{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:56:07Z","timestamp":1791597367414,"version":"4.3.4"},"reference-count":94,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publishing Fund of Philipps-Universit\u00e4t Marburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014\u20132024) were synthesized. After screening, 32 studies comparing ExR-HMD and traditional surgical training methods for medical students or residents were identified. Quality and bias were assessed using the Medical Education Research Study Quality Instrument, Newcastle\u2013Ottawa Scale-Education, and Cochrane Risk of Bias Tools. Results indicate that ExR-HMD offers benefits such as increased immersion, spatial awareness, and interaction and supports motor skill acquisition theory and constructivist educational theories. However, challenges such as system fidelity, operational inconvenience, and physical discomfort were noted. Nearly half the studies reported outcomes comparable or superior to traditional methods, emphasizing the importance of social interaction. Limitations include study heterogeneity and English-only publications. ExR-HMD shows promise but needs educational theory integration and social interaction. Future research should address technical and economic barriers to global accessibility.<\/jats:p>","DOI":"10.3390\/bioengineering11080741","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T11:40:36Z","timestamp":1721734836000},"page":"741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Extended Reality-Based Head-Mounted Displays for Surgical Education: A Ten-Year Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5318-3881","authenticated-orcid":false,"given":"Ziyu","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany"},{"name":"Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5365-7511","authenticated-orcid":false,"given":"Felix","family":"Corr","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-3568","authenticated-orcid":false,"given":"Dustin","family":"Grimm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-9410","authenticated-orcid":false,"given":"Christopher","family":"Nimsky","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany"},{"name":"Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1574-7572","authenticated-orcid":false,"given":"Miriam H. A.","family":"Bopp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany"},{"name":"Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jamcollsurg.2016.11.004","article-title":"The elite athlete, the master surgeon","volume":"224","author":"Verrier","year":"2017","journal-title":"J. Am. Coll. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1503\/cjs.017515","article-title":"Teaching surgery takes time: The impact of surgical education on time in the operating room","volume":"59","author":"Vinden","year":"2016","journal-title":"Can. J. Surg."},{"key":"ref_3","first-page":"56","article-title":"The European working time directive has a negative impact on surgical training in the UK","volume":"9","author":"Simpson","year":"2010","journal-title":"Surg. J. R. Coll. Surg. Edinb. Irel."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1472-6920-14-S1-S14","article-title":"Effects of the reduction of surgical residents\u2019 work hours and implications for surgical residency programs: A narrative review","volume":"14","author":"Jamal","year":"2014","journal-title":"BMC Med Educ."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1287\/isre.12.1.1.9720","article-title":"Research commentary: Technology-mediated learning\u2014A call for greater depth and breadth of research","volume":"12","author":"Alavi","year":"2001","journal-title":"Inf. Syst. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.wneu.2018.07.015","article-title":"Effectiveness of cadaveric simulation in neurosurgical training: A review of the literature","volume":"118","author":"Gnanakumar","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_7","first-page":"1","article-title":"3D printing in neurosurgery education: A review","volume":"7","author":"Bernstein","year":"2021","journal-title":"3D Print. Med."},{"key":"ref_8","first-page":"77","article-title":"Virtual and augmented reality in medical education","volume":"26","author":"Pantelidis","year":"2018","journal-title":"Med Surg.-Educ.-Past Present Future"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1007\/s10639-017-9676-0","article-title":"A review of the use of virtual reality head-mounted displays in education and training","volume":"23","author":"Jensen","year":"2018","journal-title":"Educ. Inf. Technol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1002\/ase.2049","article-title":"Virtual and augmented reality enhancements to medical and science student physiology and anatomy test performance: A systematic review and meta-analysis","volume":"14","author":"Moro","year":"2021","journal-title":"Anat. Sci. Educ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1117\/12.197321","article-title":"Augmented reality: A class of displays on the reality-virtuality continuum","volume":"Volume 2351","author":"Milgram","year":"1995","journal-title":"Proceedings of the Telemanipulator and Telepresence