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Published on: August 29, 2018

Stress During Virtual Reality and High-Fidelity Simulation in Anesthesia Trainees: A Randomized Controlled Trial.

Gianluca Bertolizio, Catherine Paquet, Natalie Buu

    Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
    |June 4, 2026
    PubMed
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    This summary is machine-generated.

    Anesthesia trainees experience similar perceived stress in virtual reality (VR) and high-fidelity simulation (HFS). VR showed lower heart rate variability, suggesting potentially greater physiological stress during simulation-based training.

    Area of Science:

    • Medical Simulation
    • Anesthesiology Education
    • Human Factors Engineering

    Background:

    • High-fidelity simulation (HFS) is crucial for anesthesia training but can cause significant stress, potentially hindering learning.
    • Virtual reality (VR) offers a promising alternative to HFS, yet its impact on trainee stress is not well understood.
    • This study investigates stress levels in anesthesia trainees undergoing VR versus HFS.

    Purpose of the Study:

    • To compare perceived and physiological stress in anesthesia trainees during VR and HFS.
    • To analyze stress differences between high- and low-performing trainees post-HFS.

    Main Methods:

    • Secondary analysis of a randomized controlled trial involving anesthesia trainees undergoing VR or HFS.
    • Perceived stress assessed using State-Trait Anxiety Inventory (STAI), Medical Emotion Scale (MES), and NASA Task Load Index (NASA-TLX).
    Keywords:
    NASA-TLXSTAIanesthesia trainingheart rate variabilityhigh-fidelity simulationmanikin-based simulationstressvirtual reality

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  • Physiological stress measured by heart rate variability (SDNN and LF/HF ratio).

    • Main Results:

    • Both VR and HFS groups reported similar perceived stress levels (STAI, MES, NASA-TLX).
    • VR scenarios resulted in lower SDNN values, indicating potentially higher physiological stress (P=0.034).
    • No significant differences in stress indicators were found between high- and low-performing trainees.

    Conclusions:

    • Anesthesia trainees report comparable perceived stress in VR and HFS environments.
    • Lower heart rate variability in VR suggests potentially greater physiological stress, warranting further investigation.
    • The implications of these stress findings for simulation-based anesthesia training require additional research.