Authors: Cynthia Peng, MD, Kristen M. Ng, MD, Kelly N. Roszczynialski, MD, Steven J. Warrington, MD, Kimberly Schertzer, MD

Transvenous pacemaker insertion is a high-risk, low-frequency emergency procedure often constrained by the resource intensity of traditional mannequin training. To optimize instruction, researchers evaluated Rapid Cycle Deliberate Practice (RCDP), a model featuring immediate micro-debriefs and repeated trials, delivered via a custom SimX virtual reality (VR) simulation.

Sixteen emergency medicine residents completed pre-intervention checklist assessments on a physical task trainer, underwent the immersive VR RCDP module, and were re-assessed post-intervention. Post-test checklist scores showed statistically significant improvement over baseline (24.1±2.0 vs. 19.5±3.5, p<0.001), regardless of post-graduate year, gender, or prior VR experience. Furthermore, participants reported marked gains in procedural comfort and preparedness.

The authors concluded that VR-integrated RCDP is an effective, scalable modality for teaching complex procedural steps, offering high-yield individualized practice while reducing physical space, equipment, and faculty resource demands in residency training programs.