Virtual reality training on lumbar puncture quality (VIRTUAL): a randomized controlled trial

Considering the limited data on the feasibility of virtual reality (VR) in lumbar puncture (LP) training, we aimed to evaluate the effectiveness of VR combined with conventional training (instructional videos and high-fidelity LP simulation) on LP proficiency. In this single-blind randomized controlled trial, 88 medical students were randomly assigned to the purely conventional training (CT) group (undergoing 30 min of conventional training) and the virtual reality training (VRT) group (undergoing 20 min of conventional training and 10 min of VR training). After the 30-min intervention, all participants were asked to perform the entire LP procedure independently to check for their proficiency level. After 3 months, they will be reconvened for a follow-up to check their retention of LP skills. The 12 key points of lumbar puncture (maximum total score: 12) were used as the primary assessment parameters. The proficiency in LP performance was not different between the CT and VRT groups (8.29 vs. 7.79, respectively, P > 0.05). Each training modality demonstrated specific strengths at the procedural step level. The participants in CT group displayed higher success rates in preparation, administration of anesthesia, and completion of the procedure, whereas those in the VRT group performed better in measuring cerebrospinal fluid pressure. Meanwhile, the performance of LP in the two groups exhibited no significant differences in the follow-up after 3 months (CT group vs VRT group: 5.04 vs 4.74, P > 0.05). Furthermore, the participants who introduced VR into their training demonstrated a higher level of interest in clinical skills (CT group vs. VRT group: 60.5% vs 75.6%) and satisfaction with their training (CT group vs VRT group: 41.9% vs 51.2%). Training mode combined with VR and conventional training was comparable with CT training in terms of overall proficiency of LP performance. Nonetheless, it was associated with higher self-reported interest and satisfaction among medical students and could be used as a supplement to CT. The efficacy of VR training can be enhanced by further optimizing its programming settings. The study was approved by the China Clinical Trial Registry (ChiCTR2200057109) on 28 February 2022 before initiation.