Aim: The overall aim of this study was to evaluate the use of Virtual Environment for Radiotherapy Training Image-Guided Radiotherapy (VERT™IGRT) as a teaching and assessment tool for 3D image matching competency within the radiotherapy clinical setting and explore radiographer perceptions, experiences and integration of VERT™IGRT as an imaging tool. Materials and methods: A mixed-methods study was utilised to measure clinical image matching competencies in the first quantitative phase through means of a workbook and imaging assessment. Phase II used qualitative semi-structured interviews to explore radiographer perceptions. Results: Workbooks enabled participants to prepare for image assessments. Interview findings were highlighted in three distinctive themes: (1) The need for supervision, guidance and feedback; (2) Experience and practice leads to confidence and competence and (3) Technology supports process but not evaluation. Findings: VERT™IGRT provides a sound platform for training therapeutic radiographer image matching skills, but needs to be delivered with continuous feedback to develop individual decision-making skills. The technology provides opportunities for staff to increase confidence in utilsing image matching technology, but analytical and evaluation skills require supervision and continuous feedback which should be embedded in any educational training programme.