Background: As medical education evolves, innovative methods like virtual reality (VR) and 3D-printed mannequins are increasingly used to simulate high-stress medical scenarios realistically. This study investigates the effectiveness of VR and 3D-printed mannequins in replicating stress levels during pericardiocentesis training, comparing their impact on the emotional and physiological responses of learners. Methods: We enrolled 108 final-year medical students who were randomized to train with both VR and 3D-printed mannequins. Heart rate variability (HRV) analysis was employed to assess stress responses. Additionally, a secondary analysis examined the influence of demographic factors, lifestyle, medication use, and academic stress on these responses. Results: Both VR and traditional mannequin-based training methods proved equally effective in simulating the stress levels encountered in real medical procedures. Our findings indicate significant interactions between stress markers and demographic factors, which highlights the complex nature of stress responses in medical education and underscores the necessity for personalized training approaches. Conclusion: The study validates the use of VR as a viable alternative to traditional mannequins, capable of simulating the technical skills and emotional pressures of medical procedures such as pericardiocentesis. Incorporating VR into medical training programs may enhance learning outcomes and accessibility, particularly in settings constrained by resources.

The authors have declared no competing interest.

This study did not receive any funding

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Ethics Committee of HM Monteprincipe University Hospital gave ethical approval for this work

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The datasets used and/or analyzed during the current study are available in publicly available repositories.