Virtual Reality Simulation Research Articles

Effects of immersive virtual reality simulation–based maternity nursing education: A randomized controlled trial

BackgroundWe investigated the impact of an immersive virtual reality (IVR)-based scenario simulation education program as an alternative to traditional maternity nursing practicums. MethodA simulation maternity nursing class at Wonkwang University in South Korea was conducted with 59 junior nursing students (experimental group = 30, control group = 29). This randomized controlled trial evaluated the effects of the IVR simulation on students’ knowledge, satisfaction, self-efficacy, and confidence in delivering nursing care. We conducted data collection from September 2021 to February 2022. SPSS version 25.0 was used for data analysis. ResultsBoth groups’ most common previous-semester grade was B, followed by A and C. In the experimental group, 17 participants reported high or very high satisfaction, and 12 in the control group reported high satisfaction. The groups showed significant differences in knowledge (p = .024), satisfaction (p < .001), self-efficacy (p = .018), and confidence (p < .001) in normal vaginal delivery nursing care. ConclusionsCompared to traditional simulation, IVR simulation can enhance maternity nursing students’ knowledge, satisfaction, self-efficacy, and confidence.

Endodontic access cavity training using artificial teeth and Simodont® dental trainer: A comparison of student performance and acceptance

AbstractIntroductionCompetency in endodontic access cavity preparation requires key motor skills, good conceptual understanding, along with an appreciation of 3‐dimensional pulp chamber anatomy. These are traditionally learned using natural or artificial teeth (AT) mounted within a phantom head (PH). Simodont® (Nissin Dental Products INC, JPN) is a haptic virtual reality simulator (HVRS) and offers an alternative to AT for training.AimsThis study aimed to (1) evaluate the evolution in the performance of learners trained to prepare access cavities incorporating Simodont (test group) against learners trained on AT mounted within PH (control group), (2) determine learner acceptability of HVRS.MethodologyForty dental students, with no prior endodontic training, were given instruction and video demonstration of access cavity preparation using a mandibular left 1st molar AT (LL6). Thereafter, they prepared an access cavity on PH mounted AT LL6. This provided a baseline record of performance. Participants were randomly assigned to the test or control groups. The test group (n = 22) trained using Simodont: preparing a virtual tooth LL6 for a period of 60 minutes with instructor feedback. The control group (n = 18) trained using AT LL6 on a PH for 60 minutes with instructor feedback. Subsequently, learners from both groups prepared an access cavity on an AT LL6 in a PH. This provided a re‐evaluation record. Two calibrated examiners graded the teeth from the baseline and re‐evaluation using rubric criteria; assigning scores with a grading range from 0 to 17. The examiners were blinded to which group the teeth belonged. Change in performance was determined by calculating the difference in assessment grade from baseline to re‐evaluation. Scores which improved by 3 or more units were labelled improvers, all other scores were described as non‐improvers.ResultsWithin the test group, the numbers of improvers were 5 (23%) versus 7 (39%) in the control group The difference failed to indicate statistical significance (p = .315). The Cohen kappa values for intra and inter‐examiner agreement were 1.00 and 0.73 respectively.ConclusionThe evolution of skills in learners trained using Simodont is comparable to those trained using AT. It is, therefore, reasonable to use Simodont, which was acceptable to learners, as an adjunct to AT for endodontic access cavity training.

Expanding virtual reality simulation with reflective learning to improve mental health nursing skills of undergraduate nursing students

Expanding virtual reality simulation with reflective learning to improve mental health nursing skills of undergraduate nursing students

Needs assessment for a new military burn care educational curriculum focused on prolonged field care: The Burns for Providers Program (BP2).

