108 Comparing Virtual Reality Versus Simulation to Teach the Assessment and Management of Acute Surgical Scenarios

Abstract Background Traditional apprenticeship-based surgical training presents with challenges, especially in acute scenarios. Simulation is the current gold standard but has its drawbacks. Virtual reality (VR) offers immersive three-dimensional computer-generated training scenarios and can connect users from various locations. Aim We aimed to compare the performance of junior doctors to manage an acute surgical scenario using VR and mannequin-based simulation. We hypothesised that VR would be as effective as mannequin-based simulation in performance outcomes. Method This multicentre, randomised controlled pilot study was conducted with eighteen junior doctor volunteers (Foundation and Core Trainee Year 1). Ten were randomly allocated to VR and eight to mannequin-based simulation. Participants completed questionnaires and a 15-minute pneumothorax scenario. Quantitative metrics included overall score, time-to-critical decisions, and academic buoyancy scores (ABS). Qualitative metrics included participants’ likes and dislikes of their allocated simulation modality. Results VR participants scored significantly higher than mannequin-based simulation participants in overall scores (74.30% (SD±5.08%) versus 59.75% (SD±10.14) (p=0.04)), and technical skills aspects (77.20% (SD±8.01%) versus 65.00% (SD±8.21%) (p=0.01)). Mannequin-based simulation participants initiated critical decisions faster and demonstrated a trend towards a faster mean time-to-completion (p=0.06). ABS scores increased for both study groups, though was only significant for VR participants (p≤0.01). VR participants liked how VR fostered independent learning but disliked the formulaic content and impaired communication-learning compared to mannequin-based simulation. Conclusions VR can be as effective as mannequin-based simulation in training junior doctors in acute surgical scenarios. Future research should recruit a larger sample size for a full comparative randomised controlled trial.