From Simulation to Reality: The Evidence for VR in Clinical Education

Eight peer-reviewed studies on Virtual Medical Coaching simulations in radiography, radiation safety and midwifery, and what they mean for educators planning their programmes.

Why clinical education needs more than placements

Most healthcare programmes still prepare students through classroom teaching, physical simulation and clinical placement. Each has limits. Placements are scarce and every student sees a different mix of cases. Physical labs are expensive to staff and equip. And some skills are hard to practise safely at all: a radiography student cannot repeat an exposure on a real patient, and a nurse cannot see the scatter radiation they are standing in.

VR simulation offers repeatable, standardised practice with no risk to patients or staff. The question educators rightly ask is whether that practice transfers to clinical performance. The studies below were designed to answer it.

Radiography: better preparedness and clinical performance

Three studies have measured outcomes for students trained with X-ray Pro VR, VMC's radiography simulation.

Clinical preparedness after qualifying. Karimi and colleagues compared 80 newly qualified radiographers from two universities: 40 trained with VMC's VR and 40 with traditional simulation. The VR-trained group had significantly higher clinical preparedness scores (p < 0.001) and scored higher on confidence, adaptability, technical proficiency and problem-solving. They also outperformed in supervisor evaluations, radiograph quality and emergency performance.^[1]

Three years of hybrid teaching. Arroyo and Garcia followed a radiography programme for three years. Students taught with a hybrid of X-ray Pro VR and physical simulation had significantly higher post-test scores, practical exam scores, career readiness, internship performance, motivation and engagement than students who used physical simulation alone (P < .001).^[2]

Transfer to clinical practice. O'Connor and Rainford compared first-year students' clinical assessments before and after VR was introduced. The VR cohort (n = 98) had seven hours of practice in VMC's immersive VR suite; the control cohort (n = 93) had none. The VR cohort performed better on 20 of 22 assessment criteria, with significant gains in patient positioning, exposure factor selection and image appraisal. The authors describe it as the first study to examine whether VR learning translates into radiography clinical practice.^[3]

Radiation safety: lower measured staff dose

Radiation safety training is usually judged by quiz scores. These three trials went further and measured the radiation dose staff actually received, using dosimeters, before and after training. All three used a crossover design, so each group received both VR and traditional training in turn. VMC's radiation safety simulation is RadSafe VR.

• Scrub nurses, cardiac catheterisation labs (Romanenko et al., 2026). In a randomised crossover trial of 100 scrub nurses in Ukraine, with dosimeters at the eye, chest and pelvis over 18 months, RadSafe VR training produced significantly greater dose reductions than traditional training at all three sites (Cohen's d = −0.49, P < 0.0001). A significant carryover effect showed the benefit lasted after training.^[4]
• Cath lab and orthopaedic theatre staff (Mwangi and Tanaka, 2025). In a two-year randomised crossover trial of 39 medical professionals, RadSafe VR reduced radiation exposure significantly more than didactic training, with larger effects per hour of training. Satisfaction, engagement and confidence were also significantly higher after VR (p < 0.001).^[5]
• Interventional radiology nurses (Khamis et al., 2025). Across eight hospitals in Nigeria, 34 scrub nurses were randomised to VR (developed by Virtual Medical Coaching) or face-to-face training first. Eye dose fell by about 25% after VR training in the first group, against about 7% after traditional training in the second. When the second group then switched to VR, their eye dose fell by about 23%.^[6]

Midwifery: stronger skills, knowledge and confidence

Two studies have evaluated VMC's midwifery simulation, BirthWise VR, against established physical training methods.

