Comparing virtual reality and simulation to teach the assessment and management of acute surgical scenarios: A pilot study.

Background And Aims: Traditional apprenticeship-based surgical training presents with challenges, especially in acute scenarios. Simulation provides the current standard of facilitating surgical training in a low-risk environment but is restricted by limited accessibility and high costs. Virtual reality (VR) offers immersive three-dimensional computer-generated training scenarios and can connect users from various locations. We aimed to compare the performance of junior doctors to manage an acute surgical scenario using VR and mannequin-based simulation. We hypothesised that VR would be as effective as mannequin-based simulation in performance outcomes.

Methods: This multicentre, randomised controlled pilot study was conducted with eighteen junior doctor volunteers (Foundation and Core Trainee Year 1). Ten were randomly allocated to VR and eight to mannequin-based simulation. Participants completed questionnaires and a 15-min pneumothorax scenario. Quantitative metrics included overall score, time-to-critical decisions, and academic buoyancy scores (ABS). Qualitative metrics included participants' likes and dislikes of their allocated simulation modality.

Results: VR participants scored significantly higher than mannequin-based simulation participants in overall scores (74.30% (SD ± 5.08%) 59.75% (SD ± 10.14) ( = 0.04)), and technical skills aspects (77.20% (SD ± 8.01%) 65.00% (SD ± 8.21%) ( = 0.01)). Mannequin-based simulation participants initiated critical decisions faster and demonstrated a trend towards a faster mean time-to-completion ( = 0.06). ABS scores increased for both study groups, though was only significant for VR participants ( ≤ 0.01). VR participants liked how VR fostered independent learning but disliked the formulaic content and impaired communication-learning compared to mannequin-based simulation.

Conclusion: Both VR and mannequin-based simulation training are effective in training junior doctors in acute surgical scenarios but present different educational benefits. Future research should recruit a larger sample size for a full comparative randomised controlled trial.