Skip to main content
NCBI home page
Resuscitation Plus logoLink to Resuscitation Plus
. 2025 Mar 14;23:100927. doi: 10.1016/j.resplu.2025.100927

Extended reality technologies in adult basic life support education: A scoping review

Nino Fijačko a,b,⁎, Špela Metličar c, Boža Janžekovič d, Benjamin S Abella e, Vinay M Nadkarni f, Todd P Chang g, Robert Greif h,i
PMCID: PMC11999490  PMID: 40235926

Graphical abstract

graphic file with name ga1.jpg

Open in a new tab

Keywords: Extended reality, Immersive technology, Virtual reality, Augmented reality, Adult basic life support, Headsets, Software, Applications

Abstract

Aim

In recent years, virtual and augmented reality (VR/AR) technologies have gained increasing attention as innovative tools for education, including in the field of adult Basic Life Support (BLS). While existing reviews on this topic primarily focus on comparing VR/AR with other educational approaches, our research aimed to identify the VR/AR hardware and software applications assessed in published studies and their alignment with learning objectives in adult BLS education.

Methods

We conducted a scoping literature review using the Population, Exposure, and Outcome (PEO) framework to analyse publications from 2018 to 2024. The review focused on the impact of VR/AR (exposure) on affective, behavioral, and cognitive learning outcomes (outcome) in adult BLS education among laypersons, healthcare professionals, pre-licensure students, and duty-to-respond laypersons (population).

Results

From 1,282 database records and 54 alternative sources, 31 articles were selected for comprehensive analysis. Many of the studies (11/31; 36%) targeted pre-licensure students, such as nursing students, and laypersons (9/31; 20%), primarily high school students. Only one study focused on duty-to-respond laypersons (1/31; 3%). VR studies (24/31; 77%) were more common than AR studies (6/31; 19%), featuring a broad spectrum of ten VR headsets compared to just two types of AR headsets. Among the assessed software applications, twenty-one commercial programs were examined—sixteen designed for VR and five for AR. Most studies investigated affective outcomes (25/31; 81%), while behavioural outcomes were also commonly examined (22/31; 71%). In contrast, cognitive outcomes were explored in fewer studies (9/31; 29%).

Conclusion

Our review identified several challenges in existing studies, including variability in software and hardware, diverse learning outcomes, and accessibility issues with extended reality (XR) technology. To maximize its effectiveness, XR should be aligned with specific learning objectives rather than adopted for its novelty. Prioritizing educational efficacy ensures that XR enhances learning by addressing precise gaps, ultimately improving the understanding and retention of resuscitation skills among both laypersons and healthcare professionals.

Introduction

Retention of knowledge and skills following adult Basic Life Support (BLS) courses remains low.1 As a response, new immersive technologies have been applied in an attempt to make significant advancements in educational adult BLS courses.2 Extended reality or xReality,3 as a new umbrella term that encompasses Virtual Reality (VR), Augmented Reality (AR), Mixed Reality (MR), and any immersive technology4, 5, 6, 7 that merges the physical and digital worlds, is reshaping healthcare education.3, 8 Meta-analyses on the use of eXtended Reality (XR) as a treatment and teaching tool in healthcare have revealed significant heterogeneity,9, 10, 11 making it difficult to draw definitive conclusions. Additionally, the scoping review highlighted the diversity of healthcare-related XR applications, many of which are still in their early stages, making their learning potential uncertain.12 Previously published reviews13, 14, 15, 16, 17, 18 on the use of XR for teaching in basic or advanced life support for adults, children, or newborns have mainly concentrated on comparing VR/AR with other educational methods across diverse populations to achieve various outcomes. In contrast, our scoping review aims to map the landscape of VR and AR hardware and software applications evaluated in published studies, focusing on their potential to support diverse learning objectives in adult BLS education.

Methods

We conducted a scoping review following established methodological guidelines.19 The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used (Supplementary appendix 1)20 and the scoping review protocol has been registered with the Open Science Framework registries (https://doi.org/10.17605/OSF.IO/RJ9BA).