Technologies"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Qi, Z., Bopp, M.H., Nimsky, C., Chen, X., Xu, X., Wang, Q., Gan, Z., Zhang, S., Wang, J., and Jin, H. (2023). A Novel Registration Method for a Mixed Reality Navigation System Based on a Laser Crosshair Simulator: A Technical Note. Bioengineering, 10.","DOI":"10.3390\/bioengineering10111290"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Qi, Z., Jin, H., Wang, Q., Gan, Z., Xiong, R., Zhang, S., Liu, M., Wang, J., Ding, X., and Chen, X. (2024). The Feasibility and Accuracy of Holographic Navigation with Laser Crosshair Simulator Registration on a Mixed-Reality Display. Sensors, 24.","DOI":"10.3390\/s24030896"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E22","DOI":"10.3171\/2021.5.FOCUS21175","article-title":"Holographic mixed-reality neuronavigation with a head-mounted device: Technical feasibility and clinical application","volume":"51","author":"Qi","year":"2021","journal-title":"Neurosurg. Focus"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Voinescu, A., Sui, J., and Stanton Fraser, D. (2021). Virtual reality in neurorehabilitation: An umbrella review of meta-analyses. J. Clin. Med., 10.","DOI":"10.3390\/jcm10071478"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.genhosppsych.2021.04.008","article-title":"Use of virtual reality in the inpatient rehabilitation of COVID-19 patients","volume":"71","author":"Kolbe","year":"2021","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_17","first-page":"E15","article-title":"A patient-specific, interactive, multiuser, online mixed-reality neurosurgical training and planning system","volume":"56","author":"Wang","year":"2024","journal-title":"Neurosurg. Focus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s00701-020-04303-y","article-title":"Informed consent through 3D virtual reality: A randomized clinical trial","volume":"163","author":"Perin","year":"2021","journal-title":"Acta Neurochir."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.medengphy.2015.11.021","article-title":"A review of virtual reality based training simulators for orthopaedic surgery","volume":"38","author":"Vaughan","year":"2016","journal-title":"Med Eng. Phys."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.nedt.2019.05.026","article-title":"Learning procedural skills with a virtual reality simulator: An acceptability study","volume":"79","author":"Bracq","year":"2019","journal-title":"Nurse Educ. Today"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1037\/h0026739","article-title":"Movement control in skilled motor performance","volume":"70","author":"Keele","year":"1968","journal-title":"Psychol. Bull."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102945","DOI":"10.1016\/j.amsu.2021.102945","article-title":"Virtual reality (VR) as a simulation modality for technical skills acquisition","volume":"71","author":"Nassar","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_23","unstructured":"World Health Organization (2024, June 20). World Health Organization Guideline: Recommendations on Digital Interventions for Health System Strengthening. Available online: www.who.int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1007\/s11695-018-03680-9","article-title":"Virtual reality single-port sleeve gastrectomy training decreases physical and mental workload in novice surgeons: An exploratory study","volume":"29","author":"Michelet","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(15)60160-X","article-title":"Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development","volume":"386","author":"Meara","year":"2015","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e29080","DOI":"10.2196\/29080","article-title":"Augmented, mixed, and virtual reality-based head-mounted devices for medical education: Systematic review","volume":"9","author":"Barteit","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_27","first-page":"e1843","article-title":"Head-mounted display virtual reality is effective in orthopaedic training: A systematic review","volume":"4","author":"Berthold","year":"2022","journal-title":"Arthrosc. Sport. Med. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102757","DOI":"10.1016\/j.media.2023.102757","article-title":"The HoloLens in medicine: A systematic review and taxonomy","volume":"85","author":"Gsaxner","year":"2023","journal-title":"Med Image Anal."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/SIH.0000000000000636","article-title":"Virtual reality head-mounted displays in medical education: A systematic review","volume":"18","author":"Jensen","year":"2023","journal-title":"Simul. Healthc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/15391523.2009.10782544","article-title":"Technological pedagogical content knowledge (TPACK) the development and validation of an assessment instrument for preservice teachers","volume":"42","author":"Schmidt","year":"2009","journal-title":"J. Res. Technol. Educ."},{"key":"ref_31","unstructured":"Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V. (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley. [2nd ed.]