The Use of Immersive Virtual Reality Surgical Simulation to Increase Medical Student Confidence and Surgical...

Immersive virtual reality surgical simulation (IVRSS) is an innovative and cost-effective tool for surgical training, providing a reusable and standardized platform for skill development. While IVRSS is increasingly used in surgical training, it holds promise for addressing limited early exposure to orthopedic surgery for medical students. This is especially relevant given limited musculoskeletal education and few pre-residency surgical simulation opportunities. This study evaluates the use of IVRSS to introduce medical students to orthopedic surgery and build procedural confidence and knowledge.

A prospective cross-sectional study was conducted with 50 medical students completing a femoral intramedullary nail (IMN) module using the IVRSS Precision OS system. Students completed pre-procedure questionnaires assessing demographics, surgical confidence, and knowledge. After a tutorial video, the participants performed the IMN procedure, after which they completed post-procedure questionnaires. Statistical analysis included Wilcoxon signed-rank and McNemar's tests to assess paired changes in non-parametric and binary variables, respectively, with significance set at p < 0.05.

Fifty students participated (mean age 25.4 ± 1.6 years), with 60% identifying as female. Most were second-year medical students (78%), and over half had no prior orthopedic surgery shadowing experience (52%). Following completion of the module, students demonstrated significant improvement in total knowledge scores (mean 4.76 ± 0.90 to 5.54 ± 0.63; p < 0.001). At the item level, knowledge gains were significant for radiographic views (48%-74%; p = 0.005), deep dissection anatomy (82%-98%; p = 0.010), and post-guidewire surgical steps (66%-88%; p = 0.010). Students also reported improved confidence in identifying reduced fractures (p = 0.012), locating anatomical landmarks (p = 0.041), using the C-arm (p < 0.001), and feeling prepared for surgical rotations (p < 0.001).

This study highlights IVRSS as an effective tool for enhancing orthopedic knowledge and improving procedural confidence among medical students. By offering structured learning experiences, virtual simulations help bridge gaps in traditional curricula and better prepare students for clinical rotations.