Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Quantification of Student Radiographic Patient Positioning Using an Immersive Virtual Reality Simulation

Sapkaroski, Daniel MMedRad, BBiomedSc; Baird, Marilyn PhD, BA, DCR; Mundy, Matthew PhD, MSc; Dimmock, Matthew Richard PhD, MSc, BSc

doi: 10.1097/SIH.0000000000000380
Empirical Investigations

Introduction Immersive virtual reality (VR) simulation environments facilitate novel ways for users to visualize anatomy and quantify performance relative to expert users. The ability of software to provide positional feedback before a practitioner progresses with subsequent stages of examinations has broad implications for primary and allied healthcare professionals, particularly with respect to health and safety (eg, exposing to x-rays). The effect of training student-radiographers (radiology technicians), with a VR simulation environment was quantitatively assessed.

Methods Year 1 radiography students (N = 76) were randomly split into 2 cohorts, each of which were trained at performing the same tasks relating to optimal hand positioning for projection x-ray imaging; group 1 was trained using the CETSOL VR Clinic software, whereas group 2 was trained using conventional simulated role-play in a real clinical environment. All participants completed an examination 3 weeks after training. The examination required both posterior-anterior and oblique hand x-ray positioning tasks to be performed on a real patient model. The analysis of images from the examination enabled quantification of the students' performance. The results were contextualized through a comparison with 4 expert radiographers.

Results Students in group 1 performed on average 36% (P < 0.001) better in relation to digit separation, 11% (P ≤ 0.001) better in terms of palm flatness and 23% (P < 0.05) better in terms of central ray positioning onto the third metacarpal.

Conclusion A significant difference in patient positioning was evident between the groups; the VR clinic cohort demonstrated improved patient positioning outcomes. The observed improvement is attributed to the inherent task deconstruction and variety of visualization mechanisms available in immersive VR environments.

From the Department of Medical Imaging & Radiation Sciences, School of Biomedical Sciences Faculty of Medicine, Nursing & Health Sciences (D.S., M.B., M.R.D.); and School of Psychological Sciences and Turner Institute for Brain and Mental Health (M.M.), Monash University, Clayton, Melbourne, Victoria, Australia.

Reprints: Daniel Sapkaroski, BBioMed, MMedRad, Monash University School of Medicine, Nursing and Health Science, Melbourne, Australia (e-mail:

The authors declare no conflict of interest.

The cost of this study was approximately AUD $10,000, for which funding was provided by a grant awarded from the Victorian Medical Radiation Practitioners Education Trust (VMRPET). The funding allowed for a dedicated laboratory to be built consisting of 5 high-end PC's and 5 oculus rift virtual headsets and leap motion controllers.

Ethics approval was obtained from Monash University Human Research Ethics Committee (MUHREC) CF16/661 – 2016000317.

Online date: July 5, 2019

© 2019 Society for Simulation in Healthcare