The short answer
Why use revenue-generating or waiting-list-reducing imaging capacity to teach skills that can be learned before the learner reaches the equipment?
Published studies using Virtual Medical Coaching show that important radiography skills can be developed in simulation and can transfer into physical assessment, clinical practice and workforce preparedness.123
That creates a different return-on-investment question for imaging departments.
What is the value of moving appropriate early-stage training away from productive clinical equipment and into simulation?
An X-ray room, CT scanner, MRI scanner or other imaging system is a productive clinical asset. When productive equipment is used for training, the cost is not simply the salary of the person being trained.
There is an opportunity cost.
A training session may occupy equipment that could otherwise be imaging patients. It may require an experienced radiographer or radiologic technologist to supervise the learner. It may slow normal throughput. In some circumstances, training must be fitted around clinical lists or moved outside normal operating hours.
Those costs are rarely attributed directly to the training budget. They are nevertheless real.
NHS England reported 1,918,239 patients waiting for one of 15 key diagnostic tests at the end of March 2026, including 393,913 waiting for MRI and 207,524 waiting for CT.4
The United States measures access differently, but workforce and demand pressures are also clear. The U.S. Bureau of Labor Statistics projects about 15,400 openings for radiologic and MRI technologists each year, on average, from 2024 to 2034. The American College of Radiology has also described pressure from workforce shortages and increasing imaging volumes.56
Training cannot stop because services are busy. Healthcare systems need more trained staff, not fewer.
The question is whether every stage of that training needs to happen on productive clinical equipment.
A novice needs to learn how to position the patient, orient the X-ray tube and detector, select exposure factors, adjust source-to-image distance, collimate the beam, evaluate the resulting image and recognise what needs to be corrected.
Repetition is essential. But much of that repetition does not inherently require a real patient or a productive clinical X-ray room.
Virtual Medical Coaching Radiography Simulation allows learners to practise patient positioning, X-ray tube and detector alignment, exposure-factor selection and radiographic image evaluation in immersive VR or on desktop computers.7
The first attempt on clinical equipment therefore does not have to be the learner's first attempt at understanding the procedure.
The case for simulation is not simply that it is convenient. Researchers have compared VMC with physical simulation and examined whether learning transfers into clinical practice.
188 first-year radiography students were allocated through stratified randomisation to VMC VR simulation or physical simulation using X-ray equipment. Both groups learned the same 31 radiographic views over a 25-week semester.
VMC-trained students completed the subsequent physical OSCE in less time and made fewer equipment-movement and patient-positioning errors. Exposure-setting errors did not differ significantly between groups.
First-year radiography clinical performance before and after the introduction of seven hours of immersive VMC practice.
VMC-trained students performed better across 20 of 22 clinical assessment criteria, with significant improvements in patient positioning, exposure-factor selection and image appraisal.
80 newly qualified diagnostic radiographers from two universities, with 40 trained using VMC immersive simulation and 40 using traditional simulation.
The VMC-trained group had significantly higher clinical preparedness scores and higher scores for confidence, adaptability, technical proficiency and problem-solving.
Rowe and colleagues provide particularly relevant evidence for the capacity argument because the study did not compare VR with lectures or textbooks. It compared Virtual Medical Coaching with physical X-ray simulation.
Through stratified randomisation, 188 students were allocated to matched VMC and physical-simulation groups. Both groups were taught the same 31 radiographic views over one 25-week semester. Both groups then completed an Objective Structured Clinical Examination using actors as patients in a physical X-ray environment.
The VMC group completed the OSCE in less time and made fewer errors in equipment movement and patient positioning. Those differences were statistically significant.1
Operationally, that matters. For the technical skills measured in the study, repeated access to physical X-ray equipment during the simulation component was not necessary for learners to perform successfully when they later entered a physical X-ray environment.
Simulation has limited operational value if competence remains trapped inside the virtual environment.
O'Connor and Rainford investigated the impact of VMC training on first-year radiography students during subsequent clinical assessment. The VMC cohort received seven hours of immersive practice. Experienced clinical tutors then assessed students performing an extremity radiographic examination in the clinical setting.
The study therefore provides evidence that skills developed through VMC simulation can transfer into real clinical performance.2
Karimi, Clarke and Watson compared 80 newly qualified diagnostic radiographers. Forty had trained using VMC immersive simulation and 40 had received traditional simulation training.
