Biometric analysis of induced stress and learning during the performance of pericardiocentesis in a virtual reality simulated scenario: a before and after study

Background The CoBaTrICE program (Competency Based Training Program in Intensive Care Medicine) has been instrumental in standardizing intensive care training across Europe. Among the various procedures taught, pericardiocentesis is notably challenging due to its high-risk nature. This study aims to compare the efficacy and stress levels induced by two simulation models for pericardiocentesis training: a traditional 3D-printed mannequin and a virtual reality (VR) model. Methods A pilot, before and after study was conducted with last-year medical students. Participants were trained using both a 3D-printed mannequin and a VR model. Learning outcomes were assessed using a questionnaire modeled after the Objective Structured Clinical Examination (OSCE). Stress levels were measured through Heart Rate Variability (HRV) analysis, supplemented by the Biosignal plux system for real-time biometric data collection. Results Thirty-six students participated, with no significant differences in learning outcomes between the two models, except in parameters requiring fine motor skills. Stress levels, as measured by HRV, showed no statistically significant differences between the two simulations models. Conclusion The study suggests that VR model is as effective as 3D printed for pericardiocentesis training. Take Home Message The study demonstrates that virtual reality (VR) and traditional 3D-printed mannequins are equally effective for training medical students in pericardiocentesis, with no significant difference in learning outcomes or induced stress levels. This suggests that VR could be a viable, resource-efficient alternative in intensive care medicine training, particularly for high-risk procedures. Tweet Study finds VR as effective as 3D mannequins for pericardiocentesis training in med students, offering equal learning and stress levels. #MedEd #VRinMedicine ### Competing Interest Statement The authors have declared that no competing interests exist. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The present study was approved by the HM Hospitales Drug Research Ethics Committee at the meeting of January 16, 2019, in minute no. 149, with favorable resolution 18.12.1339.GHM as accredited in the attached document. The participation of the students in the present study was voluntary, and the data were analyzed anonymously. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files