UNIVERSITY OF MANAGEMENT

& TECHNOLOGY
Department of Information Technology

RESEARCH PAPER
Virtualized Medical Training Simulation
An Analytical Study on the Use of Simulation Technologies in
Medical Education

AUTHORS:
M.Haseeb Asif
[email protected]
Jannat Imtiaz
[email protected]
Malika Zahra
[email protected]

SUBMITTED TO:
SIR.FAHAD ALI

SECTION:
Y-2

Date of Submission:
June 19, 2025
Abstract:
Virtualized medical training simulations have emerged as a powerful educational
approach that complements traditional teaching in healthcare by offering safe, realistic,
and interactive environments for learners. Simulation-based learning (SBL) helps
integrate theoretical knowledge with hands-on practice, especially for undergraduate
medical students. With advancements in technology, SBL has evolved into Virtual
Simulation (VS), accessible through web platforms and enhanced by immersive
technologies such as Virtual Reality (VR), Augmented Reality (AR), and Virtual
Standardized Patients (VSPs). Scientific research supports the effectiveness of virtual
simulations in disciplines like neurosurgery, where realistic, 3D anatomical models built
using CT/MRI scans allow in-depth exploration and interaction. Additionally, Virtual
Patients (VPs) provide standardized software for simulating rare or critical clinical cases,
enhancing students’ clinical reasoning and diagnostic skills. Recognized by global medical
education standards and institutions, virtualized simulations continue to transform
medical education by bridging gaps between classroom knowledge and real-world clinical
practice. In this paper, we will discuss how simulation-based learning, particularly
through Virtual Reality (VR), Augmented Reality (AR), and Virtual Standardized Patients
(VSPs), is transforming medical education by improving clinical skills, decision-making,
and bridging the gap between theoretical knowledge and real-world practice.
Keywords: Virtual Simulation, Medical Education, Simulation-Based Learning (SBL),
Virtual Reality (VR), Augmented Reality (AR), Virtual Standardized Patient (VSP)