The VMC-trained group had significantly higher clinical preparedness scores. They also scored higher in confidence, adaptability, technical proficiency and problem-solving, and performed better in supervisor evaluations, radiograph quality and emergency performance.3
Simulation does not reproduce every element of clinical practice. Learners still need experience with real patients, real departmental workflows, multidisciplinary communication, physical equipment, difficult presentations, local protocols and the unpredictable nature of healthcare.
The boundary matters: the objective is not to remove the clinical environment. It is to stop using the clinical environment for learning that can appropriately occur before the learner gets there.
A 2023 narrative review of clinical replacement activities in medical radiation sciences concluded that simulation-based education provides clinically focused learning opportunities, but that more evidence is required before broad assumptions are made about replacing clinical placement time.8
The College of Radiographers currently recommends 120 hours of simulation-based education in addition to 1,200 hours of practice-based learning for standard-route pre-registration diagnostic and therapeutic radiography programmes in the UK.9
Simulation is well suited to repeated technical practice before access to clinical equipment. The clinical environment can then be used for what it is uniquely good at: integrating technical skills around actual patients, real equipment, departmental workflow and clinical decision-making.
The goal is not to eliminate equipment-based training. It is to make every minute of equipment-based training more valuable.
The calculator deliberately uses conservative assumptions. It does not assume that every training hour can move into simulation, and it does not assume that every released hour can be filled with patient activity.
Enter your organisation's own figures. Enter 0 for value per examination if patient capacity is the primary outcome.
Please check the inputs. Percentages must be between 0 and 100, and all values must be zero or greater.
Important: This is a planning model based on the assumptions entered by the user. Faster competency, lower repeat rates and other workforce effects are deliberately excluded unless measured separately.
Get a VMC price for your organisation, then compare that investment with the scanner time, patient capacity, and staff supervision your current training model consumes.
Get a VMC quoteFor publicly funded imaging services, the most persuasive result may be expressed in patient capacity rather than currency.
If a service can move appropriate early-stage training away from productive equipment and then use the released time for patients, the ROI is partly a capacity dividend.
Published VMC evidence gives healthcare providers good reason to investigate workforce outcomes. O'Connor and Rainford reported improved clinical assessment performance after VMC training. Rowe and colleagues reported fewer positioning and equipment-movement errors in a subsequent physical OSCE. Karimi and colleagues reported greater clinical preparedness among newly qualified radiographers trained using VMC.123
Those findings justify measuring outcomes such as time to competency, supervised hours before independent practice, repeat examinations during onboarding, image-quality measures and competency-assessment results.
They do not justify inventing a financial saving, so those possible benefits are not included in the core calculator.
Collect the same measures after implementation. The difference is the operational value.
Clinical imaging equipment should be used for learning that requires clinical imaging equipment.
Real patients matter. Real equipment matters. Clinical judgement matters. Supervised practice matters.
But the earliest repetitions of positioning, equipment manipulation, exposure selection and image appraisal do not necessarily need to consume productive clinical capacity.
Get pricing for your cohort and compare it with the imaging capacity and staff time your current training model consumes.
Get a VMC quoteNot completely. Clinical practice remains essential. Published research does show that important technical skills can be developed using VMC before learners use physical X-ray equipment. In a randomised study, VMC-trained students subsequently completed a physical OSCE faster and made fewer patient-positioning and equipment-movement errors than students trained using physical X-ray simulation.1
Does Virtual Medical Coaching training transfer to clinical practice?Published evidence indicates that it can. O'Connor and Rainford found that students who completed VMC VR training performed better across 20 of 22 criteria when subsequently assessed in clinical practice.2
How do you calculate the ROI of radiography simulation?Start with clinical equipment time used for early-stage training. Estimate the percentage suitable for simulation, discount the released hours by the proportion that can genuinely be reused, calculate additional patient capacity and add any measurable staff-supervision capacity. Compare that measurable annual benefit with the annual simulation cost.
How can simulation help reduce imaging waiting lists?Simulation does not reduce waiting lists by itself. It can create an indirect capacity benefit if appropriate training is moved away from productive clinical equipment and the released capacity is then used to image additional patients.
Does simulation mean fewer clinical placement hours?Not necessarily. The model is about preparing learners before they consume scarce clinical capacity, not automatically replacing clinical placement. The College of Radiographers currently recommends simulation-based education in addition to practice-based learning hours.9