Evaluation of advanced life support training through virtual reality: A cross-sectional observational study in a hypothermia and helicopter evacuation scenario.

To evaluate clinical performance and user perception after advanced life support training through immersive virtual reality (VR) simulation, focused on decision-making in a hypothermia scenario involving a helicopter evacuation. Cross-sectional observational study with an analytical component. Update Course on Ultrasound and Emergencies organized by the semFYC, held in Las Palmas de Gran Canaria from February 6 to 8, 2025. 101 healthcare professionals who fully completed the simulation experience and assessment questionnaires. Immersive VR clinical simulation using a 360° video recorded at a ski station, presented through Meta Quest 3® headsets. The scenario included 16 clinical decisions related to the management of a hypothermic patient during air transport. Percentage of correct clinical decisions, subjective perception (satisfaction, realism, confidence), and system usability assessed using the System Usability Scale (SUS). The mean score for correct decisions was 69.4% (SD = 15.2). Participants rated the experience very positively, highlighting realism (8.87/10), training usefulness (M > 4.7/5), and increased clinical confidence. The mean SUS score was 76.7, indicating "good" usability. A lower performance was identified in specific advanced hypothermia decision-making items. Immersive VR simulation proved to be a feasible, well-accepted, and useful strategy for training in clinical decision-making in complex, low-frequency scenarios. The results support its integration as a complementary tool in continuing emergency training programs.