Emergency Medicine · Medical Literature
Effectiveness of VR and traditional training in medical education for mass casualty management: an OSCE-based randomized controlled trial.
Abstract
OBJECTIVE: This study aimed to evaluate the effectiveness of VR-based training compared to traditional lecture-based training for medical trainees in managing MCIs, specifically focusing on road traffic accidents. The primary assessment was performed using an Objective Structured Clinical Examination (OSCE) and a theoretical knowledge test. METHODS: A randomized controlled trial was conducted with 46 medical trainees receiving emergency medicine training. Participants were randomly assigned to either a VR-based Training Group or a Lecture-based Training Group, with each group receiving a 2-hour training session on mass casualty management. The training effectiveness was evaluated through pre- and post-training knowledge tests, OSCE performance, and post-training feedback questionnaires. Statistical analyses were performed to compare the two groups. RESULTS: Baseline characteristics were well-matched between groups. The VR-based Training Group demonstrated significantly higher post-test scores (83.96 ± 13.11) compared to the Lecture-based Training Group (72.17 ± 20.89, p = 0.03). The learning gain was also significantly greater in the VR-based Training Group (40.26 ± 15.61) compared to the Lecture-based Training Group (28.26 ± 17.04, p = 0.02). OSCE results showed that the VR-based Training Group demonstrated better performance than the Lecture-based Training Group across all stations, with significant improvements in triage, injury assessment, and overall scene management. Additionally, feedback from the post-training questionnaire revealed that the VR-based Training Group reported greater confidence in performing critical tasks. CONCLUSION: VR-based training may represent a more effective and engaging approach for teaching mass casualty management relative to traditional lecture-based methods. It may enhance both theoretical knowledge and practical skills, which could help better prepare medical trainees for high-pressure scenarios such as MCIs. As VR technology continues to evolve, its integration into medical education holds considerable potential for improving preparedness and clinical performance in emergency settings.
Clinical relevance
Among medical trainees receiving emergency medicine training, does a single 2-hour fully immersive VR-based training session improve theoretical knowledge, OSCE performance, and learning gain in mass casualty incident management compared to a single 2-hour traditional lecture-based session? __SNAPSHOT__ {"studyDesign":"Randomized controlled trial (RCT) with pre/post assessment design","setting":"Guangxi Zhuang Autonomous Region People's Hospital, Nanning, China; conducted January–October 2024; single-center","sampleSize":"n=46 total; group sizes not explicitly reported in accessible abstract (likely n≈23 per arm based on equal randomization described)","population":"Medical trainees actively receiving emergency medicine training at a regional tertiary hospital in China; baseline characteristics reported as well-matched between groups","intervention":"Single 2-hour fully immersive VR-based training session on mass casualty incident (MCI) management, specifically road traffic accident scenarios","comparator":"Single 2-hour traditional lecture-based training session on the same MCI content","primaryOutcome":"OSCE performance across simulated mass casualty stations (scene assessment, triage decision-making, injury evaluation) and theoretical knowledge post-test score","followUp":"Immediate post-training only; no longer-term follow-up reported","fundingSource":"Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (grant S2023013) and Guangxi Natural Science Foundation (grant 2024GXNSFA-series); government-funded, no declared industry sponsorship"}
Key findings
Both groups demonstrated pre-to-post improvement in theoretical knowledge. The VR-based Training Group achieved a significantly higher post-test knowledge score (83.96 ± 13.11) compared to the Lecture-based Training Group (72.17 ± 20.89; p=0.03). The absolute mean difference in post-test scores was 11.79 points (calculated), favoring VR. Learning gain (post-test minus pre-test score) was also significantly greater in the VR group (40.26 ± 15.61 vs. 28.26 ± 17.04; p=0.02), with an absolute difference of 12.0 points (calculated). On OSCE performance, the VR group demonstrated statistically superior results across all stations, with specific significant improvements in triage and injury assessment domains (all p-values reported as <0.05 or <0.01 per station; exact station-level scores not fully reported in available abstract). The minimum clinically important difference for these OSCE scoring instruments is not established in the literature, so the clinical significance of the observed score differences cannot be independently verified. Effect sizes (Cohen's d, confidence intervals) were not reported. NNT is not calculable from the data provided. No adverse events or VR-related side effects (e.g., motion sickness, cybersickness) were formally reported in the accessible abstract; adverse event data from the full article were not retrievable.
Practice implications
This RCT establishes that a single 2-hour VR-based training session produced statistically significantly greater immediate post-training knowledge scores and learning gain compared to a single lecture-based session among medical trainees in China, with superior OSCE performance across simulated MCI stations. The study does NOT establish: (1) durability of learning advantage beyond the immediate post-training period, as no follow-up assessment was performed; (2) transfer of these skills to real-world MCI performance, as all outcomes are educational surrogates assessed in simulated settings; (3) generalizability to practicing physicians, nurses, paramedics, or trainees in resource-limited or non-Chinese settings; (4) cost-effectiveness or scalability of VR infrastructure in diverse institutional contexts. The population studied was exclusively medical trainees at a single Chinese regional hospital, limiting external validity. The effect sizes were not reported, precluding formal judgment of clinical importance versus statistical significance. This summary is based on the published abstract and limited full-text accessible via open sources; full peer-reviewed article data (including detailed OSCE subscores, randomization methodology, blinding procedures, and adverse event reporting) were not fully retrievable, which is an additional interpretive limitation. __LIMITATIONS__ Very small sample size (n=46), yielding low statistical power and wide uncertainty around effect estimates; per-arm sample size likely approximately 23, substantially underpowered for detecting small-to-moderate effects reliably,No intermediate or long-term follow-up: skill retention, decay, or durability of VR advantage beyond immediate post-training was not assessed,Single-center, single-country study (China) limits generalizability to other healthcare systems, resource settings, or trainee populations,Blinding: inherent impossibility of blinding participants or trainers to intervention type; assessor blinding of OSCE evaluators was not described in available abstract,All outcomes are educational surrogates (knowledge test scores, OSCE performance); no real-world patient outcomes or actual MCI performance data were captured,Effect sizes and confidence intervals were not reported, preventing assessment of clinical magnitude of observed differences,The minimum clinically important difference for these specific OSCE instruments in MCI training is not established,Significant heterogeneity of variance in the lecture group (SD 20.89) versus the VR group (SD 13.11) raises questions about distributional assumptions for the statistical tests used,Trainee-level satisfaction and qualitative feedback described but not fully reportable from abstract alone,No reporting of adverse effects or VR-related side effects (cybersickness, motion sickness) in accessible abstract,Government-funded study with no declared industry conflict; however, confirmatory independent replication is still required __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ In this small single-center RCT of 46 emergency medicine trainees, a 2-hour VR-based training session produced statistically significant improvements in immediate post-training knowledge scores and OSCE performance compared to a traditional lecture-based session. Findings are limited by very small sample size, single-center design, absence of follow-up beyond the immediate post-training period, and reliance on surrogate educational outcomes without real-world MCI performance data. VR-based MCI training is a promising educational modality warranting confirmation in larger, multi-center trials with longer follow-up before it can be considered a preferred standard over lecture-based instruction.