Currently submitted to: JMIR Medical Education
Date Submitted: May 10, 2026
Open Peer Review Period: May 14, 2026 - Jul 9, 2026
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Psychological Effects of Virtual, Augmented, and Mixed Reality in Medical Education: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Background:
Extended reality (XR) technologies including virtual reality (VR), augmented reality (AR), and mixed reality (MR) are progressively evolving from peripheral innovations to essential elements of modern medical education. While their effectiveness in knowledge acquisition is well-documented, a significant gap remains regarding their impact on the psychological well-being and subjective experiences of health professions students. This systematic review and meta-analysis synthesize empirical evidence on the psychological effects of XR, specifically evaluating engagement, motivation, cognitive load, stress, and technology acceptance.
Methods:
Method: A comprehensive search of seven electronic databases (PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, CINAHL, and ERIC) was conducted in accordance with PRISMA 2020 guidelines. Of the 2,890 records identified, 84 studies were included in the narrative synthesis, with 42 meeting methodological homogeneity requirements for quantitative meta-analysis using a random-effects model.
Results:
Results:
Quantitative synthesis revealed significant positive impacts on student engagement (pooled SMD = 0.68, 95% CI: 0.54–0.82) and usability (SMD = 0.63, 95% CI: 0.49–0.77) across all XR modalities. XR interventions were associated with beneficial reductions in performance anxiety (SMD = -0.45, 95% CI: -0.65 to -0.25) and extraneous cognitive load (SMD = -0.53, 95% CI: -0.72 to -0.34). While VR showed the strongest effects for presence and immersion (SMD = 0.78), it also produced the highest incidence of cybersickness (28–42%) compared to AR (≤8%).
Conclusions:
Conclusion: XR technologies offer broad psychological benefits by enhancing immersion and motivation while simultaneously reducing cognitive load and emotional burdens. However, these benefits depend on the situation and the quality of the instructional design, hardware specifications, and learner expertise. The findings provide a strategic framework for educators to implement psychologically supportive immersive learning experiences, emphasizing that pedagogical planning must precede technology purchase.
Citation
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