SP9.08 Realism and Immersion in Virtual Reality Surgical Training: A Scoping Review

Background Virtual reality (VR) allows interaction with an artificial environment and is used for surgical training. The goal is to create a fully immersive and life-like experience, yet the quality of different metrics that impact its realism are not assessed in literature. This scoping review aimed to determine the key metrics which impact realism in VR training for surgery. Methods OvidMEDLINE & Embase databases were interrogated for articles published in English between 1950-2024. A systematic search strategy was conducted to identify all qualitative and quantitative studies evaluating the realism and immersion of VR/Augmented Reality/Mixed Reality in surgical education. Results were reported according to PRISMA Extension for Scoping Review(PRISMA-ScR) guidelines. Results The systematic search returned a total of 4156 studies [11-156], of which 11 were included. Two digital-based studies showed that their models increased realism, and five surgical intervention studies reported improved realism through interventions measured with haptics, visual, design, general realism and force feedback metrics. Three studies provided quantitative outcomes. There was no clear definition of either realism or immersion and construct validity was only discussed by one study. Haptics and tactile metrics were the most common measures of realism and immersion. Conclusion Improving sensory and haptics metrics, as well as the transferability of skills, improves the realism and immersion of a VR training model. Definitions for ‘realism’ and ‘immersion’ should be universally established. Future research should aim to produce quantitative data for assessment of realism using as a minimum the 5 metrics identified.