Development and pilot evaluation of a virtual reality simulator for HDR prostate brachytherapy

TL;DR

This study developed a virtual reality simulator for HDR prostate brachytherapy and found that it significantly improved immediate self-reported confidence in procedural skills among users.

Contribution

The paper introduces a VR simulator for HDR prostate brachytherapy and demonstrates its effectiveness in enhancing confidence in clinical procedures.

Findings

Confidence increased in recalling and explaining steps

Confidence improved in identifying equipment

Confidence gains were statistically significant

Abstract

Purpose: To develop a virtual reality simulator for high dose rate prostate brachytherapy and to test whether participation is associated with immediate gains in self-reported confidence across predefined procedural domains in two cohorts. Methods: Two modules were developed and implemented using Unreal Engine: patient preparation and template guided needle insertion. Oncology staff and trainees completed pre and post surveys that assessed confidence for recalling steps, explaining steps, identifying equipment, and explaining equipment function. Studies were conducted at the Hands On Brachytherapy Workshop (HOWBT) in London, Ontario, and at Sunnybrook Odette Cancer Centre in Toronto, Ontario. Paired Wilcoxon signed rank tests with two-sided p values compared before and after scores within each module. Results: Patient preparation (N=11) confidence increased for recalling steps (W=65, p=0.002), explaining steps (W=51, p = 0.023), identifying equipment (W=65, p=0.002), and explaining equipment function (W=60, p=0.0078). Needle insertion (N=27) confidence increased for recalling steps (W=292, p<0.001), explaining steps (W=347, p<0.001), identifying equipment (W=355, p<0.001), and explaining equipment function (W=354, p<0.001). Conclusion: The simulator was feasible to deploy and was associated with higher self-reported confidence across key domains immediately after training. Findings may inform future curriculum design and implementation work.