Want doctors to use VR simulation? Make it mandatory, accessible, educationally valuable, and enjoyable! [version 2; peer review: 2 approved]

Background Virtual reality (VR) simulation training is mandatory for postgraduate year 1–2 doctors at the author’s hospital trust. Despite this, a preceding quantitative study demonstrated uptake below required levels. While the educational value of VR simulation has been highlighted, little attention has been paid to participant utilisation in postgraduate curricula. With the increasing development and incorporation of VR-based clinical education, it is essential to understand the factors influencing how frequently postgraduate doctors utilise it so that its potential can be maximised. Methods A qualitative study design was employed. All 108 postgraduate year 1–2 doctors from the 2020-21 training year were invited for a semi-structured interview. Interviews continued until data saturation was reached in the form of informational redundancy. Reflexive thematic analysis was conducted. Results A total of 17 interviews were conducted. Four main themes that influenced participation in VR simulation were identified: (1) the mandatory nature encouraged participation but led to negative perceptions as a tick-box exercise; (2) there were multiple challenges to accessing the resource; (3) the scenarios were felt to have limited educational value; and (4) there was untapped potential in drawing benefits from VR as an enjoyable leisure activity. Conclusions Recommendations from these findings include: (1) VR simulation should be mandatory but with a degree of learner autonomy; (2) sessions should be integrated into doctors’ rotas as protected time; (3) more challenging scenarios ought to be created aligned with postgraduate courses, examinations, and specialty training, and (4) presented as a difficulty level system akin to gaming experiences.