Journal of Radiation Oncology

, Volume 6, Issue 3, pp 317–322 | Cite as

A pilot study to determine if the use of a virtual reality education module reduces anxiety and increases comprehension in patients receiving radiation therapy

  • Matthew Marquess
  • Shirley Pinegar Johnston
  • Noelle L. Williams
  • Carolyn Giordano
  • Benjamin E. Leiby
  • Mark D. Hurwitz
  • Adam P. Dicker
  • Robert B. Den
Original Research



Pre-treatment patient education has been shown to decrease anxiety and enhance comprehension. Our pilot study evaluates the impact of VERT™, a virtual environment education tool, on these endpoints.


Twenty-two patients with prostate cancer being treated with radiotherapy completed a 16-question comprehension/anxiety survey. Patients proceeded to VERT™, modeled after a flight simulator using realistic sounds and views. The test was then repeated. A power analysis determined that enrolling 20 patients achieves 80% power to detect an effect size of 0.89 with a Bonferroni-adjusted significance level of 0.003125 using a one-sided one-sample paired t test to analyze differences between individual pre/post-test scores. Descriptive statistics were reported and effect size was computed.


Pre/post-test measures for all questions were statistically significant, favoring our hypothesis of improved education and reduced anxiety following virtual simulation except three measures of anxiety (low in both assessments). Baseline anxiety was highest for treatment precision, which also demonstrated the most significant pre/post-intervention improvement.


Decreased anxiety and improved comprehension influence patient-reported satisfaction and can contribute to quality assurance. Implementation of virtual simulation was successful in improving comprehension and reducing anxiety. Development of personalized, site-specific, clinic-based virtual modules is a long-term goal of this pilot study.


Virtual reality Patient anxiety Comprehension Patient education 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Matthew Marquess
    • 1
  • Shirley Pinegar Johnston
    • 2
  • Noelle L. Williams
    • 3
  • Carolyn Giordano
    • 4
  • Benjamin E. Leiby
    • 5
  • Mark D. Hurwitz
    • 3
  • Adam P. Dicker
    • 3
  • Robert B. Den
    • 3
  1. 1.Radiation Therapy Program, Jefferson College of Health ProfessionsThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Medical Dosimetry Program, Jefferson College of Health ProfessionsThomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Department of Radiation OncologySidney Kimmel Cancer Center and Sidney Kimmel Medical College at Thomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Office of Institutional ResearchThomas Jefferson UniversityPhiladelphiaUSA
  5. 5.Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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