Virtual Reality Simulation in Colonoscopy Training: A Systematic Review and Meta-analysis of Studies Published from 2019 to 2024

Colonoscopy has a substantial learning curve, and inadequate training is associated with missed pathology and avoidable complications. Virtual reality (VR) simulation training has increasingly been adopted to supplement early colonoscopy training. To evaluate the evidence published from 2019 to 2024 on the effectiveness of VR-based simulation training in colonoscopy. A systematic search was conducted on PubMed, Medline, Embase, and the Cochrane Library. Eligible studies were synthesized qualitatively, and quantitative outcomes were pooled using random-effects meta-analysis. In total, 12 publications met inclusion criteria, of which 7 contributed quantitative data. Meta-analyses demonstrated statistically significant improvements in colonoscopy performance favoring VR simulation training, with large between-group effects (Cohen's d = 1.005; p < 0.001) and very large pre-post improvements (Cohen's d = 1.750; p = 0.033). The present review found that VR simulation training represents a safe and effective adjunct to early colonoscopy training and supports integration into modern endoscopy education.