Effectiveness of fully immersive virtual reality-based simulation training on objective knowledge acquisition in acute coronary syndrome/ST-elevation myocardial infarction emergency management: a pre-post-intervention study
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Oxford University Press
Abstract
Effective management of emergencies, particularly acute coronary syndrome (ACS), demands rapid, guideline-based interventions
to optimize outcomes. However, many medical students and young professionals report feeling unprepared due to
limited hands-on experience. Virtual reality (VR) presents a promising training tool, though its efficacy remains unproven.
In this single-center study, 247 medical students were assigned to three different guidance modes to manage a virtual STelevation
myocardial infarction patient using the Simulation-based Training of Emergencies for Physicians using Virtual
Reality (STEP-VR) application. A pre-post-test design, based on European Society of Cardiology (ESC) guidelines, was
used to evaluate learning outcomes. Our results showed a significant increase in knowledge after the training. Students
in the tutor-moderated ‘human guidance’ group demonstrated the greatest knowledge improvement
(M = +24%, SD = 13%), being significantly better than the ‘no guidance’ group (M = 14%, SD = 9%). However, there
was no significant difference between the ‘human guidance’ group and the ‘integrated guidance’ group
(M = +19%, SD = 14%), which used an embedded learning mode within STEP-VR. To evaluate the potential impact on
clinical performance, we calculated composite quality indicators based on ESC-defined metrics. Consistently, we found a
significant improvement in these indicators [clinical quality indicators (CQI) 0.47 (pre) vs. 0.76 (post) and 0.8 (post), respectively],
with no significant difference between the ‘human guidance’ and ‘integrated guidance’ groups.
In conclusion, our findings demonstrate that VR-based acute coronary syndrome/ST-elevation myocardial infarction training
is both operationally feasible and educationally effective. Notably, integrated guidance yielded outcomes comparable to tutor-
led instruction, underscoring the potential of this approach as a platform for independent, extracurricular learning.
While our data suggest VR training may support clinical performance, future studies with objective assessments are needed
to confirm its real-world value.
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Except where otherwise noted, this item's license is described as Attribution 4.0 International