Virtual Reality (VR) Training for Anesthesiologist in Invasive Procedures (VR TAIP) - a Single Center Randomized Controlled Trial

Objective: To evaluate whether a blended virtual reality (VR)-manikin curriculum enhances anesthesiology residents’ performance in internal jugular central venous catheter (IJ-CVC) placement compared with manikin training alone. Design: A single-center, randomized trial involving 26 first-year anesthesiology residents, assigned to either manikin training (n = 14) or VR plus manikin training (n = 12), was conducted. Both groups received two sessions before the elective cardiac rotation. Clinical performance during the first IJ-CVC placement in the cardiac rotation was video-recorded and assessed by blinded experts. Setting: This study was conducted from July 2023 to July 2025 at a single university hospital. Participants: This single-center study included first-year anesthesia residents (PGY-2) enrolled in the anesthesia residency program. Interventions: Introduction of VR-based training using the Vantari system to train junior anesthesia residents in the placement of a central venous line. Measurements and Main Results: The primary outcome was the total performance score; the secondary outcomes included post-training satisfaction, self-efficacy, and cost-effectiveness. Data were analyzed using generalized linear models for continuous outcomes and Mann-Whitney U or Fisher's exact tests for categorical variables. Significance was set at p < 0.05. Overall clinical performance was comparable between groups (manikin: 86.49 ± 10.34% v VR: 83.88 ± 8.07%, p = 0.486), as were hands-on interventions by supervising physicians (p = 0.900). Self-efficacy and training satisfaction did not differ significantly. VR trainees more often felt they “knew the procedural steps without guidance” (p = 0.037), whereas manikin training rated higher for “needle tracking” (p = 0.00023) and “motor skills” (p = 0.0036). No differences were observed for realism (p = 0.541), comfort with performing a CVC on a patient (p = 0.460), or overall satisfaction (p = 0.678). Additionally, VR training was more cost-efficient ($131/session v $291.30/session), with scalability advantages due to lower recurring equipment and personnel costs. Conclusion: VR plus manikin training yielded comparable overall clinical performance, procedural confidence, and satisfaction to manikin training alone for IJ-CVC placement. Step-specific differences suggest that VR emphasizes structured procedural flow, while manikin training better supports tactile and postprocedural tasks. These findings support VR as a viable adjunct in a blended CVC training curriculum, complementing traditional manikin-based methods. Future work should evaluate long-term retention, multimodal integration, and improvements in VR motor realism. Additionally, VR may serve as an effective refresher tool for clinicians with prior procedural experience, given lower satisfaction with fine motor skill development among novice users.