculum on intensity modulated radiotherapy (IMRT) offered to existing radiation therapy (RT) clinics across Africa and Latin America (LATAM) at no cost.
Methods
A curriculum was created based on prior needs assessments and adapted for participating medical physicists, radiation oncologists, radiation therapists, and trainees in LMICs. English-speaking and Spanish-speaking teams of volunteer educators delivered 27 hour-long sessions 1–2 times weekly for 4 months using video conferencing to African and LATAM cohorts, respectively. Pre- and post-course multiple-choice examinations were administered to LATAM participants, and pre- and post-course self-confidence (1–5 Likert-scale) and open-ended feedback were collected from all participants.
Results
Twenty-five centers across Africa (13) and LATAM (12) participated, yielding a total of 332 enrolled participants (128 African, 204 LATAM). Sessions were delivered with a mean of 44 (22.5) and 85 (25.4) participants in the African and LATAM programs, respectively. Paired pre and post-course data demonstrated significant (p < 0.001) improvement in knowledge from 47.9 to 89.6% and self-confidence across four domains including foundations (+ 1.1), commissioning (+ 1.3), contouring (+ 1.7), and treatment planning (+ 1.0). Attendance was a significant predictor of change in self-confidence in “high attendance” participants only, suggesting a threshold effect. Qualitative data demonstrates that participants look forward to applying their knowledge in the clinical setting.
Conclusion
A specialized radiation oncology curriculum adapted for LMIC audiences was effective for both African and LATAM participants. Participant feedback suggests that the refined IMRT course empowered clinics with knowledge and confidence to help train others. This feasible “Hub and Spokes” approach in which a distance-learning course establishes a hub to be leveraged by spokes (learners) may be generalizable to others aiming to reduce global health care disparities through training efforts.
... The components of the social environment include social, human and health services, power relations, cultural practices, and beliefs about place and community. 59 Searching 'environment' in medical imaging resulted in multiple articles on the carbon footprint of medical imaging on the environment, the work environment of the radiographer, the clinical environment, the educational environment, the simulated learning environment, and virtual environment literature mentioning environment; however, no explicit definitions of 'environment' could be found in these studies. 59e61 Therefore, nursing literature was explored to provide a subject definition of 'environment'. ...
... Virtual simulation has emerged as a potent method for training in medical imaging, creating a safer environment. It has led to the development of PC-based virtual environments as extensions of current clinical labs to support teaching in the medical field [5,6,12,13,30]. Recently, head-mounted display (HMD) based Virtual Reality (VR) has been employed to overcome the limitations encountered in various subjects, including medical education [35]. These technologies, compared with traditional 2D monitor-based simulations, provide immersive and engaging interactions that closely simulate reality. ...
... Following the use of the SmartSimulator in week three of the course, participants were invited to complete an online survey. This was conducted at this stage to provide students with sufficient time to form a perspective regarding their simulator experience.The survey questionnaire design and timing was informed by previous studies investigating the effectiveness of simulated learning for diagnostic radiography students (Liley et al., 2018;Bridge et al., 2014;Kong et al., 2015;Shanahan, 2016). The survey included five-point Likert-scale response options to questions about student learning experiences. ...
Background: Simulation-based learning is a crucial educational tool for disciplines involving work-integrated learning and clinical practice. Though its uptake is becoming increasingly common in a range of fields, this uptake is less profound in diagnostic radiography and computed tomography.
Aim: This study explored whether CT simulator software may be a viable option to facilitate the development of practical clinical skills in an effective, safe and supported environment.
Methods: A cross-sectional mixed methods design was employed. Students in their third year of study undertook formal simulation CT learning using the Siemens SmartSimulator, prior to a six-week off-campus clinical experience. A pre- (n = 42, response rate = 39%) and post-clinical placement Likert scale survey was completed (n = 21, retention rate = 50%), as well as focus group interviews to gather qualitative data (n = 21). Thematic analysis was employed to explore how the simulator developed students’ knowledge of CT concepts and preparedness for clinical placement.