We performed a needs assessment to determine the essential elements for a curriculum teaching burn care during Large Scale Combat Operations against peer/near-peer adversaries within multi-domain contested combat environments. Virtual and face-to-face site visit meetings were conducted with 20 stakeholders at 3 levels: 1) Subject Matter Experts (SMEs) in military burn casualty care at the U.S. Army Institute of Surgical Research (USAISR), the Joint Trauma System (JTS), and the U.S. Army Medical Center of Excellence (US Army MedCOE) in Joint Base San Antonio (JBSA) - Fort Sam Houston, TX; 2) Course Directors, Instructors, Curriculum Innovators and Writers for the Combat Paramedic Branch and the Critical Care Flight Paramedic Program (CCFPP) at JBSA; and 3) regulatory administrators providing education, research and IRB administration for USAISR and US Army MEDCOE. The identified terminal learning objectives consisted of training in: burn casualty monitoring and principles of burn wound care according to available resources; best practices during PCC for pain, nutrition, and infection control; specific management of inhalation, chemical, radiation, electrical, pediatric, and mass casualty burn injuries; and procedural skill training for patient decontamination, debridement, dressings, and escharotomy. Additionally, needs were identified for novel technology that provides asynchronous individual learning opportunities using interactive role play simulations, immersive simulation, or virtual reality simulation as well as hands-on procedure simulators. Stakeholder engagement resulted in identification of sixteen terminal learning objectives that were subsequently used as the basis for a military curriculum we are calling the "Burns for Providers Program" (BP2).

Assessing the Use of a Training Model Using Immersive Virtual Reality for Sacrospinous Fixation Surgery: A Pilot Study.

Sacrospinous fixation (SSF) is a surgical complex procedure for uterovaginal prolapse that may result in pudendal plexus and vascular damage. The objective was to evaluate a training model using virtual reality to perform SSF. We conducted a prospective single-center pilot study in the university's academic innovation department in November 2023. We recruited 20 participants, 10 gynecology resident surgeons (group 1) and 10 experienced gynecology surgeons (group 2). The mean age was 26.6 ± 0.6years in group 1 and 39.7 ± 3.1years in group 2. The satisfaction rate reached 90% in both groups. A scale from 1 to 4 (1 = not-at-all, 4 = completely) was used to assess participants' perceptions. The realism of the simulation was rated at 3.3 ± 0.1 in group 1 and 3.5 ± 0.2 in group 2 (p = 0.41), the haptic feedback was rated at 2.0 ± 0.3 and 1.8 ± 0.3 (p = 0.66), the mean exercise time was 6.4 ± 1.3min and 4.8 ± 0.7min (p = 0.58), and the mean success rate was 70.8 ± 3.2% and 83.5 ± 6.8% (p = 0.14). In group 2, left and right instruments were placed at 2.6 ± 0.8mm and 2.9 ± 0.7mm from the target respectively, and in group 1 at 4.8 ± 0.7mm and 3.8 ± 0.5mm respectively. Participants reported greater comfort in performing sacrospinous fixation after simulation training (3.0 ± 0.2 versus 2.3 ± 0.3, p = 0.17). Our virtual reality simulation model is feasible and accurate for SSF training for both residents and experienced surgeons with a high level of satisfaction. Virtual reality simulation improves technical skills and promotes surgical comfort.

Assessing the Effectiveness of Virtual Reality Simulation in ICT Education: A Study Based on the Technology Acceptance Model

Assessing the Effectiveness of Virtual Reality Simulation in ICT Education: A Study Based on the Technology Acceptance Model

Medical VR Simulator for Pediatric Strabismus Treatment

In the process of treating pediatric strabismus, great difficulties arise with maintaining attention and a high level of motivation in patients. Existing computer programs and medical equipment should be supplemented with more modern tools and approaches based on virtual reality (VR) technologies, ensuring the full immersion of children in the treatment process. The aim of this study is to develop and evaluate the effectiveness of a virtual reality medical simulator for the treatment of pediatric strabismus. The specifics of the realization of ophthalmic exercises for the virtual simulator and the methods for evaluation of the quality of their performance are considered. In the course of experimental research, a control group of 58 people using the VR simulator and a reference group of 59 people receiving the standard process of strabismus treatment were compared. The average value of visual acuity in the control group increased from 66.1% to 80.4% (p = 0.002); the average value of objective strabismus angle decreased from 5° to 0° (p &lt; 0.001). The subjective strabismus angle was also found to improve from 3° to 0° (p &lt; 0.001). In terms of exercise quality metrics, a selected subgroup of participants who have been training for a long time have shown positive dynamics in terms of improved accuracy and a reduction in their average number of errors. In summary, virtual reality technologies demonstrated a statistically significant improvement in the metrics used to evaluate orthoptic treatment in the control group and the superiority of this approach over standard treatment.