We used the population, exposure, and outcome (PEO) framework to outline the research objective. Our research question focused on the impact of using VR, AR, or both technologies (exposure) on affective, behavioral, and cognitive learning outcomes (outcome) in adult BLS education of laypersons, healthcare professionals, pre-licensure students, and duty-to-respond laypersons (population). Based on PEO framework our research question was: In adult BLS education, what is the impact of VR, AR, or both (exposure) on affective, behavioral, and cognitive learning outcomes (outcome) among laypersons, healthcare professionals, pre-licensure students, and duty-to-respond laypersons (population)?

Population: We categorized population groups as follows: Laypersons were defined as individuals without a healthcare degree (e.g., high school students), healthcare professionals as those with a healthcare degree (e.g., registered nurses or medical doctors), pre-licensure students as individuals currently pursuing a healthcare degree (e.g., nursing or medical students), and duty-to-respond laypersons as those without a healthcare degree but with a responsibility to respond in emergencies (e.g., firefighters or lifeguards)”.

Exposure: For identification of VR/AR studies we adhered the most widely cited definitions as our guiding reference: “VR is best described as a collection of technologies that allow people to interact efficiently with 3D computerised databases in real time using their natural senses and skills” and “AR is defined as systems that integrate real and virtual environments, are interactive in real time, and are registered in three dimensions””.21, 22 For the VR component, we established two key inclusion criteria. The first criterion was the incorporation of “six degrees of freedom,” a term that denotes the capacity for movement along six distinct axes in three-dimensional space, enabling full-range motion. The second criterion focused on the integration of specific design features.23 Based on these criteria we excluded studies related to VR with lower integration level design features (e.g., played with Google Cardboard or Samsung gear), serious games (e.g., played on smartphone or on a computer) or others virtual environment facility (e.g. interacting in Octave room or 360 degrees rooms). If information about VR/AR headsets or VR/AR software applications were not mentioned in the study, we contacted the corresponding author. Details regarding VR or VR headsets, such as whether they are standalone or PC-powered, year of release, and purchase price were sourced from the Vrcompare database.24

Outcomes: Our aim was to identify the learning outcomes associated with using VR or AR for teaching adult BLS. Learning outcomes were categorized into three domains: affective (e.g., increased adult BLS self-efficacy or confidence in performing CPR), behavioral (e.g., improved high quality chest compressions or using an AED), and cognitive (e.g., enhanced knowledge of adult BLS algorithms).25 Additionally, we excluded VR/AR studies that used XR technologies for educating in advanced life support for adults, children or neonates.

Timeframe: Eligible studies for inclusion were published after 2018 till September 2024. The reason for starting the search in 2018 was that in 2019 the standalone headset was launched by Facebook (now Meta, California, USA), a pivotal development that significantly enhanced user accessibility of VR headsets. The introduction of the even more affordable headsets set a new industry standard, prompting other companies such as PICO (now ByteDance Ltd.) and Hewlett-Packard Company, both from USA, or High Tech Computer (HTC) Corporation from Taiwan to release their standalone headsets.26

Study design: Eligible studies included randomized controlled trials, nonrandomized (controlled) studies, controlled before-and-after studies, cohort studies, case series, conference abstracts, letters to the editor and research letters. Publications in English, and Spanish were considered. Review articles were excluded.

A search strategy was developed by a subject librarian from University of Maribor Library (BJ) and the lead author (NF) following common search syntax for health sciences databases.27 A combination of subject headings and text words were used for each of the main two search concepts: “resuscitation”, and “extended reality”, which were combined using Boolean operators. The systematic search was carried out in the following databases: Cochrane Library (advanced search via cochranelibrary.com), PubMed (advanced search via National Institute of Health), Scopus (advanced search via scopus-com.ezproxy.lib.ukm.si), Medline and CINAHL (advanced search via EBSCOhost), Wiley Online Library (advanced search via Wiley Online Library), ERIC and CINAHL (advanced search via EBSCOhost), ScienceDirect (advanced search via sciencedirect-com.ezproxy.lib.ukm.si) and Google Scholar (advanced search via scholar.google.com) (Supplementary appendix 2). The final search results were exported into Rayyan Intelligent Systematic Review software (Qatar Computing Research Institute, Doha, Qatar), and duplicates were removed (NF). Two reviewers (NF, ŠM) examine separately the titles, abstracts, and full text of the records to identify VR/AR studies. Free text searches and reference manual tracking were also conducted to locate studies which used VR, AR, or both technologies.28 Conflict was resolved through discussion with a third reviewer (TG). The entire search process spanned several months, from March to September 2024. The database search was conducted between June 28, 2024, and July 3, 2024. Data import from database was completed by the end of July 2024, and the full screening process was finalized by the end of October 2024.

