Quantification of Student Radiographic Patient Positioning Using an Immersive Virtual Reality Simulation

Abstract

Introduction Immersive virtual reality (VR) simulation environments facilitate novel ways for users to visualize anatomy and quantify performance relative to expert users. The ability of software to provide positional feedback before a practitioner progresses with subsequent stages of examinations has broad implications for primary and allied healthcare professionals, particularly with respect to health and safety (eg, exposing to x-rays). The effect of training student-radiographers (radiology technicians), with a VR simulation environment was quantitatively assessed. Methods Year 1 radiography students (N = 76) were randomly split into 2 cohorts, each of which were trained at performing the same tasks relating to optimal hand positioning for projection x-ray imaging; group 1 was trained using the CETSOL VR Clinic software, whereas group 2 was trained using conventional simulated role-play in a real clinical environment. All participants completed an examination 3 weeks after training. The examination required both posterior-anterior and oblique hand x-ray positioning tasks to be performed on a real patient model. The analysis of images from the examination enabled quantification of the students' performance. The results were contextualized through a comparison with 4 expert radiographers. Results Students in group 1 performed on average 36% (P < 0.001) better in relation to digit separation, 11% (P ≤ 0.001) better in terms of palm flatness and 23% (P < 0.05) better in terms of central ray positioning onto the third metacarpal. Conclusion A significant difference in patient positioning was evident between the groups; the VR clinic cohort demonstrated improved patient positioning outcomes. The observed improvement is attributed to the inherent task deconstruction and variety of visualization mechanisms available in immersive VR environments.

3D virtual reality simulation in radiography education: The students' experience

“…Students who trained using VR performed better in X-ray beam centring, exposure factor selection, anatomical marker placement, patient positioning and equipment locks. Sapkaroski et al 5 carried out a similar study on a cohort of 76 students and found that the VR trained student cohort performed on average 11% better in patient positioning (p < 0.01) and 23% better in beam centring (p < 0.05) for posterior-anterior and oblique hand projections. Fifty-seven percent of respondents in our study found the process of completing a simulated radiographic procedure in its entirety (reviewing request card, positioning patient, setting up equipment, exposing and reviewing resultant image) beneficial to the development of their radiographic skills.…”

“…These findings correlate with improvements noted in practical assessments following VR training. 3,5 Gunn et al stratified a first-year cohort into two groups; one group trained in the skills lab (n ¼ 23) and the other group trained using computer-based VR simulation alone (n ¼ 22). Students were then assessed performing foot and scaphoid projection radiography in the skills lab.…”

“…patient positioning, exposure, beam centring and collimation errors. There has been an extension of physical skills labs into computer-based virtual environments 2 , 3 and more recently into immersive 3D virtual reality (VR) simulation environments, 4 , 5 , 6 which overcome some of the aforementioned limitations.…”

“… 6 Another study by Sapkaroski found that students who practiced extremity radiography using VR software performed better in a practical extremity examination after a three-week period than those trained using conventional simulated role-play during that time. 5 The authors attributed this improvement to the inherent task deconstruction and the variety of visualisation mechanisms available in immersive VR environments. There has been widespread adoption of virtual simulation tools in radiation therapy education over the past decade.…”

Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

“…In recent years, virtual simulations have been used to help students improve their clinical skills in radiography education [2][3][4][5][6][7][8]. These simulations provide training for tasks such as radiographic positioning, image evaluation, radiographic equipment arrangement, and radiographic procedures.…”