Published online Mar 16, 2026. doi: 10.4253/wjge.v18.i3.117820
Revised: January 5, 2026
Accepted: February 3, 2026
Published online: March 16, 2026
Processing time: 86 Days and 17 Hours
Traditional gastrointestinal endoscopy (GIE) apprenticeship training raises concerns regarding patient safety, prompting growing adoption of simulation-based training approaches. Virtual reality (VR) simulators provide a risk-free, learner-centered environment in which trainees can develop and refine endoscopic skills prior to clinical practice. Although VR-based training has been increasingly implemented worldwide, its efficacy relative to conventional training methods has yet to be conclusively established.
To evaluate the effectiveness and outcomes of VR-based training in GIE through a systematic review of interventional studies.
This systematic review followed PRISMA 2020 guidelines. PubMed, ScienceDirect, and Google Scholar were searched through June 2025 using Boolean combinations of terms related to VR, simulation, and GIE. Eligible studies were interventional trials evaluating VR-based training that reported changes in endoscopist competency. Procedures included esophagogastroduodenoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound.
VR-based training consistently improved trainee competency, procedural independence, and patient safety compared with baseline performance, with outcomes comparable to conventional training. In esophagogastroduodenoscopy, VR simulation significantly increased independent procedure completion rates (odds ratio: 65.7; 95% confidence interval: 20.1-214.4) and achieved similar procedure times to traditional training (10.5 minutes vs 12.4 minutes). In endoscopic retrograde cholangiopancreatography, VR effectively differentiated skill levels, with experts outperforming novices in key metrics such as papilla visualization and cannulation time (P < 0.05). Endoscopic ultrasound competency improved when VR was combined with clinical training (64.53 ± 4.91 vs 60.09 ± 5.49; P = 0.028). Colonoscopy studies reported higher pass rates and improved objective skill scores in VR-trained groups (100% vs 88.9% pass rate in proficiency-based VR training).
These findings support integrating VR simulation as an adjunct to conventional endoscopy training and un
Core Tip: This article synthesizes evidence from 30 interventional studies involving 901 clinicians to evaluate the efficacy of virtual reality (VR) training in gastrointestinal endoscopy. VR simulation improves trainee competency, procedural independence, and patient safety across key procedures, including esophagogastroduodenoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound. Performance gains with VR were comparable to those achieved with conventional training, supporting its role as an adjunct in endoscopic education. Heterogeneity in study design limited meta-analysis, underscoring the need for standardized VR training protocols and further research to assess long-term clinical outcomes.