Virtual Reality Simulation Training Research Articles

Comparing the impact of surgical expert versus non-ophthalmologist instructors on virtual-reality surgical performance: A randomized controlled trial.

To compare Manual Small Incision Cataract Surgery (MSICS) microsurgical performance in course participants who received virtual reality simulation-based training by either a surgical expert or a non-ophthalmologist instructor. Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark. Randomized controlled trial. Residents and specialists in ophthalmology with no prior MSICS experience were included to receive virtual reality simulation training in MSICS using the HelpMeSee simulator. The participants were randomly allocated to receive training from either an experienced MSICS surgeon or a non-ophthalmologist, also known as near-peer teaching. The performances of the participants were evaluated at baseline and post-training using a MSICS proficiency-based test with evidence of validity. Thirty participants were included in the study and 29 completed the course. There was no significant difference in final test score between the two groups (p = 0.13). The performance score of both groups of participants increased significantly after receiving the training (p < 0.001). All participants passed the proficiency-based test after receiving the training. We found no significant difference in surgical proficiency-level whether the participants were trained by a surgical expert or a non-ophthalmologist instructor for MSICS in a virtual-reality based setting. The findings of this study suggest that near-peer teaching within microsurgical performance potentially could be applied with teaching outcomes comparable to a surgical expert-instructor.

Virtual reality simulation training in laparoscopic surgery – does it really matter, what simulator to use? Results of a cross-sectional study

BackgroundVirtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training “on the patient”. However, there are no data comparing different commercially available high-end virtual reality simulators.MethodsTrainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination.ResultsAll trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (p < 0.001), median time taken improved from 305 to 167 s (p < 0.001).ConclusionsAll Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.

Development of a Virtual Reality Training Simulator for Prostate Brachytherapy

Development of a Virtual Reality Training Simulator for Prostate Brachytherapy

Impact of a virtual reality-based simulation training for shoulder dystocia on human and technical skills among caregivers: a randomized-controlled trial

This study analyzed the adherence to the modified Advanced Life Support in Obstetrics (ALSO) algorithm (HELP-RER) for handling shoulder dystocia (SD) using a virtual reality (VR) training modality. Secondary outcomes were improvements in the post-training diagnosis-to-delivery time, human skills factors (HuFSHI), and perceived task-load index (TLX). Prospective, case–control, single-blind, 1:1 randomized crossover study. Participants were shown a 360° VR video of SD management. The control group was briefed theoretically. Both groups underwent HuFSHI and HELP-RER score assessments at baseline and after the manikin-based training. The TLX questionnaire was then administered. After a washout phase of 12 weeks, we performed a crossover, and groups were switched. There were similar outcomes between groups during the first training session. However, after crossover, the control group yielded significantly higher HELP-RER scores [7 vs. 6.5; (p = 0.01)], with lower diagnosis-to-delivery-time [85.5 vs. 99 s; (p = 0.02)], and TLX scores [57 vs. 68; (p = 0.04)]. In the multivariable linear regression analysis, VR training was independently associated with improved HELP-RER scores (p = 0.003). The HuFSHI scores were comparable between groups. Our data demonstrated the feasibility of a VR simulation training of SD management for caregivers. Considering the drawbacks of common high-fidelity trainings, VR-based simulations offer new perspectives.

426 Effect of Visuospatial Feedback Versus Numeric Scores on Neurosurgical Tumor Resection Skills Among Medical Students in Virtual Reality Simulation Randomized Control Trial