Применение технологий виртуальной реальности для подготовки пожарных и спасателей

In firefighting and rescue operations, practical training plays a primary role, allowing rescuers to be constantly ready to act in the event of major incidents, accidents or emergencies. In addition to classical training methods, namely training in an unsuitable environment for breathing. Virtual reality is increasingly being used in training in many fields of activity, given the fact that in a virtual environment it is easy to simulate dangers that cannot be created in reality (explosions, fires, falls from a great height), and thus overcome the fear of such dangers. The capabilities of virtual reality simulators allow you to create training scenarios that emphasize the degree of physical fitness of rescuers, taking into account their physiological parameters, which are monitored throughout the training.

Influence of Mental Model-derived Themes on the Quality of Radiological Emergency Response by HAZMAT Technicians: Insights from a Case Study.

This paper investigates the link between gaps in emergency responders' notions of mental model regarding radiation and risk and their effectiveness in responding to radiological incidents. Particularly, this work focused on exploring themes that emerged in prior work related to improper understanding and application of knowledge concepts related to radiation risks and Radiological Dispersal Device (RDD) scenarios (Leek et al., 2024b). The research uses a quantitative approach to correlate various thematic elements, such as responders' confidence levels, comprehension, and application of radiation risk principles, with the quality of the emergency response score gained through a virtual reality simulation. The results underscore a strong effect of responders' confidence level on response quality scores. Additionally, the study identifies that improper understanding of knowledge concepts and incorrect application of radiation risk and RDD concepts are factors that detract from the quality of response, especially the tendency to overestimate health risks associated with a 25-rem (0,25 Sv) dose and to misapply principles of radiation risk. The implications of this research are significant for the development and refinement of training programs for hazardous materials (HAZMAT) technicians and other emergency responders. The findings suggest the need for a comprehensive review of current training methodologies to address the identified deficiencies that had impacts on the quality of response. The findings provide a foundation for reshaping training priorities and operational readiness, driving the development of training that is both grounded in empirical evidence and that directly addresses the knowledge gaps influencing response quality. The methodological framework developed and employed, including the quality scoring system and the Expected Mental Model State (EMMS) Diagnostic Matrix, also hold potential for broader application in future investigations, extending to diverse types of responders and emergency scenarios.

Empowering Dementia Communication via Virtual Reality AI-Driven Simulations

The use of effective communication skills is essential for direct care workers to provide quality care for persons living with dementia (PLWD) in long-term service and support settings (LTSS). However, direct care workers often report feeling unprepared, lacking competence in care, and fear interacting with PLWD. This proof-of-concept study proposes Virtual reality Communication Training Optimizing Real-world Interactions (VICTORI) intervention, aiming to develop and evaluate the usability, acceptability, and preliminary effectiveness of virtual reality (VR) simulated communication training for direct care workers using artificial intelligence (AI)-generated patients with dementia. Care-related and social communication scenarios in dementia care will be developed, based on current literature, our validated communication instrument, and AI technology. Six modules consisting of pre-briefing, simulation facilitation, and de-briefing will be developed, refined, and evaluated based on an advisory board of experts and direct care workers’ quantitative and qualitative feedback. To test the usability, acceptability, and effectiveness of the VICTORI intervention, we will use a single group pre- and post-test intervention design, integrating quantitative measures and qualitative semi-structured interviews in this mixed-methods study. Thirty direct care workers will be recruited at two LTSS in North Texas. Direct care workers will participate in six VR-AI simulation commu-nication training sessions that include communication with AI-generated patients, real-time feedback, and detailed evaluation of communication behaviors. Each simulation will be recorded to further evaluate the partici-pant’s communication skills using the Dyadic Communi-cation Observational coding scheme in Dementia care (DCODE). Additionally, participants' potential side effects during VR simulation will be assessed using continuous physiological data and self-reported questionnaires at each simulation session. Communication knowledge and com-petence in dementia care will be assessed before and after training using self-reported questionnaires. Direct care workers will also be interviewed to assess acceptability and satisfaction with the VICTORI training. This proposal will introduce innovative training methods that leverage AI technology into communication training in dementia care. Objective assessments, including AI-based feedback, physiological data, and observational assessments, ensure the reliability and validity of the data to evaluate plausibility of VICTORI intervention.

