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The Virtual Environment for Radiotherapy Training (VERT) is a simulator used to train radiotherapy students cost-effectively with limited risk. VERT is available as a two-dimensional (2D) and a more costly three-dimensional (3D) stereoscopic resource. This study aimed to identify the specific benefits afforded by stereoscopic visualisation for student training in skin apposition techniques.
Eight participants completed six electron skin apposition setups in both 2D and 3D views of VERT using a 7 cm × 10 cm rectangular applicator setup to 100 cm focus skin distance (FSD). The standard deviation (SD) of the mean distance from each corner of the applicator to the virtual patient’s skin surface [which we define as apposition precision (AP)] was measured along with the time taken to achieve each setup. Participants then completed a four-question Likert-style questionnaire concerning their preferences and perceptions of the 2D and 3D views.
There was little difference in mean setup times with 218·43 seconds for 2D and 211·29 seconds for 3D (3·3% difference). There was a similarly small difference in AP with a mean SD of 5·61 mm for 2D and 5·79 mm for 3D (3·2% difference) between views. The questionnaire results showed no preference for the 3D view over the 2D.
These findings suggest that the 2D and 3D views result in similar setup times and precision, with no user preference for the 3D view. It is recommended that the 2D version of VERT could be utilised in similar situations with a reduced logistical and financial impact.
In many countries, there is a skills gap in proton therapy with many staff unprepared to work with the new technology. The new Virtual Environment for Radiotherapy Training (VERT) proton module provides learners with a simulated proton machine 3D environment. This project aimed to evaluate the role of VERT in training the radiotherapy workforce for the future use of protons.
A practical teaching session using VERT was deployed after a traditional teaching session had provided basic knowledge. A questionnaire deployed before and after VERT enabled comparison of knowledge while a combination of Likert and open questions gathered participant feedback concerning the initiative.
A total of 38 students provided evaluation of the session. Overall, there were high levels of satisfaction and enjoyment with 35 participants reporting enjoyment and 36 indicating that the event be repeated.
Participants felt that they had learned from the experience, although quantitative data lacked statistical significance to demonstrate this. All participants agreed that VERT had provided improved understanding of proton dose deposition arising from visualisation of beams and dose deposition. Most participants agreed that the simulation was realistic and that it had improved their understanding. Feedback in relation to future sessions concerned smaller group sizes, more patient cases, more time and additional clinical datasets.
A proton simulation module has been shown to be an enjoyable teaching tool that improves students’ confidence in their knowledge of the underpinning theory and clinical usage of the modality. Learners felt better prepared to encounter protons in clinical practice. Future work will build on these findings using smaller group work and a more robust assessment tool to identify long-term impact of the training.
We have developed the Female Urinary Symptom Score (FUSS), a symptom questionnaire for the evaluation of urinary incontinence and lower urinary tract symptoms in women and their effect on quality of life. The FUSS is a modified version of the International Prostate Symptom Score adapted for use in women. It consists of a simple questionnaire of only eight questions, which patients can answer quickly on a numerical scale. We performed a validation study of the FUSS by comparing it with the King’s Health Questionnaire (KHQ), a well-validated but longer symptom questionnaire. We sent both questionnaires to 220 women between the ages of 45 and 65 years randomly selected from two general practices in the United Kingdom. Urinary symptom status was unknown; 149 (94%) of the FUSS questionnaires and 115 (73%) of the KHQs were completed correctly. Correlation was conducted on the scores of the 115 matched pairs and was high (r = 0.83). We sent another copy of the FUSS questionnaire to the same group of women after four weeks, and found that the test and re-test scores for FUSS were highly correlated (r = 0.88). We conclude that the FUSS is a simple, reliable and reproducible tool for the diagnosis of urinary symptoms in women. As it is brief, we believe that it will be useful in the primary care setting, enabling women to receive appropriate treatment and care as early as possible.
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