A Scoping Review on the Evidence for Virtual Reality Simulation in Surgical Training

Simulation has become a mainstay in surgical education as it is proven to improve trainees' surgical skills. Virtual reality is a relatively new technology that allows for high-fidelity surgical simulation for many surgical procedures across many specialties. However, there is currently a lack of evidence regarding the effectiveness and value of virtual reality simulation across all surgical specialties. Therefore, we performed a systematic review on the impact of virtual reality surgical simulation on the acquisition of surgical skills.

The review was performed across MEDLINE, Embase, and Web of Science from date inception until April 28, 2025. Articles were included if they explore virtual reality simulation for surgical skills in medical students, surgical residents/interns/fellows, or surgical staff. Outcomes of interest were performance, time, errors, and confidence.

The review yielded a total of 22,198 studies, of which 7282 were duplicates. After abstract and full text review, 235 studies were included in the systematic review. The studies came from over 30 countries, and about half studies were randomized controlled trials (51.49%). Residents were the most studied population, and most of the studies were either in general or orthopedic surgery. Most studies reported improvements in performance (75.8%), time (69.9%), errors (66.2%), and confidence (76.2%). Over 60% of studies demonstrated consistent efficacy for all but one outcome subcategory. Ultimately, this review demonstrates that virtual reality surgical simulation has clear benefits for surgical trainee skills.