## 3 Education and Training for Students and Radiation Oncology Professionals
### VR in External Beam RT and the Central Role of VERT
The improvement in understanding and confidence of students was assessed, and the TPS + VERT group commented that VERT helped them in learning RT planning for aspects such as anatomy, control of the planning system, understanding DVH and treatment technique. The overall experience in the TPS + VERT group was better compared to the TPS group, suggesting that VERT should be incorporated into RT training. The evidence acquired showed how the students receiving the TPS mode reported a lower level of confidence in completing the planning and required a longer time for self-study and practice compared to the students who received the TPS + VERT mode. [PERSON] and coll. [29] reported the experience of medical physics students for whom teaching was re-designed to increase active learning by including scaffolded in-class and online tasks supported by VR simulations. The results of a survey administered to these students indicate that there was an overall improvement in their engagement with the learning activities when they were supported by the VERT system. Similarly, [PERSON] et al. [22] investigated the potential of this virtual clinical environment to enhance the learning experiences of RT students in teaching two modules on 3 DCRT, IMRT and VMAT techniques. The students were divided into two sub-cohorts, and cohort A only used VERT for module 1, while cohort B only used VERT for module 2. Likert-scale questionnaires were administered both to lecturers and students to explore their perceptions on the usefulness of the VERT tool in the education process. The two lecturers involved in the training process were enthusiastic about the VERT teaching modules, as it enabled a more direct visualization of concepts and favored students' interaction. Regarding the sequence of modules delivery, they had the opinion that the standard one should precede the VERT one. Results from questionnaires administered to students showed that the combination of the two modules, regardless of the sequence of delivery, increased their perceived confidence and understanding of the topics object of training [22]. While the above-mentioned study investigated the potential of VERT in combination with standard theoretical teaching, [PERSON] et al. [25] evaluated its usefulness when compared to excitations for electron patients' set-ups on a real treatment unit. Outcomes were evaluated with both scores assigned by assessors and with questionnaires administered to students. The quantitative scores showed that the performance of students was higher with the actual treatment unit than with its holographic counterpart. The questionnaire highlighted some perceived weaknesses of VERT, including its lack of immersion, no tactile feedback, limited viewing angle and poor visor comfort, but also highlighted its strengths, namely, the possibility to make mistakes and training in a safe environment for patients. [PERSON] et al. [30] also tried to assess the added value of VERT in the training of RT students on the skin apposition electron technique. For this purpose, group demonstration sessions were followed by individual practical assessments during which a score on the accuracy and efficacy of set-up was assigned to each student. A moderate correlation was shown between spatial ability and improved performance outcomes. A questionnaire administered to the students to assess their overall experience highlighted that most respondents (89%) felt more confident in their practical skills after the training sessions. Of note, a minority of students (4/44, 9%) also reported adverse reactions to the training, specifically, dizziness and nausea [30]. Even if VERT dominates the applications of VR in RT education, other initiatives are being explored. Specifically, [PERSON] et al. described the implementation of a virtual educational program for medical students called Radiation Oncology Virtual Education Rotation (ROVER) and its effect on student interest and knowledge in RT.