Virtual reality increased confidence after HDR prostate brachytherapy training

KEY POINTS

• The simulator contained two interactive modules: patient preparation and template-guided needle insertion. It reproduced an HDR prostate brachytherapy operating room, equipment, transrectal ultrasound views, template coordinates, and visual catheter–anatomy feedback.
• Two single-group pre–post evaluations included 11 participants in the preparation module and 27 participants in the needle-insertion module. Participants included radiation oncologists, medical physicists, and radiation therapists, most with limited previous prostate-brachytherapy experience.
• In the preparation module, median confidence in recalling procedural steps increased from 2 to 4 out of 5 (p=0.002). Confidence in explaining steps, identifying equipment, and explaining equipment function also increased from two to four.
• In the needle-insertion module, confidence in recalling steps increased from 1 to 4 (p<0.001), while explaining steps increased from one to four. Equipment identification and explanation scores increased from two to four (both p<0.001).
• Among the seven radiation oncologists in the needle module, all four confidence domains increased from a median of three to four, but none reached statistical significance (p=0.125) because only four participants had non-zero paired changes.
• Simulator-related symptoms were reported by three of 11 preparation participants and four of 27 needle-module participants, including nausea, dizziness, headache, or discomfort. All completed the sessions and surveys.
• The virtual ultrasound was a graphical proxy rather than a physics-based simulation, and precise needle mechanics were simplified. There was no control group or delayed assessment, and the study did not measure knowledge, needle-placement accuracy, skill retention, transfer to clinical practice, or patient outcomes.

CLINICAL TAKEAWAY

SOURCE

Brachytherapy