Authors: Vernier T et al.
Journal of Clinical Anesthesia, Volume 112, June 2026
This randomized controlled trial evaluated whether adding gamification elements to a virtual reality (VR) simulator improves training outcomes in ultrasound-guided regional anesthesia. Gamification—such as rewards, leaderboards, and performance feedback—is often promoted as a way to enhance learner engagement and retention, but evidence in medical education remains inconsistent.
Sixty novice learners were randomized to train on either a standard VR simulator or a gamified version that included star-based rewards, achievement milestones, peer leaderboards, and real-time feedback. Training occurred over two sessions with structured feedback. The primary outcome was improvement in expert-assessed performance using a Global Rating Scale. Secondary outcomes included error rates, objective simulator performance metrics, learning curve progression, cognitive workload (NASA Task Load Index), and participant-reported experience.
The study found no significant differences between the gamified and non-gamified groups across all primary and secondary outcomes. This included expert-rated performance, objective simulator metrics, error scores, and learning curve progression. Cognitive workload was also similar between groups. Despite this, a large majority of participants in both groups reported that VR simulation was beneficial for learning.
The findings suggest that while VR simulation itself is a valuable educational tool, the addition of gamification features does not enhance learning outcomes in this setting. The results challenge the assumption that gamification inherently improves performance and highlight the importance of evidence-based educational design.
Key Points
- Randomized trial comparing gamified vs standard VR training for regional anesthesia
- No improvement in performance, learning curves, or error rates with gamification
- Cognitive workload similar between groups
- High learner satisfaction with VR training overall
- Gamification did not add measurable educational value
What You Should Know
Virtual reality simulation is clearly effective for teaching procedural skills like ultrasound-guided regional anesthesia. However, adding gamification elements—such as leaderboards and rewards—does not appear to improve learning outcomes. For anesthesia programs, this suggests that investing in high-quality simulation matters more than layering on gaming features that may increase complexity without improving results.
Thank you to the Journal of Clinical Anesthesia for allowing us to summarize and share this article.