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Updated: Apr 7, 2026
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Published on: May 6, 2020
Comparison of a gamified versus standard virtual reality simulator to teach ultrasound-guided regional Anaesthesia: A
Thomas Vernier1, Michelle Chong2, Joanne Tan3
1Department of Anaesthesia, Liverpool Hospital, South West Sydney Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Study Objective:
Gamification is a term borrowed from computer game design and describes using gaming elements in the non-gaming context of medical education. An existing virtual reality simulator for regional anaesthesia was gamified with star-based rewards, achievement milestones, leaderboards, and graphical feedback. We compared training effectiveness of the original non-gamified virtual reality simulator versus the new gamified version.
Design, Setting, And Participants:
Prospective, single blinded, randomised controlled trial that recruited sixty novices in ultrasound-guided regional anaesthesia, held in Liverpool, Campbelltown, and Fairfield Hospitals, Sydney, Australia. Time-distributed learning over two sessions with deliberate feedback on ultrasound-guided needling performance. The gamified simulator rewarded achieving learning milestones, provided peer leaderboards, and gave real-time performance feedback. Primary outcome was improvement in subjective, expert assessed Global Rating Scale after training. Secondary outcomes were cumulative error scores (subjective, expert assessed); simulation performance scores and individualised log-log transformed learning curves (objective, computer-assessed); NASA-Task Load Index and participant questionnaire of virtual reality simulator use (subjective, self-reported).
Main Results:
There was no difference in the Global Rating Scale between groups after adjustment for covariates, F(1,47) = 2.3, partial η2 = 0.05, p = 0.14. There was no difference in the gradient of the learning curves, F(1,47) = 2.1, partial η2 = 0.04, p = 0.15; computer-generated performance scores, F(1,47) = 2.2, partial η2 = 0.01, p = 0.51; CES, F(1,58) = 0.02, p = 0.89; or in NASA-Task Load Index weighted scores (gamified -3.5(12.3) versus standard -7.7(11.2), p = 0.17). In the questionnaire, the large majority of participants agreed or strongly agreed (range 72 to 92%, 7 out of 8 questions) that virtual reality simulation was beneficial.
Conclusion:
Gamification of an existing virtual reality simulator did not provide additional benefit compared to the original non-gamified simulator.
