1. (c) 2010 Vertual Ltd VERT - V irtual E nvironment for R adiotherapy T raining FDA Meeting - Session 2 - User Training Michael Meyer, Vertual Ltd President, North American Operations

2. Virtual Environment for Radiation Therapy Training Life size fully interactive virtual replica of RT treatment environment

3. Presentation Overview  Background & Product Overview  The case for Medical Simulation and VERT  The VERT experience  Users  BBC Video

4. BACKGROUND   VERT was developed collaboratively between The University of Hull and The Hull & East Yorkshire Hospitals NHS Trust in 2002   Founders: Mr James W. Ward Prof. Roger Phillips Prof. Andy Beavis   Currently has 60 installed clinical and training sites 1 st VERT Installation in 2007

5. PRODUCT OVERVIEW  The emulation of errors  SAFE- Non Pressured Environment for learning-  Make mistakes safely, no harm to patients  Life size 3D visualisations  Virtual replica of all Linac models and accessories  Fully interactive and in real time  3D immersive projection controlled by the real Linac pendant  Rapid assimilation of RT equipment, concepts and techniques

6. The Case for Simulation

7. The Case for Medical Simulation & VERT  NY Times Articles  I believe everyone is well aware of these articles.  U. S. Congressional Bill  H. R. 855- Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009  UK National Radiotherapy Advisory Group (NRAG) Report –  February 2007  The Report on the National VERT Experience  Birmingham, England January, 2010

8. U. S. Congressional Bill H. R. 855  H. R. 855 - The Congress finds as follows:  (1) Simulation-based education and training in medicine... can enhance procedural skills and reinforce best practices by allowing students, experienced clinicians, and health care professionals to practice procedures in a realistic setting.  (2) The enhanced clinical skill development pro- vided by simulation-based training benefits patients and health care consumers in the form of improved health outcomes, patient safety, and quality; reduced medical errors and deaths; and reduced costs associ- ated with providing patient care.

9. U. S. Congressional Bill H. R. 855 - cont.  H. R. 855 - The Congress finds as follows:  (e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are authorized to be appropriated—  (1) $50,000,000 for fiscal year 2010; and  (2) such sums as may be necessary for fiscal years 2011 through 2014

10. www.vertual.co.uk Dec 2007 Cancer Strategy for England

11. The VERT Experience Report on the National VERT Project Birmingham, England January 31, 2010

12. The VERT Experience

14. VERT Users  Global (non United Kingdom) VERT sites  1.Aarhus University Hospital, Denmark  2.Rigshospitalet, Copenhagen, Denmark  3.Copenhagen University Hospital Herlev, Denmark  4.Rotterdam Erasmus MC, Netherlands  5.Michener Institute, Toronto, Canada  6.Gertzen University, Russia  7.Trinity College, University of Dublin  8.British Columbia Institute of Technology, Vancouver, Canada  9.British Columbia Cancer Agency, Vancouver Canada

15. VERT Users  VERT Sites Universities in the UK  1.Birmingham City University  2.University of Ulster  3.City University (London)  4.Hertfordshire University  5.Kingston University  6.Liverpool University  7.London Southbank University  8.Portsmouth University  9.Sheffield Hallam University  10. University Campus Suffolk  11. University of West of England  12. Cardiff University

16. VERT Users  Radiotherapy Clinics in the UK  1.Addenbrooke's Hospital, Cambridge  2.Brighton & Sussex University Hospitals  3.Derriford Hospital, Plymouth  4.Colchester General Hospital  5.Gloucestershire Hospitals NHS  6.Imperial College Healthcare NHS  7.Leeds Teaching Hospitals NHS  8.North Middlesex University Hospital NHS  9.Northamptonshire Centre for Oncology  10. Nottingham University Hospitals NHS  11. Royal Devon & Exeter Hospital  12. Royal Marsden NHS  13. Royal Shrewsbury Hospital  14. Royal Surrey County Hospital  15. Royal United Hospital Bath NHS

17. VERT Users  Radiotherapy Clinics in the UK cont.  16. Southend University Hospital NHS  17. United Bristol Healthcare NHS  18. University Hospital Birmingham  19. Weston Park Hospital, Sheffield  20. Mount Vernon Hospital  21. Oxford Radcliffe Hospitals NHS  22. South Tees Hospitals NHS  23. Southampton Hospital  24. Poole Hospital NHS  25. Leicester Royal Infirmary  26. Clatterbridge Centre for Oncology NHS  27. Newcastle upon Tyne Hospitals NHS  28. Royal Free Hampstead NHS  29. University College London Hospital  30. Maidstone and Tunbridge Wells NHS

18. VERT Users  Radiotherapy Clinics in the UK cont.  31. Barking Havering and Redbridge Hospitals NHS  32. Castle Hill Hospital, Hull  33. Lancashire Teaching Hospitals NHS  34. Royal Berkshire NHS  35. United Lincolnshire Hospitals NHS  36. University Hospital of North Staffordshire  37. University Hospitals Coventry &Warwickshire  38. Royal United Hospital Derby NHS  39. Norfolk & Norwich University Hospitals NHS Trust  40. The Ipswich Hospital NHS Trust  61 Sites World Wide

19. Further Information www.vertual.co.uk www.vertual.co.uk www.vertual.co.uk USA & Canada Sales USA & Canada Sales – Mike Meyer – mike@vertual.co.uk mike@vertual.co.uk Head Office Head Office – info@vertual.co.uk www.vertual.co.uk

20. BBC news Report www.vertual.co.uk http://news.bbc.co.uk/2/hi/uk_news/england/7360989.stm