Video Games Could Help Train Doctors, but the Evidence Remains Weak, Review Finds

The idea that surgeons and endoscopists might sharpen their skills with a game controller before picking up real instruments sounds like science fiction, but it is an increasingly serious question in medical education. Skills learned in the virtual world have repeatedly been shown to transfer to procedures such as laparoscopy and endoscopy, where precision, hand-eye coordination and visuospatial reasoning are paramount. A new systematic review from researchers at University of Galway and collaborating institutions, published in BMC Medical Education, has now taken stock of whether video games can be deliberately deployed as training interventions, rather than simply being correlated with better performance. The verdict is cautious: there are promising signals, but the evidence base is fragile and inconsistent.

The review, led by William Shanahan and colleagues including Glen A. Doherty, Laurence Egan and Eoin Slattery, set out to answer a deceptively simple question. If prior gaming experience is associated with procedural competence, can clinicians actually use video games to enhance that competence? The distinction matters. Observational studies comparing gamers with non-gamers cannot tell educators whether gaming is a cause of skill or merely a marker for individuals with certain aptitudes. Interventional studies, in which participants are assigned to play games and then measured on technical performance, provide a stronger test of the hypothesis.

To find that evidence, the team conducted a systematic search of four major databases: PubMed, Embase, CINAHL Plus and Scopus. They restricted the search to prospective studies that included a video game intervention and targeted procedural competency among healthcare professionals in training or in clinical service. This design choice is important, because it excluded cross-sectional surveys and focused instead on experiments that could, in principle, demonstrate cause and effect. The population was deliberately broad, spanning trainees and qualified practitioners across procedural specialties, which reflects the wide range of technical skills that medical education researchers have attempted to enhance through gaming.

The search identified one thousand five hundred and seventy-one records, from which nineteen studies ultimately met the inclusion criteria and entered the review. Critically, the authors did not simply pool every study they found. Using Cochrane’s RoB2 tool for randomised trials and the ROBINS-I V2 tool for non-randomised studies, they formally assessed the risk of bias in each piece of evidence. Studies judged to be at high or serious or critical risk of bias were excluded. This rigour is noteworthy in a field where small, exploratory experiments are common and methodological quality is often uneven, and it means the surviving nineteen studies represent the more trustworthy portion of the literature.

Because the included studies measured outcomes in such heterogeneous ways, a formal meta-analysis was not possible, and the researchers instead performed a narrative synthesis. This is a common but acknowledged limitation in medical education research: one study might score performance with the Objective Structured Assessment of Technical Skills, another with the Fundamentals of Laparoscopic Surgery programme, another with the Bronchoscopy Skills and Tasks Assessment Tool or the modified Structured Assessment of Microsurgery Skills. When the measuring sticks differ this much, combining results numerically risks producing a misleading single number, so the authors described the pattern of findings qualitatively instead.

Within that synthesis, two distinct approaches to using video games emerged. The first is task warm-up, in which clinicians play a game shortly before performing a procedure, on the theory that gaming primes the visuomotor circuits needed for the task, much as athletes warm up before competition. The second is non-procedural training, in which video games are used as a standalone educational tool to build underlying skills such as dexterity, spatial orientation or instrument navigation, without simulating the procedure itself. Both strategies rest on the same neuroscience rationale: the demands of certain games overlap with the cognitive and motor demands of keyhole surgery and endoscopy, from tracking moving targets to translating two-dimensional images into three-dimensional actions.

The findings from both approaches were favourable for selected outcomes, but the pattern across studies was inconsistent. Some experiments reported measurable gains after gaming interventions, while others found no meaningful difference, and the outcomes that improved in one setting did not always replicate in another. Importantly, the authors note that the observed effects were predominantly based on simulator outcomes rather than performance in real clinical procedures. That is a substantial caveat. A score on a virtual reality laparoscopic trainer is a useful proxy, but educators and patients ultimately care about whether training translates into safer and more effective care at the bedside or in the operating theatre.

The certainty of the evidence, formally graded using the GRADE criteria, Grading of Recommendations Assessment, Development and Evaluation, was rated very low for warm-up and low for non-procedural training. These ratings reflect not only inconsistency across studies but also the inherent limitations of the study designs, small sample sizes and surrogate endpoints that characterise this literature. In practical terms, very low certainty means that the true effect of a pre-procedure gaming session is likely to be substantially different from what current studies suggest, and future research could easily overturn present conclusions. For medical educators, this means video games cannot yet be recommended as a standard component of technical-skills curricula.

Nevertheless, the authors stop short of dismissing the approach altogether. Their conclusion is that video game interventions may have a role as a supplementary strategy in technical-skills training, positioned alongside established simulation tools rather than replacing them. The low cost, accessibility and engagement value of games make them an attractive adjunct, particularly in settings where access to high-fidelity simulators is limited. But the review makes clear that robust conclusions await further well-designed studies employing standardised outcome measures and clinically relevant endpoints, so that results from different research groups can finally be compared and, ideally, pooled.

What the review ultimately delivers is a map of where the field stands and where it must go. Two decades of research have established that gaming experience and procedural skill are connected, and a smaller body of interventional work now suggests that games can actively influence performance in some circumstances. Yet the medical education community still lacks the large, standardised, clinically anchored trials needed to turn that suggestion into practice. Until those trials arrive, the controller remains an intriguing experiment in the training room, not a fixture of the surgical curriculum, and clinicians hoping to warm up with a quick game before endoscopy should know that the science is still catching up with the enthusiasm.

Subject of Research: Use of video games as warm-up and non-procedural training interventions for technical skills in healthcare professionals

Article Title: Video games as warm-up and non-procedural training tools for technical skills in healthcare: a systematic review

Article References: Shanahan, W., Doherty, G. A., Egan, L., & Slattery, E. (2026). Video games as warm-up and non-procedural training tools for technical skills in healthcare: a systematic review. BMC Medical Education. https://doi.org/10.1186/s12909-026-10440-2

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10440-2

Keywords: video games, medical education, systematic review, surgical training, endoscopy, laparoscopy, warm-up, simulation, technical skills, GRADE, risk of bias, healthcare professionals