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Updated: Jun 29, 2026
Pioneering Patient-Specific Approaches for Precision Surgery Using Imaging and Virtual Reality
Published on: April 5, 2024
360° Virtual Reality Observation in Neurosurgical Clerkship: A Comparative Study With Surgical Assistant
Tatsuya Tanaka1, Eiichi Suehiro1, Anh Tran Hue1
1Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
Background:
Opportunities for medical students to directly participate in surgical procedures during clinical clerkships are often limited because of patient safety considerations and operating room constraints. As a result, many students observe surgeries through conventional two-dimensional (2D) monitors, which may provide limited educational engagement. Immersive technologies such as real-time 360° virtual reality (VR) may enhance the quality of surgical observation by providing a more realistic perspective of the operative environment. This study compared 3 surgical observation modalities during neurosurgical clerkship-direct participation as a surgical assistant, real-time 360° VR observation, and conventional 2D monitor viewing-to evaluate the educational impact of VR-based observation.
Methods:
This single-center observational study compared 3 surgical observation modalities during neurosurgical clerkship: direct participation as a surgical assistant, real-time 360° VR observation, and conventional 2D monitor observation. Fifth-year medical students completed a Likert-scale questionnaire evaluating immersion, willingness to repeat the experience, physical discomfort, and changes in interest in neurosurgery. Responses were analyzed using the Kruskal-Wallis test followed by Mann-Whitney U tests with Holm correction.
Results:
A total of 92 medical students participated (assistant: n = 26; VR: n = 28; 2D: n = 38). Immersion differed significantly among groups (p < 0.001), with both the assistant group (median 4.5 [IQR 4-5]) and the VR group (5.0 [4-5]) demonstrating significantly higher immersion than the 2D group (3.0 [2-4]). No significant difference in immersion was observed between the assistant and VR groups after Holm correction. Willingness to repeat the observation method and interest in neurosurgery were highest in the assistant group, whereas the VR group reported slightly higher physical discomfort, although overall levels remained low.
Conclusions:
Real-time 360° VR observation significantly improved immersion compared with conventional 2D observation and achieved immersion levels comparable to direct surgical participation. Although direct participation as a surgical assistant had the greatest influence on students' interest in neurosurgery, VR observation provided a highly immersive learning experience and may serve as an effective educational bridge when hands-on participation is limited.
