###### Abstract  
The traditional training methods in radiological hot laboratories involve significant challenges, including the risk of radiation exposure and the development of radiophobia among learners. Virtual reality (VR) presents an innovative educational solution by simulating realistic hot lab environments and procedures without associated risks. This mixed-method study investigates the efficacy of VR in enhancing cognitive retention and practical skills and reducing radiophobia among students. All participants (video and VR cohorts) were given a pre-test, same-day training post-test, after 1 month, and after 3 months. In the 3-month test, 13% of the control group scored \(>80\%\), and 87% of the VR group scored \(>80\%\) (6.69-fold more significant). VR simulated the real-world hot lab more accurately than training videos, resulting in increased confidence and safety. Resulting in the control group (video training), radiophobia decreased by 1.52-fold; in contrast, the VR training group reduced by 2.42-fold. These reductions indicate that VR training was significantly more effective in reducing radiophobia than traditional video training. VR enhanced knowledge retention, reduced radiophobia, increased safety confidence, and reduced fear about pursuing a career in nuclear medicine. Overall, VR created a safer working environment, and RT students responded more positively than the instruction videos. Consequently, a mixed-method study revealed key codes of engagement, easy understanding, memory, safety, confidence, learning experiences, implementation in the curriculum, and getting ready for clinical practice. g amification; hot lab; immersive gaming; immersive learning; nuclear medicine; radiophobia; radiation safety; \({}^{99m}\)Tc-MDP; technology-enhanced learning; virtual reality +
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widely used in medical imaging for various purposes, such as diagnosis, treatment, and monitoring. These procedures occur in different healthcare settings, including radiology departments, patient wards, intensive care units, and specialized areas like catheterization labs and operating rooms. Therefore, healthcare professionals must prioritize radiation safety to protect themselves and patients from the potential risks of radiation-induced cancer. Moreover, every institution's management team is responsible for educating and implementing preventive strategies and operational norms [10]. As a result, digital learning, including virtual reality (VR), is on the rise in radiological technology (RT) education. Since VR provides risk-free, realistic, and highly effective training for medical staff, the healthcare industry is one of the key market sectors to adopt VR technology. Moreover, VR offers a unique and immersive learning experience that can significantly enhance the development of competencies among medical students. Consequently, RT students can benefit from virtual reality training simulating working in a hot radiopharmaceutical lab environment. Students can safely navigate around the hot lab before hands-on training in the hot lab. It is imperative to ensure that students can independently execute a comprehensive radiopharmaceutical preparation without any errors or reliance on external support. Students must comprehensively understand the various concerns about patients, staff, and environmental safety when handling radioactive materials. Furthermore, they should be capable of effectively applying this knowledge in practical settings, particularly when preparing radiopharmaceuticals. Moreover, VR helps reduce the risk of errors and potential harm from radioactive materials by providing a controlled environment for practicing procedures. This focus on student safety is a significant advantage of incorporating VR into RT and continuing medical education (CME). In addition, VR can also be used for ongoing professional development, allowing medical staff to stay updated with the latest medical advancements and techniques and radiation safety best practices.