Application of virtual reality and augmented reality technologies in clinical teaching of cardiac surgery

Abstract

Background: Cardiac surgery training faces challenges due to procedural complexity and limited hands-on opportunities. This study evaluated the effectiveness of a self-developed Virtual Reality/Augmented Reality (VR/AR) training system compared to traditional teaching methods in enhancing the surgical skills and clinical knowledge of cardiac surgery trainees. Methods: A single-center, parallel-group randomized controlled trial was conducted from September 2023 to June 2024. Of 123 eligible fifth-year medical students, 60 were stratified by age, gender, and prior grade point average and randomly assigned equally to an experimental group(VR/AR-based training) or a control group (traditional clinical teaching). The VR/AR system provided immersive simulation of coronary artery bypass grafting, valve replacement/repair, and atrial septal defect repair. Outcome measures included surgical skills, total clinical assessment score, learning interest, self-practice time, teacher evaluations, and system acceptance. Data were analyzed using t-tests, chi-square tests, and Pearson correlation. Results: The experimental group significantly outperformed the control group in surgical operation skills(36.5 ± 2.5 vs. 32.1 ± 3.0, P<0.001) and total clinical assessment score(90.6 ± 5.0 vs. 84.5 ± 5.5, P < 0.001). Subjective evaluations showed significantly higher learning interest(4.73 ± 0.15 vs. 3.11 ± 0.66, P<0.001), immersion and engagement(4.72 ± 0.29 vs. 2.90 ± 0.82, P<0.001), and weekly self-practice time(66.8 ± 2.1 vs. 58.3 ± 4.5 minutes, P<0.001) in the VR/AR group. Teacher ratings of clinical thinking, self-directed learning, teamwork, and interest stimulation were also significantly higher for the experimental group(all P<0.05) and correlated positively with assessment scores(r = 0.72–0.84, P<0.001). Discussion: In this single-center randomized trial, a self-designed VR/AR cardiac surgery training system was proven to significantly improve trainees' operative skills, clinical knowledge, and learning engagement compared to traditional methods. These findings support the use of VR/AR system as an effective and innovative pedagogical tool for enhancing the training of cardiac surgeons.