Next-generation birth assistance: a virtual reality operating system for real-time guidance in normal vaginal deliveries

Proficiency in normal vaginal delivery is essential for midwifery safety but remains difficult to attain due to scarce clinical training opportunities. Although virtual reality (VR) offers a promising alternative, its application in midwifery education is still nascent. This study aimed to develop and evaluate an immersive VR system that provides evidence-based, real-time guidance to support procedural familiarization and user acceptance among clinical midwives. This was a usability and immersion evaluation study, not an effectiveness trial. We developed the Virtual Reality Guided Delivery System (ViRGiD system) featuring a high-fidelity delivery environment with a structured, protocol-driven guidance module to mirror clinical standards. For evaluation, 20 senior midwives (clinical experience ≥ 10 years) completed the assessment within a two-week period. System usability and immersion were evaluated with the Post-Study System Usability Questionnaire (PSSUQ) and Learning Immersion Scale in Clinical Simulation (LISCS). The ViRGiD system delivered an interactive training platform. The PSSUQ overall score was favourable (2.08 on a 7-point scale, where lower is better), which was lower than the published benchmark of 2.82, with subscale scores for system usefulness, information quality, and interface quality also comparing favorably to published benchmarks. LISCS scores indicated high perceived immersion across all four dimensions (on a 5-point scale), with mean scores corresponding to 81.3%-95.7% of their respective maximum possible scores. Participants reported rapid familiarization with the system and endorsed it as a potentially valuable preparatory tool. The ViRGiD system may help address the theory-practice gap in midwifery education by providing an immersive, repeatable, and standardized VR training environment. These findings support real-time VR simulation as a viable and acceptable strategy for obstetric training support, though effectiveness remains to be demonstrated in future studies.