Exploring the Potential of Virtual Reality-Based Procedural Skill Training in Reducing Medical Errors: A Pilot Study

Procedural errors during 12-lead electrocardiography (ECG)particularly from incorrect electrode placement—can distort waveforms and contribute to diagnostic error. We evaluated a virtual-reality (VR) ECG training module that delivers standardized, feedback-rich practice and objective scoring. In a single-arm pre-post pilot at a medical college skills lab, second-year MBBS students$(\mathrm{N} = 30)$completed one guided VR session followed by an evaluation run. The primary outcome was total procedural error score in Evaluation Mode; secondary outcomes covered five domains (patient communication, preparation, lead placement, verification/patient safety, documentation). The platform scored swap errors (e.g., RA↔LA, V1↔V2) and positional misplacements exceeding a predefined geometric tolerance around anatomical targets (e.g., V1/V2 at the fourth intercostal space, V4 at fifth intercostal space mid-clavicular, V6 at mid-axillary). Analyses used Wilcoxon signed-rank tests with rank-based effect sizes$r=Z / \sqrt{N}$; domain inferences-controlled multiplicity (Bonferroni,$\boldsymbol{\alpha}_{\text{adj }}=\mathbf{0. 0 1}$). Total errors fell from$51.33 \pm 23.04$pre-VR to$18.08 \pm 18.68$post-VR$(Z=-4.36, \mathrm{p}< 0.001, \mathrm{r}=0.80$), a 64.8% reduction. Domain improvements remained significant after adjustment for lead placement, preparation, and communication$(r=0.68-0.71)$; verification/patient safety and documentation did not. No sessions were terminated; no adverse events were recorded. A baseline comparison showed no difference in pre-training errors by prior VR exposure (Mann-Whitney$Z=-1.48$,$p= 0.139$). Findings suggest that a brief VR session can substantially reduce ECG procedural errors, particularly for tolerance-based lead placement. Future randomized, blended-learning studies with bedside transfer (OSCE), retention, usability, simulator-sickness metrics, and cost-per-learner analyses are warranted.