Immersive virtual reality simulation for technical skills acquisition in pneumothorax management and chest tube insertion: A randomized controlled trial among surgery interns.

Abstract

Immersive virtual reality (IVR) offers a cost-effective, high-fidelity approach to enhance technical skills training. This study assessed the efficacy of IVR simulation delivered on a head-mounted display (HMD) for technical skills acquisition in pneumothorax management and chest tube insertion (CTI) among first-year surgery residents. A novel IVR module on pneumothorax management and CTI was developed using Unity software by a multidisciplinary team of surgeon-educators and software engineers. Forty-five surgical residents were randomly assigned to either IVR instruction or traditional classroom didactics. Participants in both groups then performed CTI on a high-fidelity task trainer, and technical skills acquisition was measured using a validated ten-item Objective Structured Assessment of Technical Skills (OSATS) tool. The IVR group (n = 21) outperformed the control group (n = 24) in mean OSATS score [39.8 (4.4) vs 36.7 (2.9), p = 0.008]. The IVR group also scored higher in rib blunt dissection [4.14 (0.48) vs 3.79 (0.59), p = 0.035], economy of time and motion [3.71 (0.72) vs 3.21 (0.51), p = 0.009], and required less tutor assistance [4.00 (0.89) vs 3.33 (0.70), p = 0.008]. Five HMDs were utilized at a total cost of $1749.95. In this randomized controlled trial, a novel, cost-effective IVR module demonstrated superior technical skills acquisition in CTI when compared with traditional didactic instruction. These findings support the broader implementation of IVR in surgical education. Level I (Therapeutic/Care Management).