A multicentre immersive virtual-world course for radiology residents: feasibility, educational outcomes, and participant perceptions

OBJECTIVES: To design and implement an immersive course on plain radiograph interpretation for radiology residents within a three-dimensional virtual world and to evaluate its feasibility, participants' perceptions, and short-term changes in knowledge-test performance. MATERIALS AND METHODS: The course, delivered in a three-dimensional virtual world over 22 days, included seven 3-h synchronous sessions and asynchronous case-based activities. Educational outcomes were assessed using pre- and post-course multiple-choice tests. Participants' experience was evaluated using 9-point Likert-scale items assessing cognitive load, perceived course level, and usefulness for clinical practice. After the course, participants completed an evaluation questionnaire including 5-point Likert-scale items, numerical ratings (0-10), and open-ended questions. Student's t-test was used for continuous variables and the Mann-Whitney U test for ordinal data. RESULTS: Sixty-seven residents from 27 hospitals met the certification criterion across two editions in 2021 and 2022. Forty-seven completed both the pre- and post-course tests, with mean scores increasing from 60.4 ± 6.5% to 70.2 ± 9.0% (p < 0.001). Participants reported positive perceptions, with high agreement for usefulness and adequacy (> 90%) and a mean usefulness score of 7.7 ± 1.2. Ratings were generally high (> 7/10), particularly for instructors, educational content, and course organisation, whereas interaction among participants received lower ratings. CONCLUSIONS: Immersive online teaching in a three-dimensional virtual world is a feasible approach for radiology resident education. Participation in the course was associated with improved short-term performance on a repeated knowledge test and positive participant perceptions. This format may complement traditional teaching methods in cohorts composed predominantly of early-year radiology residents. KEY POINTS: Question Flexible educational approaches are needed to reinforce plain radiograph interpretation training among radiology residents, but evidence supporting virtual-world training remains limited. Findings The virtual-world course was feasible and positively valued by participants, with participation associated with improved short-term performance on a repeated knowledge test. Critical relevance statement Immersive teaching in a three-dimensional virtual world is a feasible and well-accepted approach that may complement plain radiograph interpretation training in cohorts composed predominantly of first and second-year radiology residents.