Immersive Patient Education in Radiation Oncology: A Prospective, Randomized, Feasibility Pilot Study

Background and objective Patients undergoing external beam radiation therapy (EBRT) frequently experience anxiety, uncertainty, and difficulty understanding the treatment process. Immersive educational approaches incorporating 360° video technologies may improve patient understanding and preparedness while enhancing the overall patient experience. This study aimed to prospectively evaluate the operational feasibility and patient experience outcomes associated with implementation of a flexible immersive patient education program (IPEP) integrated into routine radiation oncology workflows for patients undergoing EBRT.  Methods  A prospective randomized pilot study was conducted to compare standard-of-care (SOC) education with an immersive education intervention integrated into routine radiation oncology workflows. Immersive educational materials consisting of 360° first-person-perspective videos were delivered through either a virtual reality (VR) headset or a flattened video format based on patient preference and tolerance. Patient-reported anxiety, understanding, and satisfaction were assessed longitudinally throughout treatment using Likert-scale survey instruments. Treatment workflow metrics including treatment time, imaging frequency, and setup shifts were also evaluated.  Results  Forty-nine patients completed the study (24 SOC and 25 intervention: eight VR, 17 flattened first-person-perspective video). The intervention group demonstrated greater reductions in treatment-related, cancer-related, and care plan-related anxiety throughout treatment. Reduction in care plan-related anxiety was significantly greater in the intervention arm (p = 0.01). Patient-reported understanding improved significantly in the intervention group compared with standard of care (p = 0.03). Satisfaction improved in both groups, with larger positive changes observed in the intervention arm. Exploratory workflow metrics demonstrated directional trends toward improved treatment efficiency in the intervention arm, including reductions in treatment time, imaging frequency, and number of setup shifts over the treatment course.  Conclusions  The implementation of an IPEP was associated with improvements in patient-reported anxiety and understanding during radiation therapy. These findings support the feasibility of integrating an IPEP into routine radiation oncology workflows and suggest potential benefits for patient experience outcomes. Larger studies are needed to determine the effectiveness of immersive education approaches and their impact on workflow efficiency.