Immersive Virtual Reality Versus Mannequin-based Simulation Training for Trauma Resuscitation: A Randomized Controlled Noninferiority Trial.

Introduction: Despite its high potential, the effect of immersive virtual reality simulation (VRS) in trauma resuscitation training has not been studied. The aim of this study was to test the hypothesis that VRS is non-inferior to mannequin-based simulation (MBS) in trauma resuscitation training.

Methods: In a single-center, randomized controlled noninferiority trial, we compared individual training with an immersive virtual reality Trauma Simulator to live MBS training in a facilitated group. The primary outcome was the Trauma Score (ranging from 55 to 177) during the MBS assessment. The secondary outcomes were the Trauma Score VRS assessment, System Usability Scale (SUS) (ranging from 0 to 100), and Simulation Sickness Questionnaire (SSQ) (ranging from 0 to 235.62).

Results: A total of 38 participants were enrolled in the study. The mean Trauma Score in MBS assessment was 163.2 (SD 7.9) for the control group and 163.1 (SD 13.8) for the intervention group; the difference of means 0.1 (95% confidence interval: -7.3, 7.5; P = .977). The mean Trauma Score in VRS assessment was 134.2 (SD 24.4) for control group and 158.4 (SD 17.6) for intervention group; the difference of means 24.2 (95% confidence interval: 10.1, 38.3; P = .001). The mean SUS of Trauma Simulator was 74.4 (SD 10.5). The median SSQ Total Severity score was 3.7 (IQR 0-18.7).

Conclusions: This study showed that VRS led to noninferior effects on trauma resuscitation skills to MBS. Trauma Simulator had good usability, was well received by the participants, and had minimal adverse effects.