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

Area of Science:

• Medical Simulation
• Surgical Education
• Virtual Reality in Medicine

Background:

• High dose rate (HDR) prostate brachytherapy requires specialized skills.
• Traditional training methods may not fully replicate the complexities of the procedure.
• Virtual reality (VR) offers a potential solution for immersive and safe skill acquisition.

Purpose of the Study:

• To develop a VR simulator for HDR prostate brachytherapy.
• To evaluate the immediate impact of the VR simulator on self-reported confidence in procedural domains.
• To assess confidence gains in two distinct clinical cohorts.

Main Methods:

• Development of VR modules using Unreal Engine for patient preparation and template-guided needle insertion.
• Pre- and post-training surveys assessing confidence in recalling, explaining, and identifying procedural steps and equipment.
• Data collection from oncology staff and trainees at two Canadian institutions.
• Statistical analysis using paired Wilcoxon signed rank tests to compare pre- and post-training confidence scores.

Main Results:

• Significant increases in self-reported confidence were observed across all assessed domains for both patient preparation and needle insertion modules.
• Patient preparation module (N=11) showed statistically significant improvements in recalling, explaining, identifying equipment, and explaining equipment function (p<0.023).
• Needle insertion module (N=27) demonstrated highly significant improvements in all confidence domains (p<0.001).

Conclusions:

• The developed VR simulator is feasible for deployment in brachytherapy training.
• Participation in the VR simulator training led to immediate, significant increases in self-reported confidence.
• These findings support the integration of VR simulators into brachytherapy curricula for enhanced procedural training.