The quality of evidence is downgraded by study limitations (methodological heterogeneity) and by indirectness.
A Cochrane review [Abstract] 1 included 18 trials (421 participants; 3817 endoscopic procedures). Ten trials compared VR training with no training, five trials with conventional endoscopy training, one trial with another form of endoscopy simulation training, and two trials compared two different methods of VR training.
Virtual reality endoscopy simulation training versus no training: There was insufficient evidence to determine the effect on composite score of competency (MD 3.10, 95% CI 0.16 to 6.36; 1 trial, 24 procedures).
Virtual reality endoscopy simulation training versus conventional patient-based training: Virtual reality training compared to conventional patient-based training resulted in fewer independent procedure completions (RR 0.45, 95% CI 0.27 to 0.74; 2 trials, 174 procedures). Virtual reality training in combination with conventional training appears to be advantageous over VR training alone.
SOF table http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008237.pub3/full#CD008237-sec1-0001
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