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Completed

NCT Number: NCT07304570

VR-Live Hybrid Neurosurgery Clerkship:Boosting Neurosurgical Presence & Decisions

The goal of this randomized controlled trial was to learn whether a hybrid telemedicine curriculum that combines virtual-reality (VR) simulation with interactive live-streamed neurosurgical cases improves neurosurgical intentionality and clinical decision-making in fourth-year medical students whose clerkships were disrupted by COVID-19. It also assessed technical skills, theoretical knowledge, and student experience. The main questions it aimed to answer were:

Does the 4-week hybrid model (VR + live cases) produce greater gains in neurosurgical intentionality and decision-making than traditional online videos and readings? Does the hybrid model improve VR technical skill performance and student satisfaction without harming theoretical knowledge? Researchers randomized 112 students 1:1 to the hybrid intervention (15 h VR neuroanatomy/procedures + 20 h live-streamed surgeries/ICU rounds + real-time Q&A) or a time-matched control group (pre-recorded videos, textbook readings, asynchronous forums).

Participants in both groups:

Completed 40 hours of remote content over 4 weeks Were tested at baseline and post-course on intentionality (modified Zwisch scale), decision-making (neurosurgery-specific SCT), 50-item MCQ knowledge, and VR proficiency metrics Joined focus groups and rated satisfaction on a 5-point Likert scale

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Key information

Conditions

Virtual Reality Telemedicine

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

West China Hospital

Chengdu, Sichuan, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Fourth-year medical students assigned to the neurosurgical clerkship rotation
  • Able to participate fully in remote learning (stable internet and VR-headset compatible computer)
  • Provided written informed consent

Exclusion criteria

  • Had already completed a prior neurosurgical elective
  • Lacked reliable internet access or hardware required for VR/live-streaming
  • Declined to consent or unable to complete the 4-week curriculum

Treatment and study plan

VR Simulation (15 hours)+Live-Streamed Neurosurgical Procedures (20 hours)+Live-Streamed Neurocritical Care Rounds (5 hours)

Other
  • VR Simulation (15 hours): Customized modules on the NeuroVR Platform (validated for neurosurgical education):
  • Neuroanatomy (5 hours): 3D interactive models of cerebral cortex, brainstem, cranial nerves, and spinal cord (with vascular/meningeal overlays).
  • Procedural skills (10 hours): Craniotomy basics, ventriculostomy, lumbar puncture, and spine decompression-with real-time feedback on instrument handling and anatomical precision.
  • Live-Streamed Neurosurgical Procedures (20 hours): 18 diverse cases (brain tumor resection [n=6], spine fusion [n=5], aneurysm clipping [n=3], epilepsy surgery [n=4]) via HIPAA-compliant Zoom for Healthcare. Each session included:
  • Pre-procedure briefing (anatomical landmarks, surgical goals).
  • Intraoperative expert commentary (neurosurgeon + neuroanesthesiologist).
  • Real-time Q&A (focused on neurocritical decision-making: e.g., "How do you adjust resection for eloquent cortex mapping?").
  • Live-Streamed Neurocritical Care Rounds (5 hours): Week

Primary outcomes

  1. Neurosurgical Intentionality

    Time frame: 4 weeks

    Neurosurgical Intentionality: Intervention group post-intervention scores were compared with controls, the higer the score, the better the outcome

  2. Clinical decision-making score

    Time frame: 4 weeks

    Clinical Decision-Making Score Range: 24-120 points (5-point Likert, 24 items)

    Levels:

    24-48 = low 49-84 = moderate 85-120 = high The higher the score, the better the outcome

Secondary outcomes

  1. Theoretical Knowledge

    Time frame: 4 weeks

    These comprised of theoretical knowledge with 50-item multiple-choice-questions (MCQ) exam on neuroanatomy, pathology, and surgical indications ,the higer the score, the better the outcome

  2. Technical Skill Performance score

    Time frame: 4 weeks

    Technical Skill Performance with VR proficiency metrics such as time to completion, anatomical accuracy, and instrument error rate from NeuroVR's built-in assessment tool. The higer the score,the better the outcome

  3. Student experience score

    Time frame: 4 weeks

    Student experience using semi-structured focus groups such as 6 groups of 8-10 students/group and reflective journals, analyzed via Braun & Clarke's thematic analysis ; and satisfaction using 12-item Likert scale (1=strongly dissatisfied to 5=strongly satisfied) measuring curriculum relevance, engagement, and skill development. The higher the score, the better the outcome

Sponsors and collaborators

Lead sponsor

West China Hospital

Other

Registry information

Official study title

Enhancing Clinical Presence and Decision-Making in Neurosurgical Clerkships: A Hybrid Model Integrating Virtual Reality and Live-Streamed Encounters

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Dec 26, 2025
Registry last updated
Dec 26, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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