users of Immersive VERT indicated that 71 per cent reported at least one symptom. exercised in overexploiting final year students in this way, particularly where they
The symptoms reported most commonly were related to visual issues. These were need to focus on developing their own clinical skills and experience.
minor and did not affect individuals’ use of the system. The results are consistent
with some of the early findings of studies integral to the VERT project evaluation Access to DICOM data and integration with
strategy where users commonly report eye strain and/or headaches. Nausea and
treatment planning systems
disorientation are less commonly reported although are more prevalent in those One of the major problems faced by many centres has been a lack of data that they
users with a pre-existing illness (including hangovers), and those who are viewing can import into VERT and use subsequently in learning and teaching scenarios. Ensuring
a 3D image that is being inexpertly manipulated by an independent person. that the necessary patient consent exists for CT and treatment planning data to be used
Many users of Immersive VERT also report that the LCD shutter glasses are heavy, for teaching purposes, was an early stumbling block for many clinical departments and
uncomfortable, or do not fit well over prescription spectacles. universities, although this now appears to have been largely resolved at local levels.
There have been calls for a repository of shared DICOM plan files by some users. This
Whilst these symptoms do not appear to limit the use of the system, the severity has yet to be realised for a number of reasons, including consent issues similar to those
of them is reduced when the stereo 3D feature is turned off and users can view identified above; it is unlikely to become available in the immediate future and may
2D images without having to wear the 3D glasses. Although this might notionally not be achievable given current data protection and confidentiality policies . Efforts
reduce the extent to which users feel immersed in the virtual environment, to produce example plans based on the visible human female CT dataset have been
educators might consider this a worthwhile trade-off where appreciation of depth explored although there are obvious limitations to this approach.
cues is not vital to students understanding or skills development. Similarly, user
tracking might be worthwhile for those individuals who are susceptible to motion Those universities that have in-house treatment planning systems (TPS) and
sickness or experience disorientation when the view is manipulated by another associated CT data appear to be at a significant advantage particularly in relation
person. Both the impact of 3D stereo and user tracking on student performance to being able to use VERT to demonstrate techniques and enhance plan evaluation
and experience are being evaluated in one of the national VERT projects. (as previously discussed). The VERT technology seems to add considerable value
for these purposes although it is necessary to take full advantage of the features of
In any event, educators would be well advised to inform all users of the likelihood the VERT software to best exploit the learning opportunities.
of symptoms prior to use, to use the 3D stereo feature with caution, to minimise
manipulation of the scene when a user is interacting with it and to keep sessions Where centres have networked their TPS to the VERT facility they have had to
where 3D stereo is used relatively short. address certain issues. Data has to be exported from the TPS in DICOM format
before importing into VERT. Some users have reported this is excessively time
Staffing and time consuming with export times of up to five minutes. Where students are exporting
The implementation of VERT and the associated expectation that it will be widely and importing data themselves, the risk of accessing and inadvertently corrupting
integrated into the curriculum is undoubtedly placing substantial pressure on other vital data (on the TPS server) must be considered. These problems are
already highly stretched staff in departments and universities. Academic staff are surmountable but a quick and simple solution is to export and import the data via
having to reconsider curriculum design and prepare VERT sessions and, whilst this is a portable USB drive. This also reduces export time to a matter of seconds.
predominantly only a short term problem, the rapid introduction of the technology
has added to pre-agreed workloads and complicated timetabling. Clinical staffing Management of VERT resources
levels in many departments preclude opportunities for radiographers using VERT to The VERT technology has been funded and implemented with the education
teach students. Use of VERT in the clinical environment is further restricted in those and training of therapeutic radiographers in mind but the wider potential of the
centres where it is necessary to pre-book a shared room. technology has not gone unnoticed by those institutions where it has been installed.
Dosimetrists have been attracted by its capability to enhance plan evaluation.
Some centres are trialling the use of final year students to facilitate Seminar Academics in other disciplines are excited by possibilities for employing stereoscopic
VERT tutorials. These students are trained to operate the VERT technology and visualisation to enhance learning, teaching and research. Universities are particularly
may benefit themselves in this way through the development of mentorship and averse to any of their estate being underused. It is important, therefore, that
supervision skills. This may provide a cost-effective and symbiotic solution that academic and clinical leads for VERT take steps to protect against encroachment
alleviates the problem of limited clinical staff time although caution needs to be on the resource through maximising its use for radiotherapy education and
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IMAGING & ONCOLOGY
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2009
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