VR Simulation-Based vs Traditional Apprenticeship Training in Gynecological Laparoscopy: A Comparative Survey of Residents’ Expectations, Skills Acquisition, and Training Structure

Antoni Sierant, Julia Bijok, Michal Pirozynski Center for Endoscopy Simulation, Center of Postgraduate Medical Education, Warsaw, PolandCorrespondence: Antoni Sierant, Center for Endoscopy Simulation, Center of Postgraduate Medical Education, Marymoncka 99/103, Warsaw, 01-813, Poland, Tel +48 609170302, Email [email protected]: Simulation has emerged as a transformative method in surgical education, offering reproducible training in risk-free environments. While widely adopted in Western Europe and North America, traditional apprenticeship remains dominant in Central and Eastern Europe, raising concerns about skill acquisition and standardization.Objective: This study compared obstetrics and gynecology residents’ perceptions of simulation-based versus apprenticeship laparoscopy training in Poland, focusing on expectations, skills acquisition, instructor engagement, and training structure.Methods: A cross-sectional survey was conducted among 59 residents: 29 completed structured VR simulation-based courses and 30 participated in operating room apprenticeship. Data were collected using two course-specific questionnaires, from which nine comparable parameters were extracted. Chi-square tests were applied where distributions allowed; other items were analyzed descriptively.Results: Simulation participants reported significantly greater fulfillment of expectations (96.6% large/very large vs 6.7% apprenticeship; χ2=48.35, p< 0.05) and higher skill acquisition (86.2% high/very high vs 10% apprenticeship; χ2=40.60, p< 0.05). Training duration and repetitions were more often judged optimal in the simulation group (82.8% and 93.1%, respectively) than in the apprenticeship group (33.3% and 10%). Instructor engagement was markedly higher in simulation (96.6% high/very high vs 3.3% apprenticeship; χ2=52.24, p< 0.05). Nearly all simulation residents (96.6%) endorsed making such training mandatory, with most recommending introduction between residency years two and four.Conclusion: VR Simulation-based laparoscopy training was perceived as superior across expectations, skills acquisition, and structural factors. These findings, aligned with international literature, support integrating simulation as a mandatory component of gynecology residency curricula in Poland to improve both resident competence and patient safety.Plain Language Summary: Learning surgical skills is demanding and requires safe, structured training. For many years, young doctors relied on the traditional apprenticeship model—often summarized as “see one, do one, teach one”. Although this approach offers direct experience with real patients, it can be inconsistent and may limit the time residents have to practice essential skills in a controlled, low-risk environment.Simulation-based training has become an increasingly important alternative. Using virtual or physical models, residents can practice laparoscopic procedures repeatedly before performing them on patients. This reduces risk, supports gradual skill development, and ensures standardized feedback from instructors.In our study, we compared opinions from 59 gynecology residents in Poland. Twenty-nine of them completed structured simulation-based laparoscopy training, while 30 learned only through the traditional operating-room apprenticeship model. All residents completed a questionnaire evaluating whether the training met their expectations, what skills they gained, and how engaged their instructors were.Residents who trained with simulation reported significantly higher satisfaction. Most indicated that their expectations were fully met, they gained meaningful laparoscopic skills, and they received strong instructional support. In contrast, many residents trained exclusively by apprenticeship felt their expectations were unmet, reported minimal skill acquisition, and noted low instructor involvement.Overall, the results show that simulation-based training offers a safer, more effective, and more satisfying learning environment. Residents strongly supported introducing mandatory simulation as part of specialist training. Incorporating structured simulation may help ensure that young gynecologists develop core laparoscopic skills before operating on patients.Keywords: simulation training, apprenticeship, gynecology, laparoscopy, residency education, surgical skills