Abstract
BACKGROUND: Virtual reality's (VR) use in medical education is increasing; however, traditional VR controllers lack real-world dexterity. A post-partum hemorrhage (PPH) is an obstetric emergency with significant maternal morbidity. The use of an intrauterine balloon reduces the need for further surgical interventions, but resident doctors might lack experience with balloon insertion. OBJECTIVES: This study evaluates whether a novel VR exoskeleton (VRE) improves medical students' and residents' uterine balloon insertion technique and learning experience compared to traditional didactic teaching. METHODS: In a parallel-group randomized controlled trial, clinical year medical students and residents were allocated to either: (i) a VRE group using an immersive VR tutorial with a haptic glove, or (ii) a control group receiving a standard slide-based tutorial. All participants were assessed on the intrauterine balloon insertion technique and times using a pelvic model. Secondary outcomes included PPH knowledge (multiple-choice questionnaire), confidence, side effects, and training acceptability. This trial was then compared to a previously published VR-only cohort. RESULTS: The VRE group showed slightly higher insertion technique scores and faster insertion times than the control group (P > 0.05). Both groups improved in confidence following training (P < 0.05), with no significant difference between arms. Participants in the VRE group reported higher satisfaction and felt more supported (P = 0.04). Exploratory comparison with the VR-only group suggested improved technique with the exoskeleton, although demographic differences limit direct comparisons. DISCUSSION: Virtual reality exoskeleton is a promising and well-accepted tool for teaching obstetric skills. While both groups improved with training, VRE participants reported higher satisfaction and demonstrated modest gains in technique, supporting further investigation in larger trials.