Developing and Integrating Virtual Reality Courses in Medical Education: Tutorial and Implementation Guideline Informed by Best Practices From the National Project "medical tr.AI.ning".

The increasing adoption of virtual reality (VR) in medical education offers substantial opportunities for immersive, practice-oriented training that complements traditional teaching methods. In particular, VR enables repeated, risk-free exposure to complex clinical scenarios and supports the development of clinical reasoning, communication skills, and procedural competence. However, implementing VR-based courses remains challenging due to high development costs, technical complexity, and the need for close interdisciplinary collaboration. This tutorial presents key insights and best practices from the medical tr.AI.ning project, a 3-year interdisciplinary initiative funded by the German Federal Ministry of Education and Research. The project's objective was to develop an artificial intelligence (AI)-supported, VR-based training platform that allows medical students to practice clinical decision-making in immersive, interactive scenarios. The paper is structured as a tutorial and offers recommendations for planning, developing, and integrating VR courses into medical curricula. Each recommendation is illustrated with concrete examples from our project, serving as a practical blueprint to guide educators and developers in applying these guidelines in their own contexts. Successful implementation of a VR project in medical education requires strategic planning and collaboration, starting with a thorough identification of curricular gaps that VR can address and a clear justification of its added educational value. An interdisciplinary consortium that combines expertise from medical didactics experts, computer science, and design is essential to ensure the development of high-quality, pedagogically sound simulations and intuitive user interfaces. Key factors for success include defining specific learning objectives aligned with competency-based frameworks; iterative development with continuous feedback from medical experts, educators, and students; and structured pilot testing with systematic collection of quantitative and qualitative data to assess usability, immersion, and learning outcomes. Early engagement and walkthroughs with end users help identify practical challenges and inform iterative improvements. A dedicated authoring tool within the project allows medical teachers to create and adapt VR scenarios without prior technical experience, supporting the scalability and sustainability of the approach. Effective project management frameworks facilitate collaboration, clear task allocation, and adaptive progress throughout development. Additionally, considerations for hardware selection, technical infrastructure, and sustainable dissemination strategies, including open-access publications, project websites, and professional networking, are crucial to ensure long-term viability and broad adoption across institutions. By combining a tutorial format with practical, step-by-step recommendations, this article provides a comprehensive guide for educators and developers on implementing immersive, AI-supported VR courses to enhance medical education. It highlights key lessons learned in interdisciplinary collaboration, iterative testing, systematic evaluation, and alignment with educational objectives, thereby facilitating the effective, evidence-based, and sustainable integration of VR into medical curricula across diverse institutions.