. 2020 May 7;4(2):215–223. doi: 10.1016/j.jseint.2020.02.005

Table II.

Recommendations for development and research pertaining to VR in surgical simulation and training

Development	Research
Focus on increased surgical simulator realism and immersion in VR Development of low-cost and accessible VR solutions Development of VR platforms that focus on multiple aspects of learning, including 1. task-specific modules, 2. tracking of user skills and improvement, and 3. cognitive simulation scenarios in determining errors and focus on surgical decision making with ability for user-generated updated and produced scenarios.	Validation of surgical simulators and VR constructs in face, content, construct, concurrent, and transfer validity Focus on well-designed, randomized controlled trials representing level of evidence 1a to move toward level of recommendation 1 by the EAES recommendations for surgical simulation Validation of cognitive simulation in immersive VR platforms Reliability and retention of surgical skill and training level using VR training Cost-effectiveness of VR using the Transfer Effectiveness Ratio

Development

Research

Focus on increased surgical simulator realism and immersion in VR
Development of low-cost and accessible VR solutions
Development of VR platforms that focus on multiple aspects of learning, including
1. task-specific modules,
2. tracking of user skills and improvement, and
3. cognitive simulation scenarios in determining errors and focus on surgical decision making with ability for user-generated updated and produced scenarios.

Validation of surgical simulators and VR constructs in face, content, construct, concurrent, and transfer validity
Focus on well-designed, randomized controlled trials representing level of evidence 1a to move toward level of recommendation 1 by the EAES recommendations for surgical simulation
Validation of cognitive simulation in immersive VR platforms
Reliability and retention of surgical skill and training level using VR training
Cost-effectiveness of VR using the Transfer Effectiveness Ratio

VR, virtual reality; EAES, European Association of Endoscopic Surgeons.