Exploring the influence of body movements on spatial perception in landscape and interior design

This study investigates the influence of body movements on spatial perception in both landscape and interior design environments, focusing on how physical interactions shape spatial understanding beyond visual perception alone. Grounded in the theory of embodied cognition, the research examines how gait, posture, and movement dynamics affect spatial awareness. The study captures detailed data on movement patterns and visual engagement across different spatial contexts using a combination of real-world observations and Virtual Reality (VR) simulations, motion-tracking systems, wearable sensors, and eye-tracking technology. A total of 157 participants, aged 20 to 65, navigated both outdoor landscapes and indoor environments, with key variables such as surface materials, spatial layout, and lighting conditions manipulated to assess their effects on spatial perception. The study measured gait speed, step frequency, path deviations, time to destination, visual attention, and subjective ratings of perceived openness, ease of movement, and emotional response. Key findings include that surface materials significantly influenced gait speed and step frequency. For example, participants walking on concrete had a significantly faster gait speed (mean difference = 0.5220, p = 0.001) than those walking on gravel. In terms of spatial layout, the two-way Analysis of variance (ANOVA) results showed that winding paths led to more path deviations (F-statistic = 350.00, p = 3.19 × 10−8) and longer times to destination (F-statistic = 1744.00, p = 2.39 ´ 10−11) compared to straight paths. The environment type (landscape vs. interior) also significantly affected navigation, with landscape participants showing a more significant deviation from direct paths (F-statistic = 19.60, p = 2.37 × 10−3). Visual engagement data, analyzed through a chi-square test, indicated that vertical elements like walls approached significance in attracting visual attention (Chi-square = 2.88, p = 0.0896), while other elements like trees and benches had less impact. The Wilcoxon signed-rank test results showed significant differences between real-world and VR experiences in perceived openness (W-statistic = 0.0, p = 0.001953), ease of movement (W-statistic = 0.0, p = 0.001953), and comfort (W-statistic = 0.0, p = 0.001953), highlighting VR’s limitations in replicating the full embodied experience of physical spaces.

Automatic Final-Product Assessment of Virtual Reality Mastoidectomy Performance: A Validity and Reliability Study.

Assessment is key in modern surgical education to monitor progress and document sufficient skills. Virtual reality (VR) temporal bone simulators allow automated tracking of basic metrics such as time, volume removed, and collisions. However, adequate performance assessment further includes compound rating of the stepwise bony excavation, and exposure and preservation of soft tissue structures. Such complex assessment requires further development of automated assessment routines in the VR simulation environment. In this study, we present the integration of automated mastoidectomy final-product assessment with validation against manual rating. At two international temporal bone courses, 33 ORL trainees performed anatomical mastoidectomies in the Visible Ear (VR) Simulator with automatic performance assessment using a newly implemented rating routine based on the modified Welling Scale. Automated assessment was compared with manual ratings by experts using absolute agreement, intraclass correlation, and generalizability analysis to establish validity and reliability. The overall average agreement between manual and automatic assessment was 83.9% compared with the inter-rater agreement of 88.9%. A majority of items (15 out of 26) showed high agreement between automated and manual rating (>85%). Intraclass correlation coefficients were found to be high. Generalizability analysis with D-studies found that five repetitions per participant are needed for a G coefficient >0.8, which is considered necessary for high-stakes assessments. We have demonstrated the feasibility, validity, and reliability of an automatic assessment system integrated into a VR temporal bone simulator. This can prove to be an important tool for future self-directed training with skills certification.

Interprofessional Team Training With Virtual Reality: Acceptance, Learning Outcome, and Feasibility Evaluation Study.

Effective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)-based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning. This study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case. This 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course. The data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65-80). The perception of usefulness (median 6, IQR 5.8-6.9) and ease of use (median 5.9, IQR 5.1-6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6-9) to posttraining (median 8, IQR 7-9; z=-2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2-3 and median 3.5, IQR 3-4, respectively; z=-3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely. The new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students.

Training transfer validity of virtual reality simulator assessment

This study utilises computer-based simulations to explore the transfer effects of competency training in maritime education, addressing the current lack of research on their transferability to real-world scenarios.The research explores the accuracy of procedural knowledge assessment using virtual reality (VR), positing that head-mounted display (HMD) VR offers stronger concurrent validity through training transfer measures than 3D desktop VR. This is evaluated by regression on a training transfer condition. It also investigates motivation’s influence on training transfer and the regression model of this relationship.Fifteen marine engineering students were divided into two experimental groups using 3D desktop VR and HMD VR systems, with eight experts in the control group. The students had previously received traditional lecture-based instruction and were given practical training using a 2D desktop simulator in the same scenario as in the VR treatment and in the training transfer condition.The ANCOVA design experiment involved two levels of technical immersion before the operation of real-life equipment. Neither technical immersion nor expertise level as independent variables were found to have a significant effect in the relationship of the assessment predicting the training transfer. The direct relationship was significant (R2adj = 0.436) and further analysed with the influence of motivation, resulting in a moderation model with a decent effect size (R2 = 0.740). Based on these findings, we can infer that both types of VR simulations used for assessment demonstrate concurrent validity in predicting real-life performance before we discuss and define the characteristics of the observed transfer according to theory.

