Virtual Reality in Surgical Education: Evidence, Applications, Implementation Challenges, and Future Directions

This narrative review examines the role of virtual reality (VR) in surgical education, including practice, assessment, rehearsal, and collaboration. It considers applications across neurosurgery, ophthalmology, orthopedics, spine surgery, laparoscopy, robotic surgery, and oral and maxillofacial surgery. Targeted searches of PubMed and Crossref covered January 1990 through July 20, 2026. Titles and abstracts were screened for relevance, and study selection was cross-checked by two authors; systematic reviews, meta-analyses, randomized trials, multicenter studies, and specialty-specific validation studies were prioritized. No independent formal assessment of evidence quality was performed. Evidence most consistently supports short-term knowledge and technical-skill acquisition, particularly in laparoscopy, ophthalmology, and selected orthopedic procedures. Transfer to supervised operative performance is supported for specific tasks, but patient-level evidence remains limited and should not be generalized across platforms or specialties. Effective use depends on curricular design, deliberate practice, feedback, proficiency standards, and validity evidence appropriate to the intended educational use. Persistent barriers include incomplete haptic fidelity, cybersickness, unequal access, total cost of ownership, faculty readiness, heterogeneous outcome measures, and limited external validation. Artificial intelligence may support automated assessment and adaptive instruction, while hybrid simulation, patient-specific modeling, remote learning, and multiplayer environments may broaden educational reach. These innovations require transparent validation, human oversight, and equity-focused implementation. VR should be adopted as a targeted component of blended surgical education rather than as a replacement for other simulation methods or supervised clinical experience.