The final data extraction process, and synthesis of results were organized in a tabular and graphic format.29 Specifically, it included the surname of the author(s), publication year, country of origin, population (laypersons, healthcare professionals, pre-licensure students, and duty-to-respond laypersons), and reported outcomes (affective, behavioral, and cognitive) of VR/AR studies. Additionally, data on VR/AR technology were extracted, including VR/AR headsets, XR technology, VR/AR software, software availability, headset (names, release year, price, standalone functionality, accessibility), and the inclusion of manikins. These data are presented in Table 1, Table 2, Table 3 and illustrated in Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5. Data extraction was performed manually using Microsoft 365 Excel (Microsoft, Washington, USA), while data visualization was carried out using the free Sankeymatic tool (Sankeymatic, Florida, USA) alongside Microsoft 365 Word and Excel (Microsoft, Washington, USA). No formal critical appraisal or grading of individual sources was planned or carried out.

Table 1.

VR studies included in analyses.

VR studies Population Outcomes
Affective
learning outcomes 		Behavioral learning outcomes Cognitive learning outcomes
  • 1.

    Gent, et al., 2019,34 (US)

 Laypersons No Yes Yes
  • 2.

    Semeraro, et al., 2019a,37 (Italia)

 Pre-licensure students No Yes No
  • 3.

    Semeraro, et al., 2019b,38 (Italia)

 Laypersons and healthcare professionals Yes No No
  • 4.

    Bench, et al., 2019,48 (UK)

 Healthcare professionals Yes Yes No
  • 5.

    Leary, et al., 2019 (USA) 31

 Laypersons Yes Yes No
  • 6.

    Aksoy, et al., 2019,60 (Turkey)

 Not specifically mentioned No No Yes
  • 7.

    Buckler, et al., 2019,32 (US)

 Laypersons Yes No No
  • 8.

    Buttussi, et al., 2020,40 (Italia)

 Laypersons Yes Yes No
  • 9.

    Yigitbas, et al., 2020,45 (Germany)

 Not specifically mentioned Yes Yes No
  • 10.

    Jaskiewicz, et al., 2021,51 (Poland)

 Pre-licensure students Yes Yes No
  • 11.

    Liu, et al., 2021,52 (China)

 Pre-licensure students Yes Yes Yes
  • 12.

    Issleib, et al., 2021,46 (Germany)

 Pre-licensure students Yes Yes No
  • 13.

    Hubail, et al., 2022,49 (UK)

 Not specifically mentioned Yes Yes No
  • 14.

    Moll-Khosrawi, et al., 2022,47 (Germany)

 Pre-licensure students Yes Yes No
  • 15.

    Kim & Cho, 2023,59 (Korea)

 Duty-to-respond laypersons Yes Yes Yes
  • 16.

    Pedrosa, et al., 2023,42 (Spain)

 Laypersons and healthcare professionals Yes No Yes
  • 17.

    Chang, et al., 2023,53 (Taiwan)

 Pre-licensure students Yes Yes Yes
  • 18.

    Giacomini, et al., 2024,41 (Italia)

 Pre-licensure students No Yes Yes
  • 19.

    Bjelovucic, et al., 2023,54 (Denmark)

 Pre-licensure students Yes No No
  • 20.

    Castillo, et al., 2023,44 (Spain)

 Pre-licensure students No Yes Yes
  • 21.

    Arthur, et al., 2023,50 (UK)

 Pre-licensure students Yes No No
  • 22.

    Alcazar Artero, et al., 2024,43 (Spain)

 Laypersons No Yes No
  • 23.

    Min, et al., 2024,35 (US)

 Laypersons Yes No No
  • 24.

    Wiltvank, et al., 2024,58 (Netherlands)

 Laypersons and healthcare professionals Yes No No
Open in a new tab

VR = Virtual reality; UK = United Kingdom; US = United States.

