Accepted for/Published in: JMIR XR and Spatial Computing (JMXR)
Date Submitted: Sep 17, 2025
Date Accepted: Jul 6, 2026
Different Delivery Modalities of Virtual Reality Training in Emergency Medicine: A Systematic Review.
ABSTRACT
Background:
Simulation is a cornerstone of emergency medicine training, offering a safe environment to practice critical scenarios and learn from errors. Recently, VR (ie, virtual reality) has emerged as a promising alternative, providing immersive, reproducible, and accessible training compared to traditional high-fidelity simulation. However, despite the increasing use of VR for training in emergency medicine, the most effective VR delivery modalities remain unclear.
Objective:
In this paper we analyzed the effectiveness of different VR delivery modalities for emergency medicine training.
Methods:
A systematic review was conducted according to PRISMA guidelines across PUBMED/Medline, Scopus, Embase, and CINAHL (up to January 2025). Two independent reviewers selected studies based on predefined inclusion/exclusion criteria. Data extraction and risk of bias assessment were performed using the Joanna Briggs Institute’s Critical Appraisal Tools.
Results:
Of 3528 identified articles only 6 eventually met the inclusion/exclusion criteria. The VR modalities examined included: active use versus passive observation, varying exposure times, VR use with or without a manikin, machine-guided versus educator-guided VR use, VR software with/without elements of gamification and software with differing degrees of persuasive feedback. Outcome measures were heterogeneous. No clear advantage emerged for gamification, persuasive feedback intensity and training with an educator in metaverse. However, active engagement and closer timing of exposure to VR appeared to improve effectiveness.
Conclusions:
Despite growing interest in VR for emergency medicine training, few studies have rigorously compared different delivery methods. While data are limited and heterogeneous, active and timely VR exposure may offer benefits. Further high-quality research is needed to determine the most effective VR strategies for clinical education. Clinical Trial: The study protocol was registered in the international prospective registry of systematic reviews (PROSPERO), CRD42024507591.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.