Exploring the role of immersive virtual reality to support new training and assessment mandates in medical education: an interpretive qualitative research study

Background Trainees must demonstrate competence in entrustable professional activities (EPAs). However, some EPA exposure remains limited in residency education. Immersive Virtual Reality (IVR) can serve as a viable adjunct to support trainees in gaining competence and achieving minimum assessment requirements. This study investigated the role of IVR for training and assessment of medical learners, by exploring the perceptions of faculty. Our research questions were: What are the perceptions of faculty regarding the use of IVR for EPA assessments? What are the benefits, challenges, and opportunities of incorporating IVR into medical education? Methods An interpretive qualitative research study was employed to address the research questions. Faculty explored an EPA scenario through IVR between October 2023 and May 2024. Following the session, participants were interviewed on their experiences and perceptions of IVR for medical education (recruitment until thematic sufficiency). Interview recordings were transcribed and analyzed using reflexive thematic analysis. Results Participants included 17 faculty members and 1 senior subspecialty resident. Six themes were identified: (1) IVR has a realistic yet idealized environment for EPA training and assessment; (2) The flow of the IVR scenario is algorithmic and prescriptive in nature, which is suitable for learning but could limit the development of clinical decision-making skills; (3) Incorporation of IVR into medical education for learning purposes is favourable, depending on the trainee level, skills targeted, and function; (4) I​VR should be used for formative assessment purposes; however, with the current limitations of the technology and scenarios, further considerations should be made for summative assessment purposes; (5)​​ ​IVR is a scalable and portable training tool that offers repeated exposure for high-stakes scenarios, minimizes logistical constraints, and reduces long-term costs; (6) Several barriers for IVR adoption include a learning curve, cybersickness, and potential inequities​. Conclusions Participants indicated that IVR has potential in EPA-related training and assessment, especially for formative assessments. However, trainee orientation, scenario objectives, number of trainees per scenario, and assessment strategies should be considered for implementation. The knowledge acquired from this study will help elucidate the role of IVR as an educationally relevant adjunct to clinical and in-person simulation contexts.