115 - International Pilot of an Immersive Virtual-Reality-Based Training in Intracavitary Cervical Cancer Brachytherapy Treatment: Educational Impact and Early Outcomes
Presenter(s)
J. Peterson1, D. Kok2, H. Mahmood3, S. A. Polce1, S. Alanyali4, I. Jaradat5, M. Y. Lin6, L. Wahbeh7, K. Yamoah8, A. Jhingran9, A. Rishi1, and S. Ndarukwa10; 1H. Lee Moffitt Cancer Center and Research Institute, Department of Radiation Oncology, Tampa, FL, 2Peter MacCallum Cancer Centre, Melbourne 8006, Australia, 3Atomic Energy Cancer Hospital NOR, Islamabad, Pakistan, 4Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey, 5King Hussein Cancer Center, Amman, Jordan, 6Peter MacCallum Cancer Centre, Melbourne, Australia, 7Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan, 8Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 9Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 10International Atomic Energy Agency, Vienna, Austria
Purpose/Objective(s): Limited access to high-quality cervical cancer brachytherapy (BT) training, particularly in low- and middle-income countries (LMICs), contributes to global disparities in care. Virtual reality (VR) offers scalable, immersive procedural training with potential to improve technical knowledge and confidence. The International Atomic Energy Agency (IAEA) developed novel VR-based cervical BT training modules and conducted an international pilot study to evaluate their educational impact across diverse global training environments.
Materials/Methods:
In this IRB-approved, multi-institutional study, radiation oncology trainees from Australia, Jordan, Pakistan, Türkiye, and USA completed VR cervical intracavitary BT modules. Pre- and post-training assessments included prior BT exposure, self-rated technical confidence, procedural knowledge, and a 9-question quiz. Wilcoxon signed-rank tests with a Bonferroni adjusted significance level (p = .0167) evaluated paired pre-post changes, with effect sizes (r) calculated for scores and self-ratings.Results:
Of the 64 participants, 56 (87.5%) were in their first 4 years of training, 29 (45.3%) reported prior BT training, and 49 (76.6%) reported performing 5 or fewer gynecological BT cases. Median knowledge scores improved from 5/10 (IQR: 2-6) pre-training to 7/10 (IQR: 5–8) post-training (p <.0001); skill from 3/10 (IQR: 0-6.25) to 7/10 (IQR: 4.75-8, p<.0001). Median quiz scores improved from 4 (IQR: 3–5) to 7 (IQR: 6–8, p<.0001). Large effect sizes were seen for quiz performance (r=0.79), skill self-rating (r=0.79), and knowledge self-rating (r=0.73). Country-specific data are detailed in Table 1. Mean ratings for clarity and relevance of the training module's content were 9/10 (IQR: 7–10) and 8/10 (IQR: 7.5-10), respectively.Conclusion:
IAEA’s VR-based intracavitary cervical BT training significantly improved objective knowledge and procedural confidence across international settings. These findings support VR as a scalable educational strategy to strengthen global BT training and improve patient care worldwide. Abstract 115 - Table 1: Trainees’ Mean Self-Ratings and Quiz Scores Before and After VR-Based Intracavitary Cervical Cancer Brachytherapy Training Organized by Country| Survey Component | Australia (n=17) | Jordan (n=4) | Türkiye (n=16) | USA (n=9) | Pakistan (n=18) | ||
| Pre-training (Mean+SD) | Self-Rating | Knowledge | 3.8+3.1 | 3+1.4 | 5.6+2.2 | 4.1+3.3 | 4.1+3.1 |
| Skill | 3.7+3.5 | 2.8+2.1 | 5.2+3.4 | 4.1+3.3 | 2.4+2.9 | ||
| Quiz Score | 3.7+1.2 | 5.3+1.7 | 3.9+1.8 | 4.4+1.3 | 5.1+2 | ||
| Post-training (Mean+SD) | Self-Rating | Knowledge | 6.3+2.1 | 4.8+2.4 | 6.9+2.2 | 7.9+2.2 | 5.5+2.4 |
| Skill | 6.1+2.2 | 5+1.6 | 6.8+2.5 | 7.6+2.1 | 5.2+2.8 | ||
| Quiz Score | 6.9+1.6 | 7.5+1 | 6.3+1.6 | 6.8+1.3 | 7.3+2.3 | ||