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4. Findings from the Project

4.1. Procurement, Installation and Training

4.1.1 The procurement process was identified as challenging by the majority of institutions, primarily due to the extremely tight deadlines imposed by the funding process. The major problem encountered by both educational institutions and Trusts was identification of suitable physical space for the VERT installations.

4.1.2 The majority of installations were straightforward with few issues arising but where problems were identified they were usually resolved quickly through contact with the supplier, Vertual Ltd.

4.1.3 Vertual Ltd. provided a 2-hour training session for staff but a number of centres developed supplementary training packages for delivery to different groups of students and staff.

4.2. Management

4.2.1 Establishment of Regional and Local User Groups contributed to the successful management and development of VERT use across the sites, being particularly valuable where groups were multidisciplinary.

4.2.2 Multidisciplinary involvement facilitated acquisition of suitable treatment plans, contributing to the further development of high quality, more diverse VERT resources, enriched by the different professional perspectives of radiographers, dosimetrists, physicists and medical staff.

4.2.3 The role of institutional VERT Lead was identified as crucial to the management of the resource locally to: promote and extend VERT use; train staff; and develop the use of VERT for learning and teaching, staff development, recruitment and research.

4.2.4 Lack of available staff and/or staff time was identified as a barrier to effective use of VERT. The following were suggested as contributory solutions:

(a) problem-based learning sessions which require relatively limited direct supervision by staff also provide students with a valuable learning experience;

(b) use of final-year students to facilitate VERT sessions while providing students with the benefit of developing their own mentorship and supervision skills.

4.3. Use of VERT

4.3.1 VERT was used almost exclusively by pre-registration radiotherapy students throughout the course of the Project but many centres identified potential use of the technology for: postgraduate students; those re-entering the profession; training new staff in local techniques; staff development; evaluation of new or unusual techniques; and use with other staff groups.

4.3.2 Seminar VERT systems were under-utilised in most centres during the Project. Lack of staff; location of the VERT facility; and difficulty gaining access to the facility contributed to under-use.

4.3.3 Dosimetrists made substantial use of Seminar VERT to augment plan evaluation and, in some centres, integrated student learning within the process.

4.3.4 Widening access to other professional and student groups maximises use of VERT facilities, but the impact on pre-registration radiotherapy students needs to be considered.


4.4. Student Experience

4.4.1 Student experience of VERT was very positive with the majority reporting that they had enjoyed using VERT and found the experience motivating.

4.4.2 Student perceptions were that VERT had enhanced their knowledge, understanding, skills and confidence as well as enjoyment of the learning experience.

4.4.3 Limited individual hands-on time was identified as the most common problem experienced, with a majority considering that they had insufficient time in VERT prior to their first placement.

4.4.4 Students gained most benefit where they interacted individually; learned from mistakes made in a ‘safe’ environment; and received immediate, objective feedback on their performance via the software.


4.5. Development of Skills, Knowledge and Confidence

4.5.1 Clinical staff confirmed that pre-placement experience in VERT led to increased confidence and improvement in psychomotor skills; and that the skills developed were transferable to the clinical environment.

4.5.2 The general perception was that VERT, currently, had the greatest impact on students' knowledge and understanding of fundamental concepts, simple techniques and anatomy.

4.5.3 A study undertaken during the Project demonstrated that strategies for achieving good skin-apposition can be effectively learnt in VERT and thus use broadened to include preparation for more complex set-ups. The study also found a positive correlation between inherent spatial ability and performance in electron set-ups.

4.6. Adverse Effects

4.6.1 Adverse effects such as headaches, eye-strain and disorientation were reported by one quarter of students, the highest incidence being noted when 3-D glasses were worn for more than 30 minutes.

4.6.2 The most commonly reported symptoms were minor and detracted little from user experience. They were minimised by avoiding excessive manipulation of the scene during user interaction and limiting the length of exposure to 3D stereoscopy.

4.7. Access to Planning Data

4.7.1 Acquisition and transfer of suitable treatment planning data for Immersive VERT systems was identified as an issue throughout User Group discussions.

4.7.2 Difficulty in accessing the necessary treatment planning data resulted in some limitation in the use of Immersive VERT to demonstrate techniques and enhance plan evaluation in educational institutions without an in-house treatment planning system and associated CT data.

4.8. Recruitment, Retention and Attrition

4.8.1 It is too early to draw any significant conclusions regarding the impact of VERT on attrition in radiotherapy programmes. Although a reduction of 5.4% in student attrition was noted for the 2008/9 year it is impossible to attribute this to the introduction of VERT.

4.8.2 Educational institutions are using VERT to enhance recruitment processes but, again, it is too early to draw firm conclusions regarding its impact.

4.8.3 Feedback following use of VERT to support ‘at-risk’ students indicated that VERT had a positive impact on students continuing on the course and thus suggests that VERT may have a role to play in improving retention.

4.8.4 Enhanced enjoyment of the course and improved motivation, knowledge and understanding may also improve retention.

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