Evaluation of virtual reality in trauma training: randomized controlled trial

Simulation-based medical education is developing rapidly. In the past years new trends in virtual reality (VR) have raised in this field as well. The aim of this study was to compare VR to conventional mannequin-based simulation in trauma training of medical students. Volunteers, Riga Stradins University 3rd-6th year medical students, were randomly assigned to two groups by using minimization algorithm: training by conventional or VR simulation. The conventional simulation was performed on SimMan®3G mannequin (Laerdal Medical) with the same room and equipment set-up as in Trauma Simulator (TS) (Exonicus,Inc.) used in VR group. The primary outcome was Trauma Score (Exonicus,Inc;range 55-177) in conventional mannequin-based scenario. The sample size was calculated assuming non-inferiority limit of 10. Simulation was scored by video review of two blinded graders. The secondary outcome was Trauma Score in VR and Pre-&Post- Survey evaluation of the experience. A total of 38 students were randomized:19 to conventional and 19 VR simulation;all completed primary outcome. The differences between conventional and VR simulation groups in means of Trauma Score were 0,1 (95% CI -7.3 – 7.5;  p=0.977) and -24,2 (95% CI -38.3 - -10.1; p=0.001) for mannequin and VR based assessment, respectively. In the Survey,16% of the students reported some adverse effects after trying the VR headset. All the students rated this training as positive experience regardless the group they were divided in. Majority of students admitted that immersive VR would be a useful addition to their medical training and noted that repeated use of this simulator would help them remember correlating trauma algorithms and increase their confidence in running a similar situation in real life. TS was non-inferior to conventional mannequin-based simulation. The main advantage of TS is: it does not require vastly experienced medical facilitators. However, this study did not assess costs and critical clinical performance or outcomes.