{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:53:40Z","timestamp":1791323620621,"version":"4.3.1"},"reference-count":25,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Simulation-based learning constitutes a valuable component of medical training, with immersive 3D simulations and physical simulations being commonly used. Immersive 3D simulation training has been proven to enhance procedural skills and their transfer, whereas physical simulators allow for haptic feedback. However, direct comparative evidence between these 2 simulation modalities is scarce and often does not address cognitive, motivational, and perceived learning outcomes, which also have an effect on actual learning outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to evaluate whether immersive 3D simulation (a primarily screen-based, PC- or tablet-delivered simulator with optional virtual reality elements) can serve as a complementary or preparatory modality to physical simulator training when teaching novice trainees endourological laser-based procedures. Specifically, we investigate whether pretraining on an immersive 3D simulator facilitates the transfer of procedural knowledge and technical skills to the physical simulator, alongside its effects on cognitive load, motivation, and perceived learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We will conduct a single-center, 2-group randomized controlled trial with 70 medical students who are currently in the clinical phase of their undergraduate medical studies. Each participant will complete one training session on either the immersive 3D simulation or the physical simulator, followed by one posttraining test on the physical simulator. Technical performance will be assessed by 2 experts using an objective structured assessment of technical skills\u2013based composites, a critical error checklist as an indicator of safety, and time to task completion as an indicator of efficiency. Furthermore, we will measure motivation, cognitive load, and perceived learning. To analyze group differences in the primary and secondary outcomes, we will use independent-sample\n                      <jats:italic>t<\/jats:italic>\n                      tests (1-tailed), with nonparametric or Welch-corrected alternatives in cases in which assumptions are violated, and regression analyses to examine associations between the secondary outcomes and technical performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recruitment will start in September 2026. We will begin with the training sessions and posttraining tests in November 2026. We expect to complete data collection by December 2026 and finish analyzing by February 2027. Consequently, we expect to publish the results in April 2027.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By integrating technical performance with cognitive, motivational, and perceived learning outcomes, this study will clarify not only whether but also how immersive 3D simulation can support and prepare novice trainees for physical simulator training in endourological laser-based procedures. Furthermore, it aims to inform the evidence-based development of hybrid, simulation-based curricula in medical education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/94628","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T09:05:05Z","timestamp":1786007105000},"page":"e94628-e94628","source":"Crossref","is-referenced-by-count":0,"title":["Immersive 3D vs Physical Simulation in Training Novices for Laser-Based Endourological Procedures: Protocol for a Randomized Controlled Trial"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0384-1135","authenticated-orcid":false,"given":"Jos\u00e9phine-Charlotte","family":"Coleman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-1948","authenticated-orcid":false,"given":"Matthias J","family":"Witti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-408X","authenticated-orcid":false,"given":"Natalia","family":"Wirtz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1343-6669","authenticated-orcid":false,"given":"Maximilian","family":"Aumiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2129-6547","authenticated-orcid":false,"given":"Adrian","family":"R\u00fchm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-2407","authenticated-orcid":false,"given":"Ronald","family":"Sroka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4862-6251","authenticated-orcid":false,"given":"Tamira","family":"B\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2352-2325","authenticated-orcid":false,"given":"Benedikt","family":"Duckworth-Mothes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-8723","authenticated-orcid":false,"given":"Matthias","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.855403","article-title":"Virtual simulation in undergraduate medical education: a scoping review of recent practice","volume":"9","author":"Wu","journal-title":"Front Med (Lausanne)"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.2196\/71844","article-title":"Knowledge mapping and global trends in simulation in medical education: bibliometric and visual analysis","volume":"11","author":"Ba","journal-title":"JMIR Med Educ"},{"issue":"8","key":"R3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.89657","article-title":"Enhancing knowledge retention by simulation-based learning among first-year medical students","volume":"17","author":"Kaur","journal-title":"Cureus"},{"issue":"9","key":"R4","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.44654","article-title":"Exploring the role of simulation training in improving surgical skills among residents: a narrative