Dry lab advantage over virtual reality in robotic training uncertain in randomized studies

A systematic review and meta-analysis in Surgical Endoscopy compared virtual reality (VR) with physical simulation for robotic surgical training. Investigators included 10 controlled studies involving 333 trainees in the qualitative review, restricting quantitative pooling to six VR-versus-dry-lab studies with 168 participants. The primary outcome was post-training technical performance; task completion time was secondary.

Overall, technical performance favored dry lab training (standardized mean difference [SMD] −0.43; 95% CI −0.74 to −0.12). However, the randomized-trial subgroup, comprising 89 participants, showed no statistically significant difference (SMD −0.15; 95% CI −0.57 to 0.27). Fixed-time curricula favored dry lab training (SMD −0.51; 95% CI −0.96 to −0.05), whereas proficiency-based progression showed no significant difference. Task completion time was also similar between modalities.

The findings suggest that curriculum structure may matter when selecting simulation platforms, and both approaches may have complementary roles. The small pooled sample and lack of a significant advantage in randomized studies limit confidence in dry lab superiority. These results concern simulation performance rather than patient outcomes; evidence of skill transfer to real patients remains limited.