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Development and Validation of a Virtual Reality Circumcision Training Simulator: Simulator Sickness, User Experience, and Clinical Performance in Bali, Indonesia

IJCCS (Indonesian Journal of Computing and Cybernetics Systems) · Vol. 19 No. 4 (2025) · pp. 405–416

DOI
10.22146/ijccs.111664
ISSN
2460-7258, 1978-1520
Published
2025-10-31
Publisher
IndoCEISS in colaboration with Universitas Gadjah Mada, Indonesia.
Language
eng
License
creativecommons.org/licenses/by-sa/4.0

Abstract

Virtual Reality (VR) is increasingly integrated into medical education, yet its application in Indonesia remains limited. This study developed and validated a VR-based circumcision simulator to evaluate simulator sickness, user experience, and clinical performance. A mixed-methods, repeated-measures design was conducted with 74 participants (25 Novices, 24 Intermediates, 25 Experts). Participants engaged in three simulation modes (Autonomous, Guided, Haptic). Instruments included SSQ, FMS, VRNQ, UEQ-S, Checklist, and OSATS. Analyses employed repeated-measures ANOVA, nonparametric tests, and Spearman correlations. Simulator sickness was highest in Autonomous Mode. User experience scores improved with expertise, showing positive correlations with performance and negative correlations with sickness. Experts consistently outperformed other groups, and skill improvements were retained for up to one month. The VR circumcision simulator demonstrated strong construct validity and educational impact. Instructional modes effectively reduced sickness, while haptic integration enhanced spatial orientation. Future studies should incorporate physiological measures and assess real-world skill transfer.

Keywords

Collaboration network of the authors

4 authors · 6 co-authorship links

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  • Universitas Pendidikan Ganesha
  • Affiliation unknown
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Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://journal.ugm.ac.id/ijccs/oai, first harvested 26 Okt 2026, last seen 26 Okt 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Development and Validation of a Virtual Reality Circumcision Training Simulator: Simulator Sickness, User Experience, and Clinical Performance in Bali, Indonesia</dc:title>
	<dc:creator>Sindu, I Gede Partha</dc:creator>
	<dc:creator>Kertiasih, Ni Ketut</dc:creator>
	<dc:creator>Dinata, I Gede Surya</dc:creator>
	<dc:creator>Sugiartawan, Putu</dc:creator>
	<dc:subject xml:lang="en-US">Human-computer interaction (HCI); Medical Informatics</dc:subject>
	<dc:subject xml:lang="en-US">Virtual Reality; circumcision simulator; user experience; simulator sickness; clinical performance</dc:subject>
	<dc:description xml:lang="en-US">Virtual Reality (VR) is increasingly integrated into medical education, yet its application in Indonesia remains limited. This study developed and validated a VR-based circumcision simulator to evaluate simulator sickness, user experience, and clinical performance. A mixed-methods, repeated-measures design was conducted with 74 participants (25 Novices, 24 Intermediates, 25 Experts). Participants engaged in three simulation modes (Autonomous, Guided, Haptic). Instruments included SSQ, FMS, VRNQ, UEQ-S, Checklist, and OSATS. Analyses employed repeated-measures ANOVA, nonparametric tests, and Spearman correlations. Simulator sickness was highest in Autonomous Mode. User experience scores improved with expertise, showing positive correlations with performance and negative correlations with sickness. Experts consistently outperformed other groups, and skill improvements were retained for up to one month. The VR circumcision simulator demonstrated strong construct validity and educational impact. Instructional modes effectively reduced sickness, while haptic integration enhanced spatial orientation. Future studies should incorporate physiological measures and assess real-world skill transfer.</dc:description>
	<dc:publisher xml:lang="en-US">IndoCEISS in colaboration with Universitas Gadjah Mada, Indonesia.</dc:publisher>
	<dc:contributor xml:lang="en-US">Universitas Pendidikan Ganesha</dc:contributor>
	<dc:date>2025-10-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
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	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://journal.ugm.ac.id/ijccs/article/view/111664</dc:identifier>
	<dc:identifier>10.22146/ijccs.111664</dc:identifier>
	<dc:source xml:lang="en-US">IJCCS (Indonesian Journal of Computing and Cybernetics Systems); Vol 19, No 4 (2025): October; 405-416</dc:source>
	<dc:source>2460-7258</dc:source>
	<dc:source>1978-1520</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://journal.ugm.ac.id/ijccs/article/view/111664/42789</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 IJCCS (Indonesian Journal of Computing and Cybernetics Systems)</dc:rights>
	<dc:rights xml:lang="en-US">http://creativecommons.org/licenses/by-sa/4.0</dc:rights>
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