The performance of simulation-based virtual reality bronchoscopy training: A systematic review and meta-analysis

Background. Today, virtual reality bronchoscopy simulation technique is used increasingly. So, it is essential to validate the effectiveness of its training. The performance of training can be evaluated by synthesis of published works. Methods. Based on PRISMA guideline, we systematically searched PubMed and Scopus databases until April 15, 2022 and obtained the eligible articles. The included studies were English articles that performed virtual reality simulation by flexible and rigid bronchoscopy for novices. Random effect model meta-analysis was performed with heterogeneity tests, Egger’s test, SVE, SVT, and subgroup analysis. Results. Sixteen studies comprising two RCTs, seven prospective studies, and seven observational studies were evaluated. Meta-analysis and forest plots showed significant P-values in novices, which indicated virtual reality simulation technique is more effective. Heterogeneity tests showed high heterogeneity in studies of four groups. Published year subgroup analysis explained heterogeneity between studies. Funnel plots and Eggers' test indicated no publication bias between the two groups. Conclusion. Simulation-based virtual reality bronchoscopy training is effective in novices but does not reach experts' skills. Practical Implications. The process of bronchoscopy is critical in the evaluation of the lungs. In the past, it was generally taught by having students do it on people. Despite the low danger, this may be stressful for trainees. Using virtual reality as a simulator, this research aimed to analyze the abilities of experts and novices in medical education, as well as the effectiveness of virtual reality in medical education. A new training option for bronchoscopy simulation training can be considered for examination of the airways, particularly in the future years, stressing the need of continued medical education