INTRODUCTION:
Virtual patient (VP) is a standardized computer software which allows simulation of real
clinical scenarios that encompass the most frequent clinical cases to critical situations.
The aim of VP is to expose students to virtual scenarios that would otherwise be difficult
to find or to deal with in real life. Evidence shows that a greater number of worked cases
results in a better performance in real life. VP is still under development and relatively
unexplored from a pedagogic perspective. This tool has been accepted by the Liaison
Committee on Medical Education (LCME) as a resource to teach rare but necessary
clinical situations. In addition, it is part of the United States Medical Licensing
Examination (USMLE Step 3) since 1999. In Colombia, Fundación Santa Fe de Bogotá
(FSFB), a high complex medical institution, and SENA (National Apprenticeship Service
from the acronym in Spanish) developed a computer-based simulation model i.e., “The
Virtual Patient: Simulator of Clinical Cases”, which enables the students to prepare a
clinical record, generate a diagnosis hypothesis and a treatment plan. How to effectively
improve the medical knowledge reserve ability of medical students and establish an
effective relationship between professional theoretical study and clinical practice are two
major problems currently facing global medical education [1].The medical knowledge
system is huge, the content varies, and the learning cycle is long. It is difficult for medical
students to establish a solid knowledge system and enhance their perceptual medical
knowledge only through traditional two-dimensional learning. The traditional one-way
input theoretical learning and autopsy learning mode cannot be individualized for specific
students, and autopsy learning is limited by ethical issues and the number of available
specimens, so it is difficult to maintain teaching quality [1, 2].
In recent years, virtual reality (VR) simulators have been widely used in the field of
medical teaching and have achieved good results. Many hospitals are now using virtual
reality to assist senior surgical residents in improving surgical technology, and this
training has shown to enhance learning efficiency, knowledge transfer, and skill transfer
[3]. It is because VR simulators can give prompt feedback to learners from visual and
aural multisensory and multiangle viewpoints [4], which is also critical in clinical medical
education [5]. According to the different input operations of the operator, they can
formulate the corresponding processing results and output them in real time, which is
also called real-time interaction [6]. This kind of immediate feedback can prompt the
operators to change the learnin (Andrés Isaza-Restrepo, 2018) process from passive to
active and construct a relationship between visual feedback and psychological
expectations in the learning process [7,8,9]. The improvement in learners’ three-
dimensional imagination, active operation and exploration of learning skills can improve
their knowledge reserve ability. According to the most recent comparative bibliometrics
analysis, students may grasp the theoretical understanding of learning and improve the
teaching impact with the use of 3D technology in the classroom [10]. Compared with
traditional teaching methods(or combining with 3D technology), this immersive learning
method provided by VR technology can arouse students’ interest in learning, stimulate
their motivation for active learning and build their individual medical knowledge reserve
system [11, 12].Sports [13], tourism [14], surgical simulation [15], rehabilitation
counseling [16], simulated military operations [17], and education [18] are some of the
current uses for virtual reality. A secure, consistent, and individualized learning
environment may be offered via a VR learning platform [19]. Learners may fully express
their subjective initiative on the VR platform and, through repeated efforts and exercises,
enhance their grasp and cognition of a specific professional expertise. The prevalence of
new COVID-19 has further encouraged the use of VR technology in the area of education
[20, 21]. VR is now playing a bigger and bigger part in the educational world as online
learning steadily replaces traditional classroom instruction[19]. The majority of study
subjects in the medical area of VR have become physicians through clinical practice,
however there is a dearth of research on the education of medical students at the
undergraduate level. In addition to surgical technical supervision and tele-rehabilitation
research demonstrating that VR may cure certain major illnesses, supporting VR
instruction in undergraduate education is essential, since it is an essential component of
VR's spread [22].In our initial research, we pioneered the use of VR in undergraduate
surgical Achilles tendon suture instruction and discovered that students in the
experimental group were better able to grasp the procedure [18]. The high application
cost is the main obstacle to popularizing VR education in various countries and regions.
The rapid progress and iterative adaptation of modern digital technology is the inevitable
trend of the development of science and technology [23]. With continuous changes in
technology, in addition to enriching the diversity of VR teaching forms, reducing the
application cost is an inevitable trend of science and technology products [23]. Even
though the current application of VR simulation has some shortcomings, such as
increasing the mental pressure on users and high cost [24, 25], integrating digital teaching
into medical courses will be a long-term and continuous process. From the point of view
of teaching purposes, VR simulation improves the quality and efficiency of education and
is a supplement to traditional education rather than a substitute. During the COVID-19
epidemic, the need for remote education has skyrocketed, and VR applications in
undergraduate education are also on the rise, particularly in medical education that calls
for clinical learning experiences [16].
Methodology
This review adopts a systematic approach to identify, evaluate, and synthesize existing
literature on the role and impact of Virtual Simulation (VS) technologies in undergraduate
medical education, with a specific focus on Virtual Reality (VR), Augmented Reality (AR), and
Virtual Standardized Patients (VSPs). The methodology is structured to ensure relevance,
transparency, and reliability of findings.

Literature review:

A comprehensive literature review was conducted to gather relevant studies, articles, and
research findings related to the impact of SBT in medical education. The search was conducted
across electronic databases, including PubMed, Google Scholar, and Web of Science, using
keywords such as “simulation-based training,” “medical education,” “simulation in healthcare,”
and “virtual reality simulation.” The inclusion criteria for selecting studies were:

 Articles published in peer-reviewed journals.

 Studies focusing on SBT methods in medical education.
 Research articles, case studies, systematic reviews, and meta-analyses.
 Studies published in English.

The search was conducted from the inception of relevant databases to the present date, with
no restrictions on publication year. The initial search yielded many articles, screened based on
titles and abstracts for relevance to the topic. Full-text articles meeting the inclusion criteria
were then reviewed in detail to extract relevant information, including study objectives,
methodology, findings, and conclusions. Data from selected studies were synthesized and
analyzed to identify common themes, trends, and key findings related to the impact of SBT in
medical education. This process involved categorizing studies based on simulation modalities,
learning outcomes, and study populations. Furthermore, references cited in selected articles
were reviewed to identify additional relevant studies that may have yet to be captured in the
initial search. This iterative process ensured a comprehensive review of the existing literature
on SBT in medical education.The time frame for the search was limited to January 2020
through December 2021, ensuring recent and up-to-date insights, particularly reflective of
post-COVID-19 educational adaptations.