Results: Survey scores were high, particularly in terms of satisfaction and relevancy. Focus groups drew attention to the software’s capacity to build on foundational principles, prepare students for placement and closely emulate the clinical environment. Students highlighted the need for continual guidance and clinical relevance and maintained that interactive simulation was inferior to real-world clinical placement.
Conclusion: The integration of CT simulator software has the potential to increase knowledge, confidence, and student preparation for the clinical environment.
... Individual sample sizes range from 13 13 to 272. 14 Diagnostic radiography was the sole focus for all studies except one, which focused on diagnostic radiography and radiation therapy students. 19 No nuclear medicine studies were discovered in the systematic search. The duration of PBL engagement varied across studies, ranging from once-off sittings, 15,18,19 to within a short timeframe longer than one day or sitting, 1,2,13,17,20 or the entire duration of a semester 14 or degree. ...
... 19 No nuclear medicine studies were discovered in the systematic search. The duration of PBL engagement varied across studies, ranging from once-off sittings, 15,18,19 to within a short timeframe longer than one day or sitting, 1,2,13,17,20 or the entire duration of a semester 14 or degree. 12,16 A book chapter, 1 dissertation, 17 and magazine article 13 were included amongst a majority of peer-reviewed journal articles. ...
... 12,14,16 An explicit reference to the PBL intervention being facilitated via a group-based learning environment was made in eight studies. 1,2,13,14,16,17,19,20 Terashita and colleagues adopted a groupbased approach whereby students attended regular sessions to gain practical training experience to solve a clinical scenario involving an emergency patient requiring radiography for multiple trauma. 2 This involved group discussions, research of knowledge, and imaging of a patient phantom. A group approach was also implemented by Bridge et al. to develop a practical skills learning program, though a virtual environment was opted for. ...
Introduction:
The current educational and technological environment in medical radiation science is dynamic. Educators must seek both proven and contemporary methods to ensure graduates are equipped for the clinical environment. This scoping review sought to assess the evidence regarding the value of problem-based learning (PBL) as part of medical radiation undergraduate curricula.
Methods:
A systematic search of Medline, Emcare, and CINAHL was undertaken. Studies using both quantitative and qualitative methodologies were eligible if they reported the outcomes relating to PBL intervention for medical radiation science students in undergraduate education (diagnostic radiography, radiation therapy, or nuclear medicine). Outcomes included self-perceived benefits, disadvantages, and skills. Screening and data extraction was conducted independently by two reviewers.
Results:
Eleven studies were included. Data regarding perceived benefits, perceived disadvantages, and skills were gathered. Pre-post studies demonstrated statistically significant findings suggesting better preparedness and improved attitudes for PBL students. Across institutions globally, there is evidence suggesting PBL is positively received by medical radiation students. High satisfaction was experienced amongst participants. Negative feedback included lack of resources, limitations in realism, and issues associated with groupwork.
Conclusion:
PBL may positively impact student satisfaction, knowledge acquisition, and skills, though this necessitates further research.
Implications for practice:
Medical radiation is an evolving discipline, and problem-based learning poses an educational tool to equip graduates with adaptive qualities.
... After application of the SIGN checklist, four studies were deemed to be of 'high quality (++)' and the remainder were considered 'acceptable (+)'. Blinding of assessors was demonstrated in the majority of studies [23][24][25][26][27][28][29] , whilst subject blinding was considered impossible due to the nature of the intervention. ...
... Drawbacks across the selection included high dropout rates [28][29][30][31][32] and lack of concealment method. [24][25][26][27]32 No studies were excluded based on methodological quality (see Appendix 1). ...
... 23,24,[27][28][29]34 Four studies reported age and gender characteristics for both groups. 24,[29][30][31] Those which did not, excepting two which did not supply any relevant data 26,32 , either stated that baseline sociodemographic characteristics and/or pre-test scores between both groups were non-significant. ...