INTRODUCTION: Virtual reality (VR) simulation can be implemented with various feedback modalities to optimize learners’ surgical skills acquisition. The systems can present benchmark scores as either a numeric report or a visuospatial performance assessment. In this context, the optimal feedback methodology to enhance learning remains undefined. METHODS: One hundred and twenty medical students (mean age [SD], 23.1 [3.6] years, 41% women) from four institutions were recruited to practice a simulated subpial tumor resection in five attempts. They were randomly assigned to receive one of four interventions between each attempt: (1) no feedback (n = 30), (2) numerical feedback (n = 30), (3) visual feedback (n = 29), or (4) visuospatial feedback (n = 31). Performance on the first task determined baseline. Skill was evaluated using previously established 14-expert performance benchmarks. The primary outcome was the number of performance benchmarks achieved throughout the five attempts. RESULTS: Participants in all feedback groups significantly improved their performance compared to baseline. Between-subjects comparison demonstrated a significant increase in the number of metrics achieved with visual (mean difference 1.80, p = 0.001) and visuospatial (mean difference 1.89, p &lt; 0.001) feedback compared to control, and no significant increase with numeric assessment (mean difference 1.10, p = 0.093). In the third attempt, visual feedback was significantly superior to numeric assessment (mean difference 1.63, p = 0.016). CONCLUSIONS: Neurosurgical skill acquisition is enhanced with visual and visuospatial feedback in VR simulation training. These engaging modes of performance assessment result in more accelerated rate of benchmark acquisition compared to numerical scores alone. Further research is warranted to explore the potential benefits of visual and visuospatial feedback in other domains of surgical training.

Study of Adverse Factors During Training with Virtual Reality Simulator

Currently, the dynamic development of information technology contributes to the increasingly widespread application of Virtual Reality (VR) as modern and effective methods and training tools used in the process of self-education and/or training related to understanding the essence of the principles of operation and mastering the tasks of operating even complex systems or technical processes through simulating their actions. A significant argument for the use of virtual reality simulators in training uniformed services is the favorable cost-effect ratio and considerations of trainee safety. However, the use of VR simulators may be accompanied by the possibility of side effects or intensified symptoms of the so-called cybersickness. Bearing this in mind, the purpose of this article is to present the results of preliminary studies of adverse factors occurring during training using a VR simulator. The theoretical foundation for empirical research was provided by the results of a conducted review and analysis of literary content. Among the empirical methods, studies were conducted using a simulator sickness questionnaire and a research trial according to the parallel triangulation strategy scheme, involving the simultaneous use of quantitative and qualitative methods. The results obtained in this way can provide a valuable source of information about factors increasing the risk of adverse symptoms of cybersickness and ways of their mitigation, and can serve for further work on their development and application of VR simulators.

Integrating virtual reality technology into beginning welder training sequences

Virtual reality (VR) technology is an advanced modern resource commonly integrated into various forms of training. VR training simulations are customizable in that quality-grading parameter settings, physical environment, and user capacity can be modified to personal or professional preference. In this study, VR technology training practices are utilized to enact meaningful learning. Meaningful learning is achieved by providing visual and audial cues within the virtual training environment, weld performance skill development, and adequate skill practice time over a four-week span. This method of practice will reflect a new training style where beginning welders receive personalized feedback from both the VRTEX 360 virtual reality welding simulator and welding instructor. This training method benefits learners by expediting and enhancing their skill acquisition, adjusting their performance according to the various feedback they receive, and thereby experiencing meaningful learning. Results indicate that with each round of VR welding training participants’ test weld scores continuously increased, as well as consistently scoring 80% and higher. This enhanced performance of beginning welders implies VR welding training can effectively aid in developing complex welding skills. We recommend that future research investigate the effectiveness of parameter cues and total cost-savings of integrated VR technology into welding training methods.

Want doctors to use VR simulation? Make it mandatory, accessible, educationally valuable, and enjoyable!

Background Virtual reality (VR) simulation training is mandatory for postgraduate year 1-2 doctors at the author’s hospital trust. Despite this, a preceding quantitative study demonstrated uptake below required levels. While the educational value of VR simulation has been highlighted, little attention has been paid to participant utilisation in postgraduate curricula. With the increasing development and incorporation of VR-based clinical education, it is essential to understand the factors influencing how frequently postgraduate doctors utilise it so that its potential can be maximised. Methods A qualitative study design was employed. All 108 postgraduate year 1-2 doctors from the 2020-21 training year were invited for a semi-structured interview. Interviews continued until data saturation was reached in the form of informational redundancy. Reflexive thematic analysis was conducted. Results A total of 17 interviews were conducted. Four main themes that influenced participation in VR simulation were identified: (1) the mandatory nature encouraged participation but led to negative perceptions as a tick-box exercise; (2) there were multiple challenges to accessing the resource; (3) the scenarios were felt to have limited educational value; and (4) there was untapped potential in drawing benefits from VR as an enjoyable leisure activity. Conclusions Recommendations from these findings include: (1) VR simulation should be mandatory but with a degree of learner autonomy; (2) sessions should be integrated into doctors’ rotas as protected time; (3) more challenging scenarios ought to be created aligned with postgraduate courses, examinations, and specialty training, and (4) presented as a difficulty level system akin to gaming experiences.

