Teaching Neuraxial Ultrasonography with a Virtual Reality Simulator of Spine: A Randomized Controlled Study

To evaluate whether adjunctive virtual reality (VR) spine simulation in neuraxial ultrasound training improves performance competency among anesthesia residents compared with traditional didactic teaching alone.

In this single-center, randomized controlled trial, anesthesia residents from the Department of Anesthesiology, Peking Union Medical College Hospital were recruited and randomized (1:1, computer-generated) to receive either a traditional 30-minute didactic lecture of spine ultrasonography (control group) or an identical teaching session followed by 30-minute VR spine simulation (VR group). After the training, participants were required to perform a preprocedural spine ultrasound scan. The primary outcome was a composite learning score evaluating the theoretical knowledge, practical skills, self-assessed satisfaction, and willingness to apply the technique in future practice. The secondary outcomes included scanning time, score of anatomic structure recognition, and accuracy of depth measurement to the posterior complex.

A total of 46 participants (23 per group) were enrolled. Compared to the control group, the VR group achieved significantly higher composite learning scores (0.80±0.05 vs 0.74±0.09, P = 0.01). The score of anatomic structure recognition (0.85±0.15 vs 0.72±0.20, P = 0.01) and the accuracy of depth measurement to the posterior complex (73.9% vs 43.5%, P = 0.03) were also significantly superior in the VR group.

Among anesthesia residents, adjunctive VR simulator training improves the technical and cognitive performance in neuraxial ultrasound compared with traditional didactic teaching alone.