Virtual Patient Simulations in Advanced Anesthesia Training Programs
Abstract
Virtual patient and virtual reality (VR) simulation have moved rapidly from novelty to established teaching tool within advanced anesthesia training programs, prompting a critical look at where the evidence actually supports their use. This review synthesizes recent randomized and comparative studies of virtual patient and VR simulation in anesthesia residency and fellowship training, spanning procedural and technical skill acquisition, crisis resource management and non-technical skills, and head-to-head comparisons against high-fidelity mannequin simulation. The evidence is strongest for discrete technical skills such as regional anesthesia, airway management, and neuraxial technique, where VR platforms show outcomes comparable to traditional instruction, while crisis resource management and team-based non-technical skills remain areas where mannequin-based simulation retains an advantage. Artificial-intelligence-driven virtual standardized patients are an emerging development that may reduce the cost and logistical burden of communication-focused training if early pilot findings are replicated at scale. We conclude that the current literature supports a curriculum-embedded blend of virtual and mannequin-based simulation rather than wholesale replacement of either modality, with virtual tools best suited to scalable technical and cognitive skill-building and physical simulation preserved for crisis scenarios that depend on presence and team communication.