Comparative study to determine the proper sequence of simulation training, pelvic trainer versus virtual reality simulator: a pilot study

BackgroundIncreased surgical efficacy has led to a remarkable increase in the usage of minimally invasive surgical procedures since their inception. The use of simulation in surgical teaching has grown significantly during the past 10 years. Several laparoscopic simulators have been built. Virtual reality (VR) simulators and box trainers (BTs), often known as pelvic trainers, are the two primary training modalities used in hospitals and clinical training institutes for the development and acquisition of laparoscopic skills. Our study aimed to evaluate the proper sequence of pelvic trainers and VR simulator training to improve laparoscopic gynecological skills.MethodologyWe carried out this pilot study at the Virtual Endoscopic Simulation and Skills Acquisition Laboratory at the Obstetrics and Gynecology Department in the Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Egypt, from February to August 2022. All residents with minimal or without laparoscopic experience (twenty residents) were divided into two groups and classified as (group A versus group B). Group A’s training began with a pelvic trainer, which was tested using a checklist. Later, the group trained on a virtual reality simulator, which tested them using an electronic autoassessment. After training on a virtual reality simulator and passing an electronic autoassessment test, group B moved on to pelvic trainers and had a checklist-based assessment.ResultsWe compared pelvic trainer tasks between the training groups, and detected no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.646, 0.341, 0.179, and 0.939 respectively); when we compared VR simulator tasks between the training groups, there were no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.79, 0.3, 0.33, and 0.06, respectively).ConclusionThere was no difference in training, between residents who started on a pelvic trainer or the VR simulator; therefore, both could be used in laparoscopic training with no preferred order.Trial registrationThe trial was registered at clinicaltrials.gov with the name “Pelvic trainer vs VRS” and the identifier “NCT05255614.” The registration date was January 19, 2022, and the trial was prospectively registered. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=22&sid=S000BR5D&cx=t6mc14

15. UTILITY OF CHATGPT IN THE APPLICATION OF THREE-DIMENSIONAL RECONSTRUCTION MODELS OF THE STOMACH IN REVISIONAL BARIATRIC SURGERY

Abstract Introduction Radiological three-dimensional reconstruction from CT images is very useful in pre-surgical planning and in training for complex cases using the preoperative studies performed on the patient. In revisional bariatric surgery, there is an undiscovered field with potential applications to develop with 3D reconstruction models. Our goal is to propose the applications offered by ChatGPT with 3D reconstruction models of post-bariatric surgery anatomy, whether it be vertical gastrectomy or the gastric reservoir and gastrojejunal anastomosis in the case of bypass. Methods Three-dimensional image anatomical models of the stomach and post-bariatric surgery anatomy have been developed. CT images are obtained with the Siemens Somatom Perspective 64® device. The images are retrieved in DICOM format and processing to achieve three-dimensional reconstruction is done with the OsiriX® software, performing manual segmentation and an image density modification. ChatGPT analyzes these databases and provides us with the options that can be exploited. Results Project ideas based on ChatGPT: 1 - Surgical planning assistant. 2 - Virtual reality training simulator. 3 - Diagnostic assistant. 4 - Patient education tool. 5 - Research tool. Conclusion Obtaining three-dimensional reconstruction images of post-bariatric surgery anatomy allows us to develop models that, as guided by ChatGPT, can be applied in different aspects in revisional bariatric surgery.

