{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:19:03Z","timestamp":1791523143873,"version":"4.3.4"},"reference-count":12,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Robotic surgery training requires effective simulation methods to ensure proficiency. Virtual reality (VR) simulators and physical models offer different approaches. Methods: A study was conducted with 30 surgical residents, divided into two groups: one trained on a high-fidelity physical simulator and the other on a VR simulator. Both groups completed standardized exercises, followed by an assessment of their surgical performance using the da Vinci Surgical System simulator. Performance scores were analyzed using statistical methods, including t-tests and multiple linear regression. Results: Residents trained on the physical simulator obtained higher scores compared with those using VR simulation, with a statistically significant difference in overall scores (76 \u00b1 17 vs. 34 \u00b1 29; p &lt; 0.001). The use of the physical simulator was the most influential factor in improved performance, independent of the year of residency. Conclusions: High-fidelity physical simulators enhance robotic surgical training compared to VR simulators.<\/jats:p>","DOI":"10.3390\/jcm15062298","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:03:27Z","timestamp":1773756207000},"page":"2298","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Effectiveness of Physical and Virtual Reality Simulators in Robotic Surgical Training"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3654-4651","authenticated-orcid":false,"given":"Gaetano","family":"Romano","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7485-5150","authenticated-orcid":false,"given":"Fabrizia","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Surgical, Clinical, Molecular and Critical Care Pathology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3240-9313","authenticated-orcid":false,"given":"Carmelina C.","family":"Zirafa","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2967-4153","authenticated-orcid":false,"given":"Ilaria","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Department of Surgical, Clinical, Molecular and Critical Care Pathology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9932-5117","authenticated-orcid":false,"given":"Beatrice","family":"Manfredini","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-0262","authenticated-orcid":false,"given":"Riccardo","family":"Morganti","sequence":"additional","affiliation":[{"name":"Clinical Trial Statistical Support Unit, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selene","family":"Tognarelli","sequence":"additional","affiliation":[{"name":"The BioRobotics Institute, Scuola Superiore Sant\u2019Anna, 56025 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Romboni","sequence":"additional","affiliation":[{"name":"Department of Surgical, Clinical, Molecular and Critical Care Pathology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6348-1081","authenticated-orcid":false,"given":"Arianna","family":"Menciassi","sequence":"additional","affiliation":[{"name":"The BioRobotics Institute, Scuola Superiore Sant\u2019Anna, 56025 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello Carlo","family":"Ambrogi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Davini","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Cardio-Thoracic-Vascular Department, University Hospital \u201cSS. Annunziata\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Melfi","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Cardio-Thoracic-Vascular Department, University Hospital \u201cSS. Annunziata\u201d, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1874","DOI":"10.1002\/rcs.1874","article-title":"A comparative analysis and guide to virtual reality robotic surgical simulators","volume":"14","author":"Julian","year":"2018","journal-title":"Int. J. Med. Robot. Comput. Assist. Surg. MRCAS"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.4103\/0970-1591.128506","article-title":"Novel training methods for robotic surgery","volume":"30","author":"Sun","year":"2014","journal-title":"Indian J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"zraa066","DOI":"10.1093\/bjsopen\/zraa066","article-title":"Virtual reality simulation in robot-assisted surgery: Meta- analysis of skill transfer and predictability of skill","volume":"5","author":"Schmidt","year":"2021","journal-title":"BJS Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s11701-017-0746-5","article-title":"Novel simulator for robotic surgery","volume":"11","author":"Schlottmann","year":"2017","journal-title":"J. Robot. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s11701-021-01302-8","article-title":"A review of simulation training and new 3D computer- generated synthetic organs for robotic surgery education","volume":"16","author":"Costello","year":"2022","journal-title":"J. Robot. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s11701-018-0853-y","article-title":"Low confidence levels with the robotic platform among senior surgical residents: Simulation training is needed","volume":"13","author":"Schlottmann","year":"2019","journal-title":"J. Robot. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/imi.0000000000000423","article-title":"Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery","volume":"12","author":"Yamada","year":"2017","journal-title":"Innovations"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0039-6060(03)00156-9","article-title":"Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery","volume":"135","author":"Peters","year":"2004","journal-title":"Surgery"},{"key":"ref_9","first-page":"S1","article-title":"The Robotic Surgeon Training","volume":"82","author":"Crestani","year":"2015","journal-title":"Urol. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/SLA.0000000000003220","article-title":"Proving the Effectiveness of the Fundamentals of Robotic Surgery (FRS) Skills Curriculum: A Single-blinded, Multispecialty, Multi-institutional Randomized Control Trial","volume":"272","author":"Satava","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1089\/end.2019.0541","article-title":"Virtually Competent: A Comparative Analysis of Virtual Reality and Dry-Lab Robotic Simulation Training","volume":"34","author":"Raison","year":"2020","journal-title":"J. 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Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2298\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:15:58Z","timestamp":1773756958000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062298"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062298","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}