There has been rapid advancement and diffusion of immersive virtual reality (IVR) technology in the last few years, prompted by the gaming and entertainment industries. Similarly, there has been increased experimentation with this technology in the surgical education space within the last 5 years.1 It is clear why there would be enthusiasm regarding the use of IVR in surgical education, given the major shifts in medical education, patient safety, and attending-level oversight which have moved healthcare procedural learning away from the traditional “see one, do one, teach one” approach to more simulation-based approaches.2 IVR provides an ideal simulation-based education solution for procedural training that is reproducible and can performed iteratively without the possibility of patient harm.3

The use of virtual reality (VR) in surgical simulation has been documented as early as 1993 by Richard Satava.4 VR simulation involved the display of environmental details and situations on computer screens wherein the user could interact with the environment using various types of input devices. Unfortunately, the high cost of VR simulators has been a detractor to their use since their inception.5 IVR differs from VR however in that it provides increased interactivity and enhanced fidelity compared to conventional VR at a lower cost using portable head-mounted displays (HMD) which project a 3-dimensional (3D) environment in a 360° immersive virtual scene and allow for real-time manipulation of virtual objects.

A recent systematic review by Mao et al.1 highlighted the use of IVR for technical skills acquisition in surgical education. However, there are many nontechnical skill IVR applications reported in the surgical literature that were not included in this review. To remedy this gap in knowledge, this systematic review examines the current literature on the effectiveness of IVR deployed in nontechnical skill applications. In this review we investigate this topic and try to answer the following research questions (RQ):

RQ1: How is IVR being utilized in nontechnical skill applications?

RQ2: What is the methodological quality of studies in nontechnical skill applications?

RQ3: What technologies are being utilized in nontechnical skill applications?

RQ4: What metrics are commonly reported regarding nontechnical skill applications?

RQ5: What are the findings of studies of nontechnical skill applications?