Analysing Serious Games and Virtual Reality for Cardiac Arrest Simulation

The technological industry is a continuously evolving field, meaning that old methods are constantly being overruled by such advancement. The focus of this study is to evaluate the level of development within technology when paired with already existing practices. Cardiac arrest is a type of medical situation that requires prompt action towards the people experiencing it. This is where virtual reality (VR) simulations can be an innovative method by which one can learn how to deal when encountering such a situation. Advances in VR simulations have allowed trainees to practice realistic, full-length procedures in a safe and controlled environment, where mistakes are permitted and can be further used as learning points. VR provides a flexible learning environment that adapts to the learner’s pace. The data gathered from this study reveals that VR simulation training can prove to be a successful alternative learning method depending on various factors specific to the subject as well as the person’s preferred way of learning when comparing VR to other traditional methods.

Virtual Reality and Surgical Simulation Training for Orthopaedic Surgery Residents: A Qualitative Assessment of Trainee Perspectives.

The demonstrated benefits of virtual reality (VR) in orthopaedic surgical training are numerous. However, it is relatively unknown how best to implement VR into an already established orthopaedic resident education curriculum and how trainees will engage and use these technologies longitudinally. This was an exploratory, qualitative research study performed in accordance with Consolidated Criteria for Reporting Qualitative Research guidelines. Orthopaedic surgery residents at a single institution were recruited during the 2022 to 2023 academic year. Semistructured interviews were conducted. Data were analyzed through grounded theory methodology, beginning with open coding, followed by axial coding, and concluding with selective coding that describes orthopaedic surgery residents' current perceptions of VR as a training tool. Six residents participated in interviews before thematic saturation was achieved. Average interview length was 13:27 (±2:59) minutes. Residents felt that currently, VR is most useful for interns and junior residents as an educational adjunct for learning anatomy, surgical exposures, and the steps of a procedure in a risk- and judgment-free arena. There seems to be a "ceiling effect" with VR given current technological limitations, and residents remarked that there is an associated "opportunity cost" with using VR technology. Some residents may find it more time-efficient to study texts, videos, or surgical guides rather than use VR. Cost (limited number of headsets) and technological barriers (i.e., hardware, software, and Wi-Fi issues) were some of the described barriers to VR utilization. Residents felt that there needs to be dedicated technological support to help with these issues. At this time, given these limitations of VR, many preferred VR as an optional educational adjunct rather than as a required curricular tool or assessment of surgical competency. There is current utility for VR in orthopaedic surgical training. Future technological advances may make VR more central to resident education. This study describes resident perceptions about the technology and best use practices for the technology. Qualitative Study, Level V Evidence.

ProtoColVR: Requirements Gathering and Collaborative Rapid Prototyping of VR Training Simulators for Multidisciplinary Teams.

We present ProtoColVR, a methodology and a plugin designed for gathering requirements and collaborative rapid prototyping of virtual reality training simulators. Our methodology outlines the utilization of current technologies, the involvement of stakeholders during design and development, and the implementation of simulator creation through multiple iterations. We incorporate open-source tools and freely available environments like Twine and Unity to establish a reference implementation for requirements gathering and rapid prototyping. ProtoColVR is the outcome of our collaboration with a hospital and our Navy, and it has undergone testing in a development Jam. From these tests, we have gained valuable insights, including the ability to create functional prototypes within multidisciplinary teams, enhance communication among different roles, and streamline requirements gathering while improving our understanding of the virtualized environment.

Virtual reality case simulation to build skill competencies in working with substance-engaged clients

ABSTRACT Virtual Reality (VR) simulation training can offer social work students a person-centered learning approach that emphasizes in-vivo experience in applying social work skills to a case simulation, with post-simulation debriefing that links students’ experiences back to direct practice learning objectives. VR simulation offers the unique opportunity for interprofessional group decision-making and support in providing care, offering a context where immediate feedback around decision-making is encouraged along with the space to consider alternative decisions. This inaugural VR simulation experience for social work students in our College of Public Health (CPH) centered on an interprofessional case situated in a host setting (hospital clinic). The VR training simulation offered a safe learning environment, encouraging student dyad teams to manage engagement and adjust their skills in real-time in a low-stakes scenario. Students saw value in the learning space and were interested in participating in other case scenarios. The early adoption of VR in the CPH enabled the Department of Social Work to lead the way for interprofessional custom case creation for working with substance-involved clients in collaboration with a Certified Healthcare Simulation Educator to deliver simulations that meet Healthcare Standards of Best Practice.

