Immersive 3D vs Physical Simulation in Training Novices for Laser-Based Endourological Procedures: Protocol for a...

Simulation-based learning constitutes a valuable component of medical training, with immersive 3D simulations and physical simulations being commonly used. Immersive 3D simulation training has been proven to enhance procedural skills and their transfer, whereas physical simulators allow for haptic feedback. However, direct comparative evidence between these 2 simulation modalities is scarce and often does not address cognitive, motivational, and perceived learning outcomes, which also have an effect on actual learning outcomes.

The objective of this study is to evaluate whether immersive 3D simulation (a primarily screen-based, PC- or tablet-delivered simulator with optional virtual reality elements) can serve as a complementary or preparatory modality to physical simulator training when teaching novice trainees endourological laser-based procedures. Specifically, we investigate whether pretraining on an immersive 3D simulator facilitates the transfer of procedural knowledge and technical skills to the physical simulator, alongside its effects on cognitive load, motivation, and perceived learning.

We will conduct a single-center, 2-group randomized controlled trial with 70 medical students who are currently in the clinical phase of their undergraduate medical studies. Each participant will complete one training session on either the immersive 3D simulation or the physical simulator, followed by one posttraining test on the physical simulator. Technical performance will be assessed by 2 experts using an objective structured assessment of technical skills-based composites, a critical error checklist as an indicator of safety, and time to task completion as an indicator of efficiency. Furthermore, we will measure motivation, cognitive load, and perceived learning. To analyze group differences in the primary and secondary outcomes, we will use independent-sample t tests (1-tailed), with nonparametric or Welch-corrected alternatives in cases in which assumptions are violated, and regression analyses to examine associations between the secondary outcomes and technical performance.

Recruitment will start in September 2026. We will begin with the training sessions and posttraining tests in November 2026. We expect to complete data collection by December 2026 and finish analyzing by February 2027. Consequently, we expect to publish the results in April 2027.

By integrating technical performance with cognitive, motivational, and perceived learning outcomes, this study will clarify not only whether but also how immersive 3D simulation can support and prepare novice trainees for physical simulator training in endourological laser-based procedures. Furthermore, it aims to inform the evidence-based development of hybrid, simulation-based curricula in medical education.