Introduction: Virtual Reality (VR) has advanced in medical education, offering enhanced realism and immersion, allowing students to safely practice complex and rare scenarios like cancer truth-telling. This study aimed to develop and evaluate the effectiveness of a VR-based cancer truth-telling module.

Methods: This experimental study randomly assigned fifth-year medical students to the following groups: in-person communication skills training (iCST), VR, and a combined iCST+VR group. The intervention included a 30-minute video-based mini-lecture followed by practical application. The VR group received the VR truth-telling module, the iCST group received the small-class iCST module, and the iCST +VR group received both the iCST and VR modules. Primary outcomes assessed were cancer truth-telling perspectives, with communication confidence and learning satisfaction as a secondary outcome. Data were collected at baseline, immediately after, and at three and six months post-intervention.

Results: Seventy-nine medical students were enrolled and randomly assigned to the iCST (n = 28), VR (n = 29) and iCST +VR (n = 22) groups. The study findings showed that the iCST+VR group significantly improved in cancer truth-telling perspectives at six months post-intervention. No significant difference was found between iCST and VR groups for cancer truth-telling perspectives. Although communication confidence scores significantly improved across all groups, no differences were found between groups. The iCST group reported higher learning satisfaction compared to other groups, with no significant difference between VR and iCST+VR.

Discussion: This study demonstrated that VR is as effective as iCST in enhancing cancer truth-telling perspectives and communication confidence, highlighting VR’s potential as an innovative tool in medical education.