# Using Virtual Reality Simulators to Enhance Laparoscopic Cholecystectomy Skills Learning
## 4 Discussion
It is possible that learning laparoscopic cholecystectomy skills using simulation is new and novel to both trainees; thus, the former learning experience might not impact the performance outcomes across studies. These results encourage the medical training community to use simulation regardless of learning experience when acquiring laparoscopic cholecystectomy skills. When comparing the performance outcomes from different VRT systems in the meta-analysis, LAP Mentor, LAP Sim, and MIST-VR are three commonly used systems among all selected studies. They all have positive training effects and help trainees to develop higher performance scores compared with controls [28; 30; 31; 34; 35]. This result indicates the comparable outcomes of using different VRT systems [28; 30; 31; 34; 35]. Regardless of which training system a simulation center determines to use, it is likely that a similar positive training effect could be warranted for trainees to learn laparoscopic cholecystectomy skills. VRT could offer different benefits for medical students and residents. VRT programs can be tailored to their respective learning stages and professional needs. For medical students, VR provides a safe and engaging space to acquire foundational knowledge and basic skills, offering exposure to diverse clinical scenarios, enhancing anatomical understanding, and reducing pre-clinical anxiety. This early exposure helps develop initial clinical reasoning skills [6; 13; 14]. In contrast, residents can utilize VR to refine advanced procedural skills, practice managing complex and critical cases, improve teamwork and communication, achieve mastery through repetition, and receive objective performance feedback, ultimately preparing them for independent practice within their specialties [1; 7; 8; 11; 28; 31; 34; 35; 36]. While both groups benefit from VR's immersive and risk-free nature, the emphasis shifts from foundational learning for students to advanced skill development and performance optimization for residents. Previous studies found that practicing on a computer simulation can effectively predict a surgeon's surgical skills [45]. This suggests that computer simulations can be a valuable tool for training surgeons, as they can provide a safe and controlled environment to practice and improve their skills before operating on real patients [45]. The current meta-analysis supports the benefit of using VRT to improve laparoscopic cholecystectomy skills performance. An additional training program that uses different teaching methods (like lectures, simulations, and hands-on practice) is effective for doctors in training. Surgical educators want to know if this training works well for people with different backgrounds and learning styles. By studying this, they can improve future training programs for future surgeons [48]. There are limitations to our study; only a group of VR-specific papers were included in the analysis (n = 23), although we contend that this reflects the literature. As a result of diversity in recorded outcomes and stringent criteria for entry into data synthesis, our meta-analysis is based on a small number of studies. Furthermore, we did not include studies from diverse surgical fields, which may limit the comparability of results. Subgroup analyses were only focused on different trainees and training systems and did not consider extended factors such as training duration, proficiency goals, or trainee experience. Few systematic reviews have examined the impact of surgical simulation training on patient outcomes. [PERSON] et al. reported \"small-moderate patient benefits\" from medical simulation training, but their analysis included a broader range of medical specialties and a wider definition of patient outcomes, including procedural success [47]. Although this study specifically examines the field of simulation, we believe that several of its findings have broader applicability.