Comparison of Virtual Reality and Mannequin-based Postpartum Hemorrhage Training: A Randomized Controlled Trial

Abstract

Introduction: Training that lacks psychological and emotional preparation for high-pressure emergencies can leave healthcare providers unprepared during actual cases. Virtual Reality (VR) offers immersive learning experiences that enhance preparedness and confidence in healthcare providers. To address this, the Gadjah Mada Virtual Reality on Obstetrics and Gynecology – postpartum hemorrhage case (GAMA VROG), a virtual reality-based training application, was developed. Its effectiveness compared to traditional mannequin-based training remains unclear. Objective: This study evaluates the effectiveness of VR-based training compared to traditional mannequin-based training on the learning experience, knowledge, perceived skills, and readiness level of practicing midwives. Methods: A non-blinded randomized controlled trial was conducted involving 90 practicing midwives. Participants were allocated to either a control group (mannequin-based training) or an intervention group (VR-based training). Both groups underwent face-to-face training on postpartum hemorrhage, followed by skill practice using their respective methods. Data were collected via pre- and post-training questionnaires, which assessed the learning experience, knowledge, perceived skills, and readiness. Statistical analyses included the Wilcoxon signed-rank test, the Mann-Whitney U test, and independent sample t-tests were conducted using SPSS version 25.00. Results and Discussion: Both the mannequin and VR groups showed significant improvement in knowledge (mannequin: 55.44 to 78.44, p = 0.000; VR: 50.67 to 76.78, p = 0.000). However, neither group demonstrated significant improvement in perceived skills (mannequin: 83.37 to 87.87, p = 0.060; VR: 86.60 to 89.94, p = 0.070). The VR group showed a within-group increase in readiness (83.54 to 88.81, p = 0.015), but this did not reach statistical significance after Bonferroni correction (p < 0.0029). In learning experience domains, VR significantly outperformed mannequins across all indicators: contextual (58.03 vs. 32.97, p = 0.000), enjoyable (54.17 vs. 36.83, p = 0.000), focused (53.40 vs. 37.60, p = 0.001), interactive (53.28 vs. 37.72, p = 0.001), and readiness (50.33 vs. 40.67, p = 0.044). Conclusion and Recommendations: VR-based training demonstrated clear benefits in enhancing knowledge and learner engagement, especially in providing an immersive experience. However, these advantages did not extend to improvements in perceived skills or readiness after statistical adjustment. These findings suggest that while VR can enrich the educational atmosphere, its integration should complement, not substitute for, hands-on simulation in midwifery training. © 2025 The Author(s). Published by Bentham Open..