# Nationwide needs assessment on the potential use of virtual reality in teaching birth mechanics: perceptions of students and teaching professionals in midwifery and medicine in Germany

## TL;DR

This study explores the potential of using virtual reality to teach birth mechanics in midwifery and medical education in Germany, finding strong support and perceived need among students and professionals.

## Contribution

The study provides a nationwide needs assessment for VR in teaching birth mechanics, highlighting differences in perceptions between midwifery and medical professionals and students.

## Key findings

- 76.3% of respondents reported a high or very high need for VR in teaching birth mechanics.
- Midwifery teaching professionals had significantly more prior VR experience than medical ones.
- Commonly prioritized birth mechanics deviations included occiput posterior position and breech presentation.

## Abstract

A comprehensive understanding of birth mechanics is essential for safe and competent practice in obstetrics and midwifery. These dynamic, three-dimensional processes occur internally and are not directly observable, making them challenging to teach with traditional methods. Virtual Reality (VR) offers unique potential to visualize such complex, invisible mechanisms. This nationwide survey assessed the perceived need, curricular contexts, and preferred content for a high-fidelity VR application to teach birth mechanics in midwifery and medical education.

An anonymous, digital survey was distributed to all study programs in midwifery science and medicine in Germany via program coordinators, department heads, and teaching leads in obstetrics and gynecology. Separate questionnaires for students and teaching professionals included 17 items on demographics, prior VR experience, attitudes toward VR, curricular timing, relevant learning objectives, and prioritized birth mechanics deviations. Responses were collected using Likert scales and multiple-choice questions, with non-parametric group comparisons (Mann–Whitney U, Chi-square test) and Bonferroni correction.

A total of 1,249 complete responses were analyzed with 22.4% (n = 280) teaching professionals and 77.6% (n = 969) students; 65.7% (n = 821) medicine, 34.3% (n = 428) midwifery. Overall, 76.3% reported a high or very high need for VR, and 90.2% held a positive or rather positive attitude toward its use. Midwifery teaching professionals reported more prior VR experience (56.7%) than medical ones (12.7%). Midwifery students favored early integration, while medical students preferred later, clinically oriented phases. The most frequently prioritized deviations in birth mechanics were occiput posterior position (73.3%), breech presentation (51.4%), and direct occiput position with high station (44.0%), with notable differences between disciplines and educational roles.

This study reveals a strong perceived need for a VR application uniting anatomical accuracy with the dynamic processes of childbirth. Birth mechanics deviations were considered particularly suitable for simulation when they represent significant clinical challenges or are rarely demonstrated in current teaching. Tailored, interprofessional VR tools are perceived as potentially valuable for addressing these needs and may enhance obstetric and midwifery education. As part of the V.T.O.B.S. project (Virtual training for obstetric birth simulations), the next step will be the development and evaluation of such an application.

The study protocol was preregistered in the German Clinical Trials Register (DRKS00035186 27.09.2024).

The online version contains supplementary material available at 10.1186/s12909-025-08532-6.