Digitalization and Corporate Social Responsibility: A Case Study of the Moroccan Auto Insurance Sector

The aim of this article is to explore the impact of digitalization on corporate social responsibility (CSR) in the automobile insurance sector in Morocco. This article first explores the theoretical and conceptual foundations of digital transformation and CSR. A mixed methods approach is then used, combining qualitative interviews with a wider quantitative survey, to investigate how digital innovations influence CSR practices. Interview analysis provides the basis for the development of a conceptual framework and eight hypotheses, which are then tested using quantitative techniques to analyze survey data. The results reveal several links between the benefits of digitalization and CSR. Claims management platforms, digital roadside assistance tools, and digital vehicle assessment and inspection all positively impact policyholders’ well-being in terms of compensation and asset preservation, thereby enhancing the CSR profile of automobile insurers. Similarly, augmented reality (AR) and virtual reality (VR) training and simulation, as well as repair assistance, have positive impacts on policyholders’ well-being and advance the CSR positioning of automobile insurers. This article has limitations as it is based on a narrow industrial sector in a single country, but it nonetheless highlights certain relevant interrelationships between digitalization and CSR, contributing to the development of theory and practice in these research areas.

A Highly-Configurable Session Designer for VR Nursing Training

Virtual Reality (VR) has proven to be a valuable tool for medical and nursing education. VR simulators are available at any time and from anywhere, and can be used with or without faculty supervision, which results in a significant optimization of time, space, and resources. In this paper we present a highly-configurable session designer for VR-based nursing education following the Standards for QUality Improvement Reporting Excellence: SQUIRE 2.0 and SQUIRE-EDU. Unlike existing platforms, we focus on letting educators quickly customize the training sessions in multiple aspects. This is achieved through the use of a visual editor, where educators can choose the environment and the elements in the session, and a node-based visual system for programming the behavior of the sessions. Thanks to end-user customization, educators can develop different variants of a session, adapt the sessions to new nursing protocols, incorporate new equipment or instruments, or accommodate custom environments. We have implemented the designer and tested it on various nursing training scenarios. The designer can be integrated into VR simulators to help educators save time in delivering highly customizable training.

Virtual reality-based simulation improves rotator cuff repair skill: a randomized transfer validity study.

Although virtual reality (VR) simulators have demonstrated their efficiency for basic technical skill training of healthcare professionals, validation for more complex and sequential procedures, especially in arthroscopic surgery, is still warranted. We hypothesized that the VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions. VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions. This study is prospective, multicentric and randomized. Thirty orthopedic surgery residents were enrolled in the study and randomized in two groups: VR training (VR+) and no VR training (VR-). Only the VR + group underwent a monthly VR-based training program for rotator cuff repair. The 1 -h VR training sessions were standardized and supervised by the same instructor. After six months, all participants performed a double-row arthroscopic rotator cuff repair procedure on a benchtop shoulder model providing realistic visual and haptic conditions with implants. Two independent surgeons with expertise in shoulder repair and blinded to the randomization rated the participants' performance using the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Demographic characteristics and surgical experience were comparable between the two groups. The ASSET global rating score was higher in the VR + group than in the VR- group (34.4 ± 3.1 and 30.5 ± 5.7, respectively; p = 0.046) and the VR+ group performed the procedure faster than the VR- group (27.3 ± 3.6 vs. 31.7 ± 0.4 minutes, respectively; p = 0,003). This study demonstrated that a monthly VR-based program for 6 months was better than standard peer training alone for mastering a complex and sequential rotator cuff repair when using the validated ASSET Score. Overall, nonspecific arthroscopic skills were also higher in the VR + group. II, therapeutic study.

Co-Designing Dynamic Mixed Reality Drill Positioning Widgets: A Collaborative Approach with Dentists in a Realistic Setup.

