Immersive virtual reality versus traditional instruction for long‐term retention of cardiopulmonary resuscitation skills in medical student education: A randomized controlled trial
Hong Kong Journal of Emergency Medicine · 2026-05-21 · Randomised trial
Abstract
Abstract Background The rapid decay of cardiopulmonary resuscitation (CPR) skills remains a pervasive challenge in medical education. Although immersive virtual reality (VR) is increasingly used for training, its efficacy in mitigating long‐term skill decay compared to traditional methods remains unclear. Furthermore, the cognitive mechanisms—specifically how VR‐induced cognitive load influences learning outcomes—require further elucidation. Methods A randomized controlled trial was conducted with 128 novice medical students, randomly assigned to either a VR training group ( n = 64) or a traditional demonstration‐based control group ( n = 64). Both groups received identical content based on American Heart Association guidelines. Outcomes included theoretical knowledge (multiple‐choice questionnaire) and procedural skills (checklist), assessed immediately post‐training and at a 1‐month follow‐up. Cognitive load was measured using the NASA task load index (NASA‐TLX) instrument immediately after training. Results Although immediate theoretical knowledge scores showed no significant difference between groups ( p = 0.664), the VR group demonstrated significantly superior procedural skill retention after 1 month. The Control group experienced a substantial skill decay (−12.05 points), whereas the VR group maintained high proficiency with minimal decay (−4.36 points; p < 0.001). Notably, NASA‐TLX data revealed a cognitive divergence: the VR group reported significantly higher mental demand (56.33 vs. 45.59; p < 0.001) but significantly lower frustration levels (35.38 vs. 61.02; p < 0.001) compared to the Control group. Conclusion Immersive VR training is superior to traditional instruction in promoting the long‐term retention of CPR skills, effectively mitigating the “forgetting curve.” The coexistence of high mental demand and low frustration suggests that VR successfully converts cognitive effort into effective germane load, facilitating deep learning through embodied cognition. These findings support the integration of VR as a scalable tool for high‐frequency, low‐dose resuscitation retraining.
Abstract © the authors or publisher, via OpenAlex. Reuse and removal
Tags
Related articles
- Paramedic Student Clinical Performance During High-Fidelity Simulation After a Physically Demanding Occupational Task: A Pilot Randomized Crossover Trial. (Simul Healthc, 2022)
- Over-the-head cardiopulmonary resuscitation improves efficacy in basic life support performed by professional medical personnel with a single rescuer: a simulation study. (Anesth Analg, 2005)
- Optimizing Pediatric Chest Compressions: A Randomized Crossover Simulation Trial of Over-the-Head vs. Lateral Techniques. (Pediatr Rep, 2025)
- Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study. (World J Emerg Med, 2015)
- Effect of the rate of chest compression familiarised in previous training on the depth of chest compression during metronome-guided cardiopulmonary resuscitation: a randomised crossover trial. (BMJ Open, 2016)
- Nationwide survey of resuscitation education in Finland. (Resuscitation, 2009)