review","volume":"15","author":"Cardoso","journal-title":"Cureus"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v95i2.15601","article-title":"High-fidelity simulation and its impact on non-technical skills development among healthcare professionals: a systematic review and meta-analysis","volume":"95","author":"Vangone","journal-title":"Acta Biomed"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-06299-w","article-title":"The impact of surgical simulation and training technologies on general surgery education","volume":"24","author":"Shahrezaei","journal-title":"BMC Med Educ"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2021.104773","article-title":"The integration of immersive virtual reality simulation in interprofessional education: a scoping review","volume":"98","author":"Qiao","journal-title":"Nurse Educ Today"},{"issue":"4","key":"R8","doi-asserted-by":"publisher","first-page":"499","DOI":"10.3102\/0034654320933544","article-title":"Simulation-based learning in higher education: a meta-analysis","volume":"90","author":"Chernikova","journal-title":"Rev Educ Res"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1080\/14670100.2021.1940629","article-title":"Cochlear implant surgery: learning curve in virtual reality simulation training and transfer of skills to a 3D-printed temporal bone - a prospective trial","volume":"22","author":"Frend\u00f8","journal-title":"Cochlear Implants Int"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.compedu.2024.105124","article-title":"Immersive procedural training in virtual reality: a systematic literature review","volume":"221","author":"Jongbloed","journal-title":"Comput Educ"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssci.2023.106200","article-title":"Improving safety outcomes through medical error reduction via virtual reality-based clinical skills training","volume":"165","author":"Kennedy","journal-title":"Saf Sci"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/MOU.0000000000001145","article-title":"Virtual reality vs. physical models in surgical skills training. An update of the evidence","volume":"34","author":"Chahal","journal-title":"Curr Opin Urol"},{"issue":"5","key":"R13","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1007\/s00345-021-03886-0","article-title":"Simulation training in transurethral resection\/laser vaporization of the prostate; evidence from a systematic review by the European Section of Uro-Technology","volume":"40","author":"Tokas","journal-title":"World J Urol"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.chbr.2024.100454","article-title":"The relation between learners\u2019 experience in simulations and diagnostic accuracy: generalizability across medical and teacher education","volume":"15","author":"Chernikova","journal-title":"Comput Hum Behav Rep"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1007\/s10648-010-9128-5","article-title":"Element interactivity and intrinsic, extraneous, and germane cognitive load","volume":"22","author":"Sweller","journal-title":"Educ Psychol Rev"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1006\/ceps.1999.1015","article-title":"Expectancy-value theory of achievement motivation","volume":"25","author":"Wigfield","journal-title":"Contemp Educ Psychol"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.53.100901.135153","article-title":"Motivational beliefs, values, and goals","volume":"53","author":"Eccles","journal-title":"Annu Rev Psychol"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"138","DOI":"10.5213\/inj.2448042.021","article-title":"Effect of self-training using virtual reality head-mounted display simulator on the acquisition of holmium laser enucleation of the prostate surgical skills","volume":"28","author":"Jang","journal-title":"Int Neurourol J"},{"key":"R19","unstructured":"Quantitative Surgical GmbH. URL: https:\/\/quantitative-surgical.com\/ [Accessed 18-09-2026]"},{"issue":"2","key":"R20","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/bf03193146","article-title":"G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","journal-title":"Behav Res Methods"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1046\/j.1365-2168.1997.02502.x","article-title":"Objective structured assessment of technical skill (OSATS) for surgical residents","volume":"84","author":"Martin","journal-title":"Br J Surg"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1016\/j.juro.2015.02.2959","article-title":"Multi-institutional validation of an OSATS for the assessment of cystoscopic and ureteroscopic skills","volume":"194","author":"Argun","journal-title":"J Urol"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1037\/0022-3514.45.4.736","article-title":"Relation of reward contingency and interpersonal context to intrinsic motivation: a review and test using cognitive evaluation theory","volume":"45","author":"Ryan","journal-title":"J Pers Soc Psychol"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.01997","article-title":"Development and validation of two instruments measuring intrinsic, extraneous, and germane cognitive load","volume":"8","author":"Klepsch","journal-title":"Front Psychol"},{"issue":"10","key":"R25","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1080\/0142159X.2020.1838465","article-title":"The recommended description of an entrustable professional activity: AMEE guide no. 140","volume":"43","author":"Ten Cate","journal-title":"Med Teach"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:41:29Z","timestamp":1791322889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e94628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":25,"URL":"https:\/\/doi.org\/10.2196\/94628","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"article-number":"v15i8e94628"}}