The impact of immersive virtual reality training in thyroid surgery: a prospective randomized controlled trial

Up to this date, there have been no reports on immersive virtual reality (IVR) training in thyroid surgery. The purpose of this blinded, randomized controlled trial was to determine the validity and impact of VR training in residents' education. Nineteen general surgery residents participated in the trial comparing IVR with traditional learning, utilizing a technical textbook as a control. A stratified randomization was used to secure balance in the distribution of residents according to their experience. The examined task pertained to the surgical steps from neck incision up to the placement of the continuous intraoperative neuromonitoring electrode and was evaluated by a blinded Fellow of the European Board of Surgery (FEBS) certified endocrine surgeon. Training superiority was assessed by the outcome measures of Objective Structured Assessment of Technical Skills (OSATS) score, need for the main surgeon to intervene, verbal answers, and time to task completion. Participants completed questionnaires regarding face validity and perceived benefits of the educational process. Immersive VR group completed the task significantly faster (p = 0.012), at a mean time of 27.25 ± 3.8 vs 35.25 ± 6.5 min in the control group, and was superior in OSATS Overall score (p = 0.035), knowledge of instruments (p = 0.015) and flow of operation (p = 0.021) scores. In the dedicated questionnaire, the participants of the IVR group stated greater overall satisfaction of the educational process (p = 0.002), ease of use (p = 0.015), enjoyment (p < 0.001), repetitivity (0.001), and perceived improvement in surgical technique (0.021). The IVR group dedicated more time in training 39 ± 8.9 vs 27.5 ± 7.2 min (p = 0.014), and performed more repetitions of the educative module, 3.5 (2-5) vs 2 (1-3) (p = 0.003) than the control group. IVR training demonstrated improved outcomes in several translational technical skills acquisition over traditional learning, while yielding improved satisfaction and repetitivity for participants. Clinical trials registration number No: NCT06917755.