Immersive Virtual Reality Simulation for Medical Student Procedural Training: Assessment of Cognitive Load and Usability

ObjectiveIn a previous randomized controlled trial, we found immersive virtual reality (VR) simulation to be effective for teaching procedural skills to medical students. We further investigated this interface's usability and cognitive load.MethodsThis was a secondary analysis of data from a previous randomized controlled trial. Twenty-two medical students with no or limited experience with VR and chest tube insertion received training for chest tube insertion using a commercially available immersive VR simulation. Participants completed post-training surveys on usability (System Usability Scale, SUS, from 0-100) and cognitive load (Leppink's scale, 11-point, 10 items). Three types of cognitive loads (intrinsic, extraneous, and germane) were evaluated. Modified Objective Structured Assessment of Technical Skills (OSATS, 5-point, 11 items) for technical skills in a mannequin simulation were assessed after VR training, and in knowledge scores before and after training were extracted to analyze their relationships with usability and cognitive load. Data are presented as median (interquartile range).ResultsMedian scores (%) for the knowledge test were 46.7 (40.0-53.3) at baseline and 86.7 (80.0-90.3) after training. The OSATS score was 40.5 (35.5-49.3), and SUS was 82.5 (73.8-88.8, with significant correlation between these variables (r = 0.51, <i>P</i> = 0.04). The intrinsic, extrinsic, and germane cognitive loads were 3.7 (1.8-6.1), 0.15 (0-1.4), and 9.2 (6.0-10), respectively.ConclusionCognitive load and usability of immersive VR simulation were reported to be excellent. Along with its effectiveness shown previously, VR simulation is a highly acceptable approach for teaching technical skills to medical students.