• Alwin Chuan, Anton Bogdanovych, Benjamin Moran, Supriya Chowdhury, Yean Chin Lim, Minh T Tran, Tsz Yui Lee, Jayden Duong, Jennifer Qian, Tung Bui, Alex M H Chua, Bahaven Jeyaratnam, Steven Siu, Clement Tiong, Mel McKendrick, and Graeme A McLeod.
• South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Department of Anaesthesia, Liverpool Hospital, Sydney, Australia. Electronic address: a.chuan@unsw.edu.au.
• J Clin Anesth. 2024 Oct 1; 97: 111535111535.

Study ObjectiveWe previously designed and validated a virtual reality-based simulator to help train novices in ultrasound-guided needling skills necessary for safe and competent ultrasound-guided regional anaesthesia. This study was designed to compare the performance and error rates of novices trained by a human faculty aided with the assistance of this virtual reality simulator (virtual reality-assisted training), versus novices trained wholly by humans (conventional training).Design, Setting, And ParticipantsIn this single centre, randomised controlled study, we used a standardised teaching protocol, rigorous blinding, iterative training of assessors, and validated global rating scale and composite error score checklists to assess skills learning of novice participants.Main ResultsWe recruited 45 novices and scored 270 assessments of performance and error rates. Inter-rater correlation coefficient of reliability of scoring between assessors for the global rating scale was 0.84 (95%CI 0.68-0.92) and for the composite error score checklist was 0.87 (95%CI 0.73-0.93). After adjustment for age, sex, Depression, Anxiety and Stress-21, and baseline score, there was no statistical difference for virtual reality-assisted training compared to conventional training in final global rating score (average treatment effect -3.30 (95%CI-13.07-6.48), p = 0.51) or in the final composite error score (average treatment effect 1.14 (95%CI -0.60-2.88), p = 0.20). Realism in the virtual reality simulator was similar to real-life when measured by the Presence Questionnaire, all components p > 0.79; and task workload assessed by the NASA-Task Load Index was not statistically different between groups, average treatment effect 5.02 (95%CI -3.51-13.54), p = 0.25. Results were achieved in the virtual reality-assisted group with half the human faculty involvement.ConclusionNovices trained using a hybrid, virtual reality-assisted teaching program showed no superiority to novices trained using a conventional teaching program, but with less burden on teaching resources.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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