. Available online: https:\/\/dariososafoula.wordpress.com\/wp-content\/uploads\/2017\/01\/cochrane-handbook-for-systematic-reviews-of-interventions-2019-1.pdf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-014-0579-0","article-title":"PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews","volume":"14","author":"Methley","year":"2014","journal-title":"BMC Health Serv. Res."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Haddaway, N.R., Collins, A.M., Coughlin, D., and Kirk, S. (2015). The role of Google Scholar in evidence reviews and its applicability to grey literature searching. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138237"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wohlin, C. (2014, January 13\u201314). Guidelines for snowballing in systematic literature studies and a replication in software engineering. Proceedings of the 18th International Conference on Evaluation and Assessment in Software Engineering, London, UK.","DOI":"10.1145\/2601248.2601268"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1001\/jama.298.9.1002","article-title":"Association between funding and quality of published medical education research","volume":"298","author":"Reed","year":"2007","journal-title":"JAMA"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1097\/ACM.0000000000000786","article-title":"Appraising the quality of medical education research methods: The medical education research study quality instrument and the Newcastle\u2013Ottawa scale-education","volume":"90","author":"Cook","year":"2015","journal-title":"Acad. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Higgins, J.P., and Green, S. (2008). Cochrane Handbook for Systematic Reviews of Interventions, Wiley Online Library. [1st ed.].","DOI":"10.1002\/9780470712184"},{"key":"ref_39","first-page":"24","article-title":"A Cochrane risk of bias assessment tool: For non-randomized studies of interventions (ACROBAT-NRSI)","volume":"1","author":"Sterne","year":"2014","journal-title":"Version"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/SIH.0000000000000413","article-title":"Augmented reality microsurgery: A tool for training micromanipulations in ophthalmic surgery using augmented reality","volume":"15","author":"Ropelato","year":"2020","journal-title":"Simul. Healthc."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Silvero Isidre, A., Friederichs, H., M\u00fcther, M., Gallus, M., Stummer, W., and Holling, M. (2023). Mixed Reality as a Teaching Tool for Medical Students in Neurosurgery. Medicina, 59.","DOI":"10.3390\/medicina59101720"},{"key":"ref_43","first-page":"O139","article-title":"Virtual Reality Head Mounted Display versus Three-dimensional Models and Two-dimensional Tomography Display for Training of Liver Surgery-A Randomized Controlled Study","volume":"37","author":"Wise","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"947","DOI":"10.2147\/AMEP.S395087","article-title":"A comparative study of traditional technique guide versus virtual reality in orthopedic trauma training","volume":"14","author":"Lamb","year":"2023","journal-title":"Adv. Med Educ. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1097\/CORR.0000000000001362","article-title":"Does virtual reality improve procedural completion and accuracy in an intramedullary tibial nail procedure? A randomized control trial","volume":"478","author":"Orland","year":"2020","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.2106\/JBJS.OA.22.00141","article-title":"Comparing Skill Acquisition and Validity of Immersive Virtual Reality with Cadaver Laboratory Sessions in Training for Reverse Total Shoulder Arthroplasty","volume":"8","author":"Crockatt","year":"2023","journal-title":"JBJS Open Access"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1002\/jdd.12598","article-title":"Comparisons of orthodontic residents\u2019 performance and attitudes using 2D, 3D, and virtual reality surgical simulation methods","volume":"85","author":"Sytek","year":"2021","journal-title":"J. Dent. Educ."},{"key":"ref_48","first-page":"S147","article-title":"Effectiveness of Immersive Virtual Reality on Pneumothorax and Chest Tube Management Knowledge Acquisition Among Novice Surgical Residents: A Randomized Controlled Trial","volume":"37","author":"Yi","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1016\/j.jsurg.2022.06.007","article-title":"The utility of virtual reality in orthopedic surgical training","volume":"79","author":"Cevallos","year":"2022","journal-title":"J. Surg. Educ."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"357","DOI":"10.2147\/AMEP.S160704","article-title":"The use of augmented reality glasses in central line simulation: \u201cSee one, simulate many, do one competently, and teach everyone\u201d","volume":"9","author":"Huang","year":"2018","journal-title":"Adv. Med Educ. Pract."