Evidence map›Paper›PMID 31172325›Full record

Trial reportSurgical endoscopy2020

Cognitive load and performance in immersive virtual reality versus conventional virtual reality simulation training of laparoscopic surgery: a randomized trial.

Joakim Grant Frederiksen, Stine Maya Dreier Sørensen, Lars Konge, Morten Bo Søndergaard Svendsen, Morten Nobel-Jørgensen, Flemming Bjerrum, Steven Arild Wuyts Andersen

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  6. Ultra-high-fidelity virtual reality mastoidectomy simulation training: a randomized, controlled trial.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020
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  17. A scoping review of cognitive load assessment tools suitable for clinicians performing REBOA.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joakim Grant FrederiksenCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Joakim.grant.f@gmail.com.ORCID 0000-0001-8254-843X
Stine Maya Dreier SørensenCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Lars KongeCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Morten Bo Søndergaard SvendsenCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Morten Nobel-JørgensenCenter for Computer Games Research, IT University of Copenhagen, Copenhagen, Denmark.
Flemming BjerrumCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Steven Arild Wuyts AndersenCopenhagen Academy for Medical Education and Simulation (CAMES), the Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual reality simulators combined with head-mounted displays enable highly immersive virtual reality (VR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room conditions. However, the increased complexity of the learning situation in immersive VR could potentially induce high cognitive load thereby inhibiting performance and learning. This study aims to compare cognitive load and performance in immersive VR and conventional VR simulation training.

methodsA randomized controlled trial of residents (n = 31) performing laparoscopic salpingectomies with an ectopic pregnancy in either immersive VR or conventional VR simulation. Cognitive load was estimated by secondary-task reaction time at baseline, and during nonstressor and stressor phases of the procedure. Simulator metrics were used to evaluate performance.

resultsCognitive load was increased by 66% and 58% during immersive VR and conventional VR simulation, respectively (p < 0.001), compared to baseline. A light stressor induced a further increase in cognitive load by 15.2% and a severe stressor by 43.1% in the immersive VR group compared to 23% (severe stressor) in the conventional VR group. Immersive VR also caused a significantly worse performance on most simulator metrics.

conclusionImmersive VR simulation training induces a higher cognitive load and results in a poorer performance than conventional VR simulation training in laparoscopy. High extraneous load and element interactivity in the immersive VR are suggested as mechanisms explaining this finding. However, immersive VR offers some potential advantages over conventional VR such as more real-life conditions but we only recommend introducing immersive VR in surgical skills training after initial training in conventional VR.

Indexed as

Virtual RealityAdultClinical CompetenceCognitionFemaleHumansInternship and ResidencyLaparoscopyMalePregnancyPregnancy, EctopicSalpingectomySimulation TrainingCognitive loadHead-mounted deviceImmersive virtual realityLaparoscopic surgical skills trainingSimulation

Identifiers

PMID31172325

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.