To develop a virtual reality simulator for high dose rate prostate brachytherapy and to test whether participation is associated with immediate gains in self-reported confidence across predefined procedural domains in two cohorts.
Using Unreal Engine, we developed and implemented two modules: patient preparation and template-guided needle insertion. Oncology staff and trainees completed pre and postsurveys that assessed confidence for recalling steps, explaining steps, identifying equipment, and explaining equipment function. Studies were conducted at the Hands-On Brachytherapy Workshop (HOWBT) in London, Ontario, and at Sunnybrook Odette Cancer Centre in Toronto, Ontario. Paired Wilcoxon signed rank tests with two-sided p values compared before and after scores within each module.
Patient preparation (N = 11) confidence increased for recalling steps (W = 65, p = 0.002), explaining steps (W = 65, p = 0.002), identifying equipment (W = 51, p = 0.023), and explaining equipment function (W = 60, p = 0.008). Needle insertion (N = 27) confidence increased for recalling steps (W = 292, p < 0.001), explaining steps (W = 347, p < 0.001), identifying equipment (W = 355, p < 0.001), and explaining equipment function (W = 354, p < 0.001).
The simulator was feasible to deploy and was associated with higher self-reported confidence across key domains immediately after training. Findings may inform future curriculum design and implementation work.
Brachytherapy. 2026 Jul 24 [Epub ahead of print]
Anton Varlukhin, Mackenzie Smith, Fahad Alam, Amandeep Tagger, Gerard Morton, Moti Paudel, Andrew Loblaw, Lucas C Mendez, Douglas Hoover, Raffi Karshafian, Humza Nusrat
Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada., Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada., Department of Anesthesiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Department of Radiation Oncology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada; Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Department of Radiation Oncology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Verspeeten Family Cancer Center, London Health Sciences Center, London, Ontario, Canada; Department of Radiation Oncology, Western University, London, Ontario, Canada., Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada; Institute for Biomedical Engineering, Science and Technology (iBEST), A Partnership Between St. Michael's Hospital, A Site of Unity Health Toronto and Toronto Metropolitan University, Toronto, Ontario, Canada., Department of Physics, Toronto Metropolitan University, Toronto, Ontario, Canada; Department of Radiation Oncology, Henry Ford Health, Detroit, MI; Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI. Electronic address: .