A multicenter evaluation of a multiplayer VR/AI platform for team-based training in maxillofacial oncologic surgery

Background: Major maxillofacial oncologic surgery requires not only advanced technical expertise but also effective perioperative coordination among multidisciplinary teams. Virtual reality (VR), especially when combined with artificial intelligence (AI), offers new opportunities for team-based surgical training. Methods: We developed a multiplayer VR platform with AI-driven procedural supervision (VR/AI Lembo) to simulate perioperative workflow in maxillofacial oncologic surgery. Usability was evaluated in a multicenter study involving 35 healthcare professionals (17 physicians, 18 nurses) from four Italian tertiary referral centers using the System Usability Scale (SUS). Results: Overall usability was high, with a mean SUS score of 81.0 ± 11.1, indicating excellent user acceptance. Most participants achieved scores ≥ 68 (88.6%) and ≥ 80 (62.9%). Nurses reported higher scores than physicians (84.9 ± 7.4 vs. 76.9 ± 12.8), although the difference was not statistically significant (p = 0.061). Conclusions: The VR/AI Lembo platform demonstrated high usability and acceptance in a multidisciplinary setting. Multiplayer VR combined with AI supervision may represent a promising tool for team-based perioperative training in complex maxillofacial surgery. Level of Evidence: Not gradable.