Virtual reality to provide caregiver skill development and problem solving

Background:Caring for persons with dementia (PWD) leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among caregivers (CGs). The VR-SIMS CARERS Initiative aims to engage Knowledge Users (KUs), older adults and community stakeholders in the co-design of a Virtual Reality (VR) simulation training environment for dementia caregivers, and to explore end-user’s perspectives, design and implementation challenges and opportunities (e.g. digital literacy, technology readiness, VR acceptability), to ensure that the resulting “Minimally Viable Prototype” is clinically efficacious, scalable and sustainable.Objectives &amp; Methodology:The specific objectives of this study are to: 1.employ a co-design approach to develop and validate an immersive VR simulation training environment for CGs to be in touch with realities of caregiving, practice communications and behavioural management of PWD based on the well-established CARERS Program;2.to evaluate feasibility, acceptability, tolerability informed by VR-CORE Framework and Hybrid development-implementation design, and to explore issues around implementation of the VR simulation training platform; and3.to conduct pilot testing to examine a) initial clinical efficacy of VR-based CG training in improving quality of relationship with PWD, competence, resilience, and reducing depression and stress in dementia CGs and its b) readiness for implementation in the community.Anticipated Outcomes:VR-SIMS CARERS innovation is intended to be an accessible, scalable and sustainable VR simulation training platform that will support CGs in the practice and acquisition of essential dementia caregiving skills, enhancing their caregiving competence and resilience. Training CGs to recognize and manage stressors can lower their risk of overall mental health decline.

The educational needs of virtual reality simulation training for novice nurses’ adaptation to clinical practice: A mixed methods study

Purpose: The purpose of this study is to identify the educational needs of virtual reality simulations that can be applied to novice nurses during the waiting period before starting work in a hospital.Methods: A convergent mixed methods was used. The survey data were collected from 230 novice nurses, and a focus group interview was conducted with 6 new nurses. The data were collected from November 2022 to January 2023. Descriptive statistics, a frequency analysis, independent t-test, and an Importance-Performance Analysis were performed using SPSS 24.0.Results: Appropriate topics for virtual reality simulation education were indicated to be medications and intravenous injections, which are high priority topics in quantitative and qualitative research. The novice nurses wanted group activity training three to four times a week for two weeks before beginning work in a hospital. They also wanted an immersive virtual reality system based on a real hospital environment.Conclusion: Based on the above results, this study provides basic data for the development of a virtual reality simulation education that can improve the adaptation of novice nurses to clinical practice. A strategy was suggested to utilize the waiting time before beginning work in a hospital as educational time.

Virtual Reality simulation training improves health professionals’ knowledge in STEMI critical care

Abstract Background In Friuli-Venezia Giulia (FVG, Italy, 1.2M inhabitants), the STEMI network has been implemented with a regional educational programme since 2018. However, each step leading to a fast-track reperfusion needs specific interactions between critical care teams on the scene and in hospital that theoretical training cannot provide. Objectives A new educational tool, based on virtual reality (VR), was developed to train emergency nurses and doctors on the STEMI pathway. Each training session consisted of a VR simulation, dynamically driven by an instructor, where a nurse-doctor pair had to provide first aid to a patient with chest pain. A plenary debriefing followed each session. Before and after the training, all participants filled out a questionnaire on the STEMI pathway (21 multiple-choice items on technical and organizational issues) to evaluate the course theoretical effectiveness. This research is part of the EASY-NET program, co-funded by the Ministry of Health and the participating Regions (NET-2016-02364191). Results Between Oct ’22 and Jan ’23, 48 nurses and 14 doctors were trained and filled in both pre- and post-training questionnaires. Before the training, the median number of correct answers was 15 (IQR 13-16), after the course it rose to 16 (IQR 15-17, p &amp;lt; 0.0001); doctors performed better than nurses both at pre- (16, IQR 15-17 and 14.5, IQR 12.5-16, respectively; p = 0.017) and post-test (18, IQR 15-18 vs 16, IQR 15-17; p &amp;lt; 0,0001) but both categories significantly improved their scores (p = 0.019 and p = 0.0001). The main improvement was observed for items concerning the Case Manager's actions after ECG, (right answers: 58 post-test vs 45 pre, p = 0.0016), morphine administration, (37 vs 25, p = 0.0073), and therapy in vagal reaction (46 vs 35, p = 0.0116). Conclusions An innovative VR simulation training improves the theoretical knowledge of the critical care pathway of STEMI in healthcare teams, which may lead to a better approach to this disease. Key messages • A new Virtual Reality simulation tool is useful for the training of doctors and nurses in patients with STEMI. • Simulation tools based on Virtual Reality can improve health professionals’ theoretical knowledge in critical care pathways.

