This study aimed to assess whether individualized deliberate practice using a virtual reality (VR) simulator enhances surgical performance in the operating room (OR). Previous research has indicated that VR training improves technical skills, but this trial explored a tailored approach where the training tasks varied based on each trainee's proficiency. Sixteen novice surgical residents were randomly assigned to either a deliberate practice group or a conventional residency training group. After an initial assessment, the deliberate practice group received individualized training on the simulator, while both groups subsequently performed laparoscopic cholecystectomies in the OR.