Radiotherapy students around the UK have been progressively enjoying a learning experience in the virtual world since the Department of Health (DoH) made a grant of £5m available for all Higher Education Institutes (HEI).
One of the original Universities who applied to have the new VERT (Virtual Environment Radiotherapy Training) system installed was the London South Bank University (LSBU). It was awarded a grant for £250,000 to build a fully-immersive VERT auditorium at its Southwark Campus, in the expectation that the VERT system would drastically reduce the time needed for clinical training and assist with the retention of students.
Designed to offer a vast range of training for radiotherapy students, medical and physics staff, VERT has been developed by Professor Roger Phillips and James Ward from the University of Hull and Professor Andy Beavis of the Hull & East Yorkshire Hospitals NHS Trust. The software is supplied by a spin out company, Vertual Ltd, and given realism by a VR stereoscopic 3D visualisation system supplied by integration specialists Virtalis. This is based around Christie Mirage S+6K three-chip active 3D stereoscopic projectors, fitted with fixed 1.2:1 lens.
Using the Christie devices, the system rear projects a life-sized treatment room onto a 5.33m x 2.44m screen, allowing up to 30 students and staff across the University, as well as qualified radiographers and clinical practitioners in the local trust, to practice cancer treatment in a real life situation.
The system utilises immersive visualisation technology, taking an actual radiotherapy handset in combination with 3D technology to recreate the ‘linac’ (linear accelerator) radiotherapy machine, the room in which it is situated and the patient lying on the treatment table.
Before this immersive auditorium could become reality, a suitable location needed to be found within the university. Knowing that clinical space within universities is often at a premium, Noreen Sinclair, principal lecturer in Therapeutic Radiography at the University’s Faculty of Health and Social Care, acquired a former Skills Lab, which measured 6m wide by 11m long. It had the added advantage of already housing a room divider (which has been reused to protect the sensitive, specially-designed fabric of the tensioned projection screen), leaving plenty of room for the projection to be mounted at the rear.
The room includes a 3-metre deep stage in front of the screen which allows the screen to meet the floor, thereby providing a greater sense of immersion in the 3D display. The room can also reorientate through 90° so that an existing data projector can deliver content onto an electric drop down screen in a conventional theatre set-up for associated training.
Mrs. Sinclair was aware of the advantages of the full Immersive VERT (rather than the smaller, meeting room-based Seminar version) right from the start of the DoH project. Academic staff are delighted with the technical integration, and confirm that the projectors, mounted on Virtalis custom stands, are delivering picture perfect images with a remarkable sense of realism.
While the University still takes advantage of its existing digital imaging laboratory — its previous resource for all radiography students — the new training facility should improve student recruitment and retention.
Wearing stereoscopic 3D active LCD shutter glasses, students can interact freely in the 3D environment, since back-projected displays do not cast a shadow. The glasses are synchronised with the display (from a signal transmitted by an infra-red emitter, attached to the computer system), with the left and right eye images being displayed time-sequentially at 100Hz.
There is the option of using a tracking system, which uses fused ultrasonic and inertial tracking technology from Intersense to offer precision accuracy in 3D space for a single, tracked user.
The two 6500 ANSI lumens Christie SXGA+ projectors overlap by 25% to give an overall on-screen resolution of 2240 x 1024, using edge blending to create a seamless blend of the two images. These projectors are driven by a single high performance PC — this uses a special NVIDIA Quadro FX graphics card which is able to support stereoscopic 3D.
Alongside the VERT software, LSBU uses the PACS (Picture Archiving Communication System) which stores and retrieves images, while the lab system is networked to the main University server so that software updates can be received.
The effect on clinical training is proving staggering. Mrs. Sinclair states, “Whereas previously it would have taken students some time to become proficient in manipulating the treatment equipment, they are now able to do this after just one week’s training and two weeks’ experience using VERT.”
It was this factor — coupled with concerns about student drop-off — that was central to the Department of Health’s rationale in investing this money. “Students were starting [Radiotherapy courses] but not completing — and a study was carried out relating to students in the clinical environment. With VERT they can develop psychomotor skills and 3D spatial skills.”
Mrs. Sinclair’s colleague, Adele Stewart-Lord, who is also course director for the Post Graduate Diploma, says that students from both the two-year accelerated PGD course and the three year traditional undergraduate can be taught together in VERT as the clinical skills are the same.
Mrs. Stewart-Lord, who also uses VERT more widely for the teaching of anatomy, says that “a clear advantage of VERT is the ability to see the three-dimensional anatomical relationship of a tumour and the internal organs. This is not something that can be seen in the clinical environment.”
Students also like the fact that from a practical point of view they can operate the handsets, which are identical to those found in real clinical practice.
Noreen Sinclair is now bracing herself for future Radiotherapy planning software — and the outcome of other research presently in progress — which will help LSBU further maximise the use of its new 3D environment.