Cost-effectiveness of virtual reality and wet laboratory cataract surgery simulation.

To evaluate the cost-effectiveness of phacoemulsification simulation training in virtual reality simulator and wet laboratory on operating theater performance. Residents were randomized to a combination of virtual reality and wet laboratory phacoemulsification or wet laboratory phacoemulsification. A reference control group consisted of trainees who had wet laboratory training without phacoemulsification. All trainees were assessed on operating theater performance in 3 sequential cataract patients. International Council of Ophthalmology Surgical Competency Assessment Rubric-phacoemulsification (ICO OSCAR phaco) scores by 2 masked independent graders and cost data were used to determine the incremental cost-effectiveness ratio (ICER). A decision model was constructed to indicate the most cost-effective simulation training strategy based on the willingness to pay (WTP) per ICO OSCAR phaco score gained. Twenty-two trainees who performed phacoemulsification in 66 patients were analyzed. Trainees who had additional virtual reality simulation achieved higher mean ICO OSCAR phaco scores compared with trainees who had wet laboratory phacoemulsification and control (49.5 ± standard deviation [SD] 9.8 vs 39.0 ± 15.8 vs 32.5 ± 12.1, P < .001). Compared with the control group, ICER per ICO OSCAR phaco of wet laboratory phacoemulsification was $13,473 for capital cost and $2209 for recurring cost. Compared with wet laboratory phacoemulsification, ICER per ICO OSCAR phaco of additional virtual reality simulator training was US $23,778 for capital cost and $1879 for recurring cost. The threshold WTP values per ICO OSCAR phaco score for combined virtual reality simulator and wet laboratory phacoemulsification to be most cost-effective was $22,500 for capital cost and $1850 for recurring cost. Combining virtual reality simulator with wet laboratory phacoemulsification training is effective for skills transfer in the operating theater. Despite of the high capital cost of virtual reality simulator, its relatively low recurring cost is more favorable toward cost-effectiveness.

EP02.47: Immersive virtual reality simulation training for Caesarean section: a randomised controlled trial

EP02.47: Immersive virtual reality simulation training for Caesarean section: a randomised controlled trial

Novice learners’ perspectives on obstetric airway crisis decision-making training using virtual reality simulation

BackgroundCurrent training on managing an obstetric difficult airway crisis is likely inadequate, as real-life opportunities to practice are rare. Frequent simulation training sessions could be helpful but are resource intensive. Virtual reality (VR) simulation training may be a potential tool to complement existing simulation curricula. MethodsIn this pilot qualitative study, a VR simulation scenario of an obstetric airway crisis was designed to test the decision-making of novice learners rotating through obstetric anesthesia training. Individual interviews were conducted pre-VR to assess learning needs and post-VR to assess perspectives on utilizing the VR teaching tool. The interviews were transcribed and thematically analyzed. ResultsTwenty-one residents were recruited and participated in the study. Analysis of pre-VR interviews identified three major themes, including gaps in the current curriculum, lack of confidence in managing obstetric difficult airway crises, and recognition that simulation is resource intensive. Post-VR interview themes revealed that VR could be helpful in learning decision-making under stress. Suggested improvements included better video and audio quality, and adding haptic feedback and potential multiplayer features in the future. ConclusionWe identified the advantages of VR simulation and its potential as an intervention to address gaps in our curriculum. Areas of improvement were identified for more effective future implementation.