CASE STUDIES AND EXAMPLES

The use of VR in medical training has advanced worldwide. Many medical schools and
organizations have integrated VR into their education programs. One notable example is the
University of Alberta, where a VR environment for studying cadaver dissection was developed.
A study on nursing students found that the VR environment was effective and easy to use,
leading to improved learning outcomes. Participants appreciated the opportunity to study at
their own pace and recommended VR for studying anatomy [8]. Holo Anatomy at Case Western
Reserve University utilizes augmented reality headsets and holographic anatomy platforms to
learn anatomy. It has significantly improved anatomy examination performance and garnered
positive feedback on learning and interest in anatomy courses. The program integrates
augmented reality modules, faculty development, and training resources to promote
technology adoption. Student simulation and perfusion of donor hearts were developed using
3D printing, and computer simulations were used to core arteries. VR heart models allowed
visualization and presentation of pathologist. Faculty received technology training for support.
The program encourages institutional investment in 3D printing and augmented/virtual reality
in education. VR enhancement of medical imaging courses at UCLA improved student
interactions with 3D objects through virtual and augmented reality features. Students could
engage with 3D CT data sets of various body parts and MRI brain real time data using
augmented reality headsets. These features were incorporated into lectures and lab activities
for first-year medical students. Survey results indicated positive ratings for the VR and AR
experience and their effectiveness in explaining medical imaging [9].

DISCUSSION & RESULTS:

This study reviewed the recent practice of VS in the undergraduate medical teaching and
learning reporting in articles since 2015. Evidence for effectiveness of VS in medical students’
knowledge or skills was sufficient.Through providing computer-generated immersive learning
scenes being highly realistic, diversified, dynamic and customized, VS used in undergraduate
medical education offers an opportunity for students to achieve first-person experiences in life-
like and complex clinical scenarios that they may not normally be exposed to, or when it is hard
to access patients, and makes learning effective and appealing to students. However, content
provided on a screen using a digital device might “decouple” users from reality. Hands-on
experience is essential for medical students to master clinical skills, for example, surgical
techniques. Several previous studies (18, 122) have suggested that improved performance in
the VS environment might not always transfer to the clinical setting. Therefore, VS is insufficient
to replace hands-on experiential practice for medical students to master clinical skills, which
might be another important challenge. The current VS simulators act as only part of the medical
comprehensive training to supplement the hands-on experience but not the only training
technique. In addition, an interesting study (86) explored the impact of compulsory
participation on the VS learning experiences of medical undergraduates. The results showed
that the learning performance and acceptance of VS technology were lower with
a compulsory participation, and the opinion toward VS-based study was even worse if dropouts
were not allowed. Therefore, learning in VS environments should be voluntary. And how to
increase motivation and engagement is an important issue for medical educators to achieve the
effective integration of VS.

Findings (Summary):

The study found that virtual simulation technologies—especially VR and AR—enhance medical
education by improving student engagement, clinical reasoning, and learning outcomes. VR
tools help students better understand anatomy and procedures, while AR platforms offer real-
time interaction with medical imaging. Virtual Standardized Patients (VSPs) support decision-
making in rare cases. However, hands-on training remains essential, as simulation alone may
not ensure skill transfer. Voluntary use of VR leads to better acceptance than compulsory use.
Despite high costs, simulation is a valuable supplement to traditional methods, not a
replacement.
FUTURE DIRECTIONS AND INNOVATIONS:
Virtual reality technology is transforming medical training. It offers numerous opportunities for
application and has the potential to revolutionize complex procedures. This will improve patient
outcomes and reduce costs. VR simulators provide practice spaces for surgeons to develop skills
away from the operating room. Trainees can practice procedures repetitively and at their own
pace, improving confidence and skill. Metrics can assess engagement and track skill progression
for educators and employers [10]. Simulations go beyond simple tasks like knot tying. Virtual
environments allow complex anatomy modeling, simulating effects of motion and forces,
obstructions, and multi-surgeon teams. They also support research, development, and training
improvements. Step-by-step training modules ensure correct skill acquisition. Bridging
academia and industry needs guarantees tailored applications and continuous user-developer
interaction for valuable insights. Unique information or techniques can lead to patents and
competitive advantages [11].

ACKNOWLEDGEMENT:

The authors would like to express gratitude to all individuals and institutions that contributed
to the completion of this paper. Their support, guidance, and encouragement throughout the
research process are deeply appreciated.

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