Ghana (Baidoo and Adu, 2025). First-year midwifery students trained with BirthWise VR (n = 46) had significantly higher post-test and practical scores than the previous year's cohort, who trained on conventional task trainers (n = 42) (P < 0.0001). They also reported significantly higher satisfaction and confidence in clinical application.^[7]

VR compared with manikins (Mwangi and Njoroge, 2024). Over two academic years, 80 midwifery students were randomly assigned to VR simulation provided by VMC or to Laerdal manikin-based simulation. The VR group scored significantly higher after training on practical skills (77.57 vs 68.26), confidence (67.17 vs 56.97) and knowledge (77.58 vs 68.00), with p < 0.001 for all three. The authors concluded that VR is a valuable adjunct to manikin-based simulation.^[8]

The evidence at a glance

What this means for educators

• Use VR to build skills before placement. The radiography studies show gains in positioning, exposure selection and image appraisal: the skills students most need on their first day in a department.
• Measure radiation safety by dose, not just by test score. The radiation safety trials tracked dosimeter readings, which is the outcome that protects staff.
• Blend, don't replace. The strongest results came from VR used alongside physical simulation and clinical teaching.
• Read the limits. Several studies compared consecutive cohorts or were run at a single institution, and follow-up periods were often short. Larger multi-site studies with long-term follow-up are the next step for the field.

Frequently asked questions

Is there evidence that VR simulation improves radiography education?

Yes. Peer-reviewed studies of VMC's X-ray Pro VR found that VR-trained students and newly qualified radiographers outperformed traditionally trained peers in clinical preparedness, practical exams and clinical assessments of positioning, exposure selection and image appraisal.

Can VR radiation safety training reduce staff radiation dose?

Three crossover trials in cardiac catheterisation labs, orthopaedic theatres and interventional radiology found that VR training reduced dosimeter-measured staff dose more than traditional training. One reported an eye dose reduction of about 25% after VR training.

Does VR work for midwifery training?

Two studies found midwifery students trained with VMC's VR simulation scored significantly higher on practical skills, knowledge and confidence than students trained on conventional task trainers or manikins.

Does VR replace physical simulation or clinical placement?

No. The evidence supports VR as part of a blended programme. VR gives every student consistent, repeatable, risk-free practice, so that physical labs and clinical placements can be used for what only they can provide.

References

1. Karimi, H., Clarke, S., and Watson, E. (2025). Comparing clinical preparedness of newly qualified diagnostic radiographers trained with immersive virtual reality vs. traditional simulation: A mixed-methods study. Journal of Medical Radiation Sciences, 72(S2), S70 to S78.
2. Arroyo, S., and Garcia, A. (2025). Enhancing educational outcomes through hybrid simulation methods. Radiologic Technology, 96(4), 257 to 265.
3. O'Connor, M., and Rainford, L. (2023). The impact of 3D virtual reality radiography practice on student performance in clinical practice. Radiography, 29(1), 159 to 164.
4. Romanenko, T., Kovalenko, M., Kovalenko, O., Bondarenkp, O., and Melnyk, I. (2026). Virtual reality vs traditional training in radiation safety for scrub nurses: a crossover trial in cardiac catheterisation labs. Journal of Perioperative Care, 1(1), 1 to 8.
5. Mwangi, W., and Tanaka, Y. (2025). Comparative effectiveness of immersive virtual reality and traditional didactic training on radiation safety in medical professionals: A crossover study. Journal of Medical Radiation Sciences, 72(S2), S52 to S60.
6. Khamis, K. K., Bello, A. S., and Abdullahi, M. L. (2025). Assessing the impact of virtual reality training on radiation dose reduction among interventional radiology nurses: A multicenter crossover study. Journal of Radiology Nursing, 44(3), 300 to 305.
7. Baidoo, K., and Adu, C. (2025). Virtual reality training to enhance clinical competence and student engagement in Ghana. British Journal of Midwifery, 33(1), 6 to 12.
8. Mwangi, W., and Njoroge, N. (2024). Comparative effectiveness of immersive virtual reality and traditional manikin-based simulation in midwifery training: a cohort study across successive academic years. MIDIRS Midwifery Digest, 34(4), 290 to 295.