J Surg Educ. 2025 Nov 23;83(1):103794. doi: 10.1016/j.jsurg.2025.103794. Online ahead of print.
ABSTRACT
OBJECTIVE: Virtual reality (VR) simulation is increasingly used in trauma training as it offers an immersive, cost-effective alternative to traditional simulation; however, its impact may differ between low- and high-resource settings due to resource and training disparities. This study aims to assess the technology acceptance, effectiveness, usability, acceptability and confidence gains of a VR-based pediatric trauma training module in India and Canada, correlating demographics and prior experience to learning outcomes and cybersickness.
DESIGN: A prospective quasi-experimental study was done. Participants completed assessments using the Technology Acceptance Model (assessing perceived usefulness, ease of use, and intention to adopt VR), System Usability Scale, VR Sickness Questionnaire, and a confidence survey.
SETTING: Participants attended a virtual reality trauma training course. These courses were held at McGill University’s Steinberg Center for Simulation and Interactive Learning, Canada in May and August 2024 and at the Christian Medical College Ludhiana, India in December 2024.
PARTICIPANTS: Sixty participants aged 25-35 years old (paramedics, medical officers, nurses, emergency technicians, and medical students) participated in a VR-based pediatric trauma training simulation module in India (n = 27) and Canada (n = 33).
RESULTS: 67% of participants had no VR experience and 48% had no previous trauma training. No significant interactions were seen by gender, age, or prior VR use. Novices without trauma training reported higher TAM scores in all categories. The SUS and VRSQ scores did not differ by prior trauma training. Confidence gains before and after simulation were significantly lower in the group with prior trauma training (p < 0.001). While previous VR experience was similar in both Canada and India (33%), formal simulation training was reported by 85% of Canadians, but only by 11.1% of Indians (p ≤ 0.0001). The mean perceived usefulness of the module was also much higher for Indians than for Canadians (82% vs. 65.6%, respectively; p ≤ 0.0011), while the mean ease of use scores were 57.8% and 70.4% (p ≤ 0.0201), respectively. Confidence in trauma management increased by 14.4% in Canada and by 30.6% in India (p ≤ 0.0001). The higher rate of usefulness, ease-of-use, and confidence increase in India suggest VR had a greater impact in that setting.
CONCLUSION: VR is a feasible and accepted tool for pediatric trauma training, with the greatest benefit seen in resource-limited settings and among novices. Minimal cybersickness supports its use as an adjunct to standard methods. VR may help address gaps in trauma education, especially where prior simulation experience is limited.
PMID:41285058 | DOI:10.1016/j.jsurg.2025.103794