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ecns.2017.09.010","article-title":"A Using game-based virtual reality with haptics for skill acquisition Clin","volume":"16","author":"Ellertson","year":"2018","journal-title":"Simul. Nurs"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10055-021-00578-3","article-title":"A novel virtual reality simulation training system with haptic feedback for improving lateral ventricle puncture skill","volume":"26","author":"Lin","year":"2022","journal-title":"Virtual Real"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Peng, Y., Xie, Z., Chen, S., Wu, Y., Dong, J., Li, J., He, J., Chen, X., and Gao, H. (2023). Application effect of head-mounted mixed reality device combined with 3D printing model in neurosurgery ventricular and hematoma puncture training. BMC Med Educ., 23.","DOI":"10.1186\/s12909-023-04659-6"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2311940","DOI":"10.1080\/24699322.2024.2311940","article-title":"Augmented reality technology shortens aneurysm surgery learning curve for residents","volume":"29","author":"Liu","year":"2024","journal-title":"Comput. Assist. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/jdd.13380","article-title":"Effectiveness of immersive virtual reality in orthognathic surgical education: A randomized controlled trial","volume":"88","author":"Wan","year":"2024","journal-title":"J. Dent. Educ."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/ca.24028","article-title":"Mixed reality technology enhances teaching of spinal blockade procedures","volume":"36","author":"Wu","year":"2023","journal-title":"Clin. Anat."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12909-019-1911-5","article-title":"Virtual reality technology for teaching neurosurgery of skull base tumor","volume":"20","author":"Shao","year":"2020","journal-title":"BMC Med Educ."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ijsu.2018.04.002","article-title":"360 virtual reality video for the acquisition of knot tying skills: A randomised controlled trial","volume":"54","author":"Yoganathan","year":"2018","journal-title":"Int. J. Surg."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Guha, P., Lawson, J., Minty, I., Kinross, J., and Martin, G. (2023). Can mixed reality technologies teach surgical skills better than traditional methods? A prospective randomised feasibility study. BMC Med Educ., 23.","DOI":"10.1186\/s12909-023-04122-6"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1097\/CORR.0000000000000542","article-title":"Can an augmented reality headset improve accuracy of acetabular cup orientation in simulated THA? A randomized trial","volume":"477","author":"Logishetty","year":"2019","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.1097\/JU.0000000000000878.02","article-title":"Evaluation of the microsoft hololens in surgical training of urological laparoscopic skills","volume":"203","author":"Abbud","year":"2020","journal-title":"J. Urol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ijsu.2016.09.002","article-title":"The use of head-mounted display eyeglasses for teaching surgical skills: A prospective randomised study","volume":"34","author":"Peden","year":"2016","journal-title":"Int. J. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e2031217","DOI":"10.1001\/jamanetworkopen.2020.31217","article-title":"Effectiveness of immersive virtual reality on orthopedic surgical skills and knowledge acquisition among senior surgical residents: A randomized clinical trial","volume":"3","author":"Lohre","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.jcjo.2017.02.015","article-title":"Teaching binocular indirect ophthalmoscopy to novice residents using an augmented reality simulator","volume":"52","author":"Rai","year":"2017","journal-title":"Can. J. Ophthalmol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1016\/j.jamcollsurg.2011.06.301","article-title":"Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room","volume":"213","author":"Palter","year":"2011","journal-title":"J. Am. Coll. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12909-020-02450-5","article-title":"Mixed reality for teaching catheter placement to medical students: A randomized single-blinded, prospective trial","volume":"20","author":"Schoeb","year":"2020","journal-title":"BMC Med Educ."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.neuchi.2020.05.006","article-title":"Applying an immersive tutorial in virtual reality to learning a new technique","volume":"66","author":"Ros","year":"2020","journal-title":"Neurochir."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.surge.2022.03.001","article-title":"Cognitive and motor skill competence are different: Results from a prospective randomized trial using virtual reality simulator and educational video in laparoscopic cholecystectomy","volume":"21","author":"Yang","year":"2023","journal-title":"Surgeon"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Peek, J.J., Max, S.A., Bakhuis, W., Huig, I.C., Rosalia, R.A., Sadeghi, A.H., and Mahtab, E.A. (2023). Virtual reality simulator versus conventional advanced life support training for cardiopulmonary resuscitation post-cardiac surgery: A randomized controlled trial. J. Cardiovasc. Dev. Dis., 10.","DOI":"10.3390\/jcdd10020067"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1016\/j.arth.2019.04.002","article-title":"Virtual reality simulation facilitates resident training in total hip arthroplasty: A randomized controlled trial","volume":"34","author":"Hooper","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.joms.2017.10.002","article-title":"Effectiveness of immersive virtual reality in surgical training\u2014A randomized control trial","volume":"76","author":"Pulijala","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"S186","DOI":"10.51253\/pafmj.v71iSuppl-1.3709","article-title":"Simulation based training improves laparoscopic surgical skills in trainee surgeons","volume":"71","author":"Shaikh","year":"2021","journal-title":"Pak. Armed Forces Med J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e1230","DOI":"10.1002\/cl2.1230","article-title":"PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis","volume":"18","author":"Haddaway","year":"2022","journal-title":"Campbell Syst. Rev."