Mixed Reality (MR) is proven in the literature to support precise spatial dental drill positioning by superimposing 3D widgets. Despite this, the related knowledge about widget's visual design and interactive user feedback is still limited. Therefore, this study is contributed to by co-designed MR drill tool positioning widgets with two expert dentists and three MR experts. The results of co-design are two static widgets (SWs): a simple entry point, a target axis, and two dynamic widgets (DWs), variants of dynamic error visualization with and without a target axis (DWTA and DWEP). We evaluated the co-designed widgets in a virtual reality simulation supported by a realistic setup with a tracked phantom patient, a virtual magnifying loupe, and a dentist's foot pedal. The user study involved 35 dentists with various backgrounds and years of experience. The findings demonstrated significant results; DWs outperform SWs in positional and rotational precision, especially with younger generations and subjects with gaming experiences. The user preference remains for DWs (19) instead of SWs (16). However, findings indicated that the precision positively correlates with the time trade-off. The post-experience questionnaire (NASA-TLX) showed that DWs increase mental and physical demand, effort, and frustration more than SWs. Comparisons between DWEP and DWTA show that the DW's complexity level influences time, physical and mental demands. The DWs are extensible to diverse medical and industrial scenarios that demand precision.

Assessing the feasibility and acceptability of a hands-on surgical robotics workshop for medical students and early-career doctors.

Despite the increased adoption of robotic surgery across various specialities, medical students and early-career doctors have limited exposure. This study aims to assess the feasibility and acceptability of a hands-on surgical robotics workshop for those early-career medics. 26 participants with minimal prior exposure to robotic surgery attended a workshop using the Versius© robotic surgical system and Virtual Reality simulation platforms. We analysed pre-workshop registration form and post-workshop feedback form utilising mixed quantitative and qualitative approach. Pre-workshop registration revealed motivations and barriers to attending surgical robotics courses. Post-workshop evaluations showed significant improvements in self-assessment scores, familiarity with robotic surgery, and confidence in using the technology. All participants expressed a strong enthusiasm for greater access to robotic surgery education and 84% of participants strongly agreed this workshop increased their interests in surgical specialities. The study also highlighted the perceived ease of use of robotic systems compared to laparoscopic instruments and explored the potential of virtual reality in surgical training. Further efforts are needed for better integration of robotic surgery training into medical curricula to prepare future surgeons for the evolving surgical landscape.

Virtual reality simulation and real-life training programs for cataract surgery: a scoping review of the literature

BackgroundCataract surgery requires a high level of dexterity and experience to avoid serious intra- and post-operative complications. Proper surgical training and evaluation during the learning phase are crucial to promote safety in the operating room (OR). This scoping review aims to report cataract surgery training efficacy for patient safety and trainee satisfaction in the OR when using virtual reality simulators (EyeSi [Haag-Streit, Heidelberg, Germany] or HelpMeSee [HelpMeSee foundation, Jersey city, New Jersey, United States]) or supervised surgical training on actual patients programs in residents.MethodsAn online article search in the PubMed database was performed to identify studies proposing OR performance assessment after virtual-reality simulation (EyeSi or HelpMeSee) or supervised surgical training on actual patients programs. Outcome assessment was primarily based on patient safety (i.e., intra- and post- operative complications, OR performance, operating time) and secondarily based on trainee satisfaction (i.e., subjective assessment).ResultsWe reviewed 18 articles, involving 1515 participants. There were 13 using the EyeSi simulator, with 10 studies conducted in high-income countries (59%). One study used the HelpMeSee simulator and was conducted in India. The four remaining studies reported supervised surgical training on actual patients, mostly conducted in low- middle- income countries. Training programs greatly differed between studies and the level of certainty was considered low. Only four studies were randomized clinical trials. There were 17 studies (94%) proposing patient safety assessments, mainly through intraoperative complication reports (67%). Significant safety improvements were found in 80% of comparative virtual reality simulation studies. All three supervised surgery studies were observational and reported a high amount of cataract surgeries performed by trainees. However, intraoperative complication rates appeared to be higher than in virtual reality simulation studies. Trainee satisfaction was rarely assessed (17%) and did not correlate with training outcomes.ConclusionsPatient safety assessment in the OR remains a major concern when evaluating the efficacy of a training program. Virtual reality simulation appears to lead to safer outcomes compared to that of supervised surgical training on actual patients alone, which encourages its use prior to performing real cases. However, actual training programs need to be more consistent, while maintaining a balance between financial, cultural, geographical, and accessibility factors.