Virtual Reality for Cognitive Mastery in Airway Trauma Management: A Prospective Randomized Controlled Trial (Preprint)

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BACKGROUND Innovation in teaching methods is essential for advancing medical education, particularly for trainees developing crisis management skills. Virtual reality (VR) offers access to immersive, scalable, and accessible learning environments, but its effectiveness compared to traditional mannequin-based simulation remains underexplored. OBJECTIVE This prospective randomized controlled trial evaluates the efficacy of VR-based simulation versus traditional gold-standard mannequin-based training in enhancing medical trainees’ knowledge acquisition and application of decision-making concepts for airway trauma management. METHODS Forty medical students were randomized to either the VR (intervention) group or the Mannequin (control) group. Participants engaged in airway trauma management training using their assigned modality. Both groups completed a pre-and post-intervention test to evaluate knowledge acquisition, and undertook a mannequin-based crisis scenario one week after training to evaluate knowledge application. RESULTS Both groups demonstrated significant knowledge acquisition (VR: mean improvement +2.0/15, P=0.006; Mannequin: mean improvement +3.2/15, P<0.001), though no statistically significant differences were observed between groups (P=0.15). The VR group achieved self-assessed readiness and knowledge saturation faster, on average, than the Mannequin group. Both groups, on average, were successful in the post-training knowledge application test, however, the Mannequin group outperformed the VR group (mean difference: 1.58/15, P=0.021), and recognized a potential airway injury more quickly (P=0.004). Nevertheless, students in the VR group reported greater engagement and satisfaction, expressing a preference for VR as a future learning modality. CONCLUSIONS Overall, VR-based simulation is a promising and engaging method for teaching airway trauma management and demonstrates comparable knowledge acquisition to traditional mannequin-based training. However, mannequin-based simulation still confers advantages for applied performance. Further studies using larger samples, multiple scenarios, and VR-based assessments are needed. CLINICALTRIAL ClinicalTrials.gov NCT04451590; https://clinicaltrials.gov/study/NCT04451590

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