Radiotherapy is a key component of cancer treatment, yet medical students often receive limited exposure to its principles and practice. This preliminary study evaluates the use of the virtual environment for radiotherapy training (VERT™), a virtual reality simulation, in enhancing medical students’ knowledge, confidence and preparedness before clinical oncology placements.

This quasi-experimental study evaluated a one-hour VERT™ session for fourth-year medical students. Using pre- and post-intervention questionnaires with Likert scale and open-ended items, the study assessed changes in knowledge, understanding and attitudes. The mixed-methods design provided a comprehensive evaluation of the intervention’s educational effectiveness.

Statistical analysis showed significant improvements in 10 of 11 questionnaire items following the VERT™ session. Students reported large increases in perceived knowledge and understanding. Only attitudes toward virtual reality use remained unchanged, indicating limited impact on broader perceptions of VR in medical education. Thematic analysis revealed that VERT™ enhanced students’ understanding of radiotherapy concepts, planning and patient perspectives through immersive, hands-on learning. Participants valued its clarity and realism but suggested longer, more interactive sessions and clearer communication. Despite minor technical and engagement challenges, VERT™ was viewed as a valuable, confidence-building complement to traditional teaching.

Considering the confines of this preliminary study, the findings begin to suggest that VERT™-based simulation enhances medical students’ knowledge, understanding and confidence in radiotherapy. Participants felt better prepared for oncology placements, supporting VERT™’s value as an immersive learning tool. Despite limitations, results advocate its integration into medical education and further research on long-term and comparative effectiveness.

Rotational setup errors remain a challenge in radiotherapy centers without six-degree-of-freedom (6DoF) couch correction systems. Small angular deviations may compromise target coverage and organ-at-risk sparing. Although image-guided radiotherapy (IGRT) has improved setup verification, many centers continue to rely on three-degree-of-freedom (3DoF) couches.

This technical report evaluates an approximation in which small rotational setup deviations are represented as equivalent translational displacements using the vector cross-product formulation (Δ = θ × r). Head-and-neck, breast, lung, pelvis, and thorax scenarios were modeled using an Elekta Infinity linear accelerator and Monaco TPS (version 6.1.4.0) with Monte Carlo dose calculation. Simulated rotational perturbations were assessed with and without translation-based correction using dose–volume histogram endpoints Dmean, D95, and V95.

Translation-based correction improved D95 across all treatment sites. The largest improvement was observed in head-and-neck geometry (approximately 2%), while pelvic and thoracic scenarios demonstrated intermediate gains. Breast and lung cases showed measurable improvements. Dmean increased modestly, whereas V95 remained essentially unchanged, suggesting improved target coverage without compromising volumetric conformity.

Translation-based correction is not a substitute for 6DoF couch technology but may provide a low-cost mitigation strategy for centers limited to 3DoF correction capability. Future studies should include phantom validation and automated correction approaches.

Providing psychosocial support to pediatric patients and their families at the end of life represents one of the most challenging yet vital aspects of healthcare practice. Despite the presence of grief and loss training in many pediatric healthcare professionals’ educational backgrounds, opportunities for practical training experience in delivering end-of-life care remain limited. This study explored the use of simulation-based training to enhance the self-reported knowledge, skills, and comfort levels of child life specialists in providing psychosocial care during end-of-life situations.

Forty-three child life specialists participated in the simulation-based training, which was combined with traditional didactic instruction, and the associated research study. Pre- and post-training surveys were used to assess impact of the training on child life specialists’ self-reported knowledge of end-of-life care and comfort in providing this care.

A statistically significant increase was seen in all measured aspects of self-reported knowledge and comfort in providing end-of-life care following the training.

Simulation combined with traditional instruction methods provides an effective way to train healthcare professionals in providing high-stakes psychosocial care while protecting patients and families from the added strain of trainees and excess staff presence during sensitive times.

Overseas large-scale combat operations (LSCOs) could require domestic hospitals to treat large numbers of combat casualties. Our goal was to evaluate the financial impact on hospitals of treating combat casualties during an LSCO.

Using a discrete event simulation model, we explored how 5 civilian hospitals in Omaha, Nebraska, would fare after accepting combat casualties during a National Disaster Medical System (NDMS) activation. We compared changes in financial measures (government payments, hospital revenues) and occupancy measures (civilian patient displacement) under different scenarios for combat casualty reimbursement rates as fractions (75%-125%) of Medicare rates.

Combat casualties replaced 100% of civilian patients at 3 of 5 hospitals, displacing a total of 10,905 civilian patients [95% CI: 10551-11248]. Combat casualty reimbursement at 125% of Medicare rates resulted in government payments of $462 million and net income gains for civilian hospitals of approximately 23 times pre-activation baselines. Combat casualty reimbursement below 125% of Medicare rates led to net income losses.

Large influxes of combat casualties could result in rapid, profound displacement of civilian patients and revenue loss at NDMS-participating facilities, potentially affecting hospitals’ ability and willingness to treat them. Policymakers need to identify appropriate reimbursement rates for combat casualties.

Exercises are an essential component of preparedness and should be used to enhance capability and contribute to continuous improvement. An exercise can be as simple as a planning group discussing an emergency plan or as complex as a major multi-agency event involving several organizations and participants. This study aims to identify and conceptualize quality indicators (QIs) influencing prehospital disaster exercises across structure, conduct, and outcome.

This research was conducted through a systematic review and searching of the databases of PubMed, Scopus, Web of Science, and Google Scholar. Thematic content analysis was used for data analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for systematic search, and the Critical Appraisal Skills Program (CASP) was used for quality assessment of the final extracted articles.

From an initial set of 3,083 articles, 10 high-quality studies were included for analysis. The quality indicators influencing prehospital disaster exercises were analyzed into 3 themes, 8 categories, and 21 subcategories. The primary themes and related main categories included: Exercise structure QIs (knowledge promotion and cognitive skills, supply of exercise hardware and software requirements and resources desirable management), Exercise conduct QIs (practical proficiency in essential skills and decision-making capacity), and Exercise outcome QIs (evaluation and reporting of exercise, promotion of managerial capabilities and competencies, and development of psychological capabilities).

The findings of this research present a knowledge framework that can help exercise planners in prehospital settings in designing scientifically sound and standardized exercises aimed at enhancing disaster response processes. Furthermore, the implementation and evaluation of both discussion-based and operation-based disaster exercises informed by these identified quality indicators can foster the development of knowledge and promote behavioral change among prehospital staff, and facilitate a standardized response to emergencies and disasters.