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.jsurg.2022.02.013","article-title":"Telestration in the teaching of basic surgical skills: A randomized trial","volume":"79","author":"Lopes","year":"2022","journal-title":"J. Surg. Educ."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.jsurg.2022.06.008","article-title":"Virtual reality training in unicompartmental knee arthroplasty: A randomized, blinded trial","volume":"79","author":"McKinney","year":"2022","journal-title":"J. Surg. Educ."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1007\/s00464-023-10615-8","article-title":"Comparing a virtual reality head-mounted display to on-screen three-dimensional visualization and two-dimensional computed tomography data for training in decision making in hepatic surgery: A randomized controlled study","volume":"38","author":"Preukschas","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_77","first-page":"273","article-title":"Objective structured assessment of technical skill (OSATS) for surgical residents","volume":"84","author":"Martin","year":"1997","journal-title":"Br. J. Surg."},{"key":"ref_78","first-page":"39","article-title":"Objective structured clinical examination (OSCE)","volume":"46","author":"McAleer","year":"1990","journal-title":"Occas. Pap. (Royal Coll. Gen. Pract."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1097\/ACM.0b013e3182677805","article-title":"The Ottawa surgical competency operating room evaluation (O-SCORE): A tool to assess surgical competence","volume":"87","author":"Gofton","year":"2012","journal-title":"Acad. Med."},{"key":"ref_80","unstructured":"Walker, M., and Peyton, J. (1998). Teaching in theatre. Teaching and Learning in Medical Practice, Manticore Europe Limited."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1097\/00001888-200410001-00022","article-title":"Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains","volume":"79","author":"Ericsson","year":"2004","journal-title":"Acad. Med."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Brown, P.C., Roediger, H.L., and McDaniel, M.A. (2014). Make It Stick: The Science of Successful Learning, Harvard University Press.","DOI":"10.4159\/9780674419377"},{"key":"ref_83","first-page":"4","article-title":"Learning Styles Again: VARKing up the right tree!","volume":"7","author":"Fleming","year":"2006","journal-title":"Educ. Dev."},{"key":"ref_84","first-page":"307","article-title":"Guide for constructing self-efficacy scales","volume":"5","author":"Bandura","year":"2006","journal-title":"Self-Effic. Beliefs Adolesc."},{"key":"ref_85","unstructured":"Kolb, D.A. (2014). Experiential Learning: Experience as the Source of Learning and Development, FT Press."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/0010-0285(73)90004-2","article-title":"Perception in chess","volume":"4","author":"Chase","year":"1973","journal-title":"Cogn. Psychol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1097\/PRS.0b013e318287a0b3","article-title":"Application of the \u201csee one, do one, teach one\u201d concept in surgical training","volume":"131","author":"Kotsis","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_88","first-page":"518","article-title":"The fruition of Halsted\u2019s concept of surgical training","volume":"32","author":"Carter","year":"1952","journal-title":"Surgery"},{"key":"ref_89","first-page":"517","article-title":"A review of constructivism: Understanding and using a relatively new theory","volume":"25","author":"Whitman","year":"1993","journal-title":"Fam. Med."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Wertsch, J.V. (1988). Vygotsky and the Social Formation of Mind, Harvard University Press.","DOI":"10.2307\/j.ctv26071b0"},{"key":"ref_91","unstructured":"Vygotsky, L.S. (2012). Thought and Language, MIT Press."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jocn.2016.09.002","article-title":"Utilizing virtual and augmented reality for educational and clinical enhancements in neurosurgery","volume":"35","author":"Pelargos","year":"2017","journal-title":"J. Clin. Neurosci."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S1701-2163(15)30964-6","article-title":"Validating a self-confidence scale for surgical trainees","volume":"35","author":"Geoffrion","year":"2013","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/11\/8\/741\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:21:33Z","timestamp":1760109693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/11\/8\/741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":94,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["bioengineering11080741"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering11080741","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,23]]}}}