Due to the lengthy learning process associated with complicated clinical techniques, undergraduate radiotherapy students can struggle to access sufficient time or patients to gain the level of expertise they require. By developing a hybrid virtual environment with real controls, it was hoped that group learning of these techniques could take place away from the clinical departments. This paper presents initial evaluation of the use of a three-dimensional immersive visualisation environment (IVE) to simulate a working radiotherapy treatment machine. A virtual patient complete with a range of different treatment sites was used to enhance learning and teaching of beam alignment in 3D. Pre- and post-questionnaires were used to evaluate the perceptions of 42-year 1 pre-registration students with regards to the learning that had taken place. 93% of students perceived an improvement in their understanding and confidence in their technical skills as a result of using the IVE. The mean overall improvement was 21.2% (p less than 0.00001), and this was positively correlated to perceived realism of the application. The application was reported to be both realistic and enjoyable. Feedback suggested it has a role to play in development of technical skills and also pre-clinical induction. More work with the application is ongoing to clarify that role and the potential benefits of this technology.