Virtual reality, real-world rhythm: evaluating gamified training for medical students

Virtual reality (VR) and gamification are increasingly recommended as adjuncts in resuscitation education, but their integration into undergraduate medical curricula and data on usability and learner acceptance remain limited. We evaluated a newly developed, gamified VR training application for medical students during their preparation for an Objective Structured Clinical Examination (OSCE).

In this single-centre observational questionnaire study, fourth-year medical students completed VR-based advanced life support (ALS) training with randomized electrocardiogram (ECG) rhythms and gamified decision tasks. The primary outcome was usability measured with the Virtual Reality System Usability Questionnaire (VRSUQ; 0-100 points). Secondary outcomes included VR-induced symptoms (VRSQ; 0-100 points), self-rated rhythm-analysis competence before and after training (1-10), self-rated in-app performance (0-10), and trainer-reported feasibility. Continuous variables are presented as median (interquartile range [IQR]). Associations between outcomes were assessed using Spearman rank correlation coefficients.

Of 660 eligible students, 294 (44.5%) participated in the VR-study and completed the questionnaires. Usability was high (VRSUQ 83.3 [IQR 72.2-91.7]). VR-induced symptoms were low (VRSQ 8.3 [IQR 0.0-16.7]). Self-rated competence increased from 5.0 (IQR 4.0-7.0) before training to 8.0 (IQR 7.0-8.0) after training (p < 0.001), corresponding to a competence gain of 2.0 points (IQR 1.0-3.0). Self-rated performance was 7.0 (IQR 5.0-8.0) and correlated with usability (ρ = 0.44, p < 0.001). Overall training quality was rated 9.0 (IQR 8.0-10.0), and 91.9% would participate again. Usability did not differ between genders but was higher among students with prior VR experience. Trainers reported short setup times, manageable supervision ratios, and occasional technical support needs.

Gamified VR-based ALS training for medical students is feasible, demonstrates high usability and low symptom burden, and improves self-assessed competence. VR appears to be a well-accepted adjunct to undergraduate resuscitation education.