Table 2.

AR studies included in analyses.

AR studies Population Outcomes
Affective
learning outcomes 		Behavioral learning outcomes Cognitive learning outcomes
  • 1.

    Strada, et al., 2019,36 (Italia)

 Pre-licensure students Yes Yes No
  • 2.

    Balian, et al., 2019,30 (US)

 Healthcare professionals Yes Yes No
  • 3.

    Ingrassia, et al., 2020,39 (Italia)

 Healthcare professionals Yes No No
  • 4.

    Yigitbas, et al., 2020,45 (Germany)

 Not specifically mentioned Yes Yes No
  • 5.

    Leary, et al., 2020,33 (US)

 Healthcare professionals Yes Yes No
  • 6.

    Hou, et al., 2022a,55 (China)

 Laypersons Yes Yes No
  • 7.

    Hou, et al., 2022b,56 (China)

 Laypersons Yes Yes No
  • 8.

    Sungur, et al., 2024,57 (Netherlands)

 Laypersons Yes Yes Yes
Open in a new tab

AR = Augmented reality; US = United States.

Table 3.

Headsets used in VR/AR studies.

Headsets name (company name, country) XR technology Release year Price Standalone Available
  • 1.

    Oculus Quest 2 (Meta, USA)

 VR 2020 300-400€ Yes Yes
  • 2.

    Oculus Quest (Meta, USA)

 VR 2019 400-500€ Yes No
  • 3.

    HTC Vive Cosmos (HTC Corporation, Taiwan)

 VR 2019 600-700€ No No
  • 4.

    HP Reverb G2 (HP, USA)

 VR 2020 500-600€ No Yes
  • 5.

    HTC VIVE Pro (HTC Corporation, Taiwan)

 VR 2018 500-600€ No No
  • 6.

    HTC VIVE Pro 2 (HTC Corporation, Taiwan)

 VR 2021 800-1400€ No Yes
  • 7.

    HTC VIVE (HTC Corporation, Taiwan)

 VR 2016 700-800€ No No
  • 8.

    HTC VIVE Focus 3 (HTC Corporation, Taiwan)

 VR 2021 1200-1300€ Yes Yes
  • 9.

    Pico Neo 3 Pro Eye (ByteDance Ltd., USA)

 VR 2021 700-800€ Yes Yes
  • 10.

    Valve Index (Valve Corporation, USA)

 VR 2019 500-1000€ No Yes
  • 11.

    Microsoft HoloLens (Microsoft Corporation, USA)

 AR 2016 3000€ Yes No
  • 12.

    Microsoft HoloLens 2 (Microsoft Corporation, USA)

 AR 2019 3500€ Yes Yes
Open in a new tab

Out of the VR/AR studies, twenty-two (70%) utilized manikins in teaching adult BLS,31, 35, 36, 40, 41, 51, 52, 44, 45, 46, 47, 48, 55, 56, 57, 58, 59 with Resusci Anne QCPR (Laerdal medical, Norway) being the predominant choice (8/22; 36%)30, 30, 32, 33, 40, 46, 47, 51, 58 (Fig. 5).

Fig. 1.

Fig. 1

Open in a new tab

PRISMA flow diagram.

Fig. 2.

Fig. 2

Open in a new tab

Learning outcomes and study populations in VR studies.

Fig. 3.

Fig. 3

Open in a new tab

Learning outcomes and study populations in AR studies.

Fig. 4.

Fig. 4

Open in a new tab

Sankey diagram with numbers of VR/AR studies, VR/AR headsets, XR technology, VR/AR software applications, VR/AR software applications availability.

Fig. 5.

Fig. 5

Open in a new tab

Manikins included in VR/AR software applications.

Results

A total of 1282 records were identified in the databases and 54 records on other websites. After removing duplicates, the 952 records from the databases were screened by title and abstract, leaving 53 records that met criteria for retrieval and screened for eligibility. Of them, 33 were excluded because of population inadequacy (n = 1), exposure inadequacy (n = 16), outcome inadequacy (n = 6), type of studies (n = 5) and authors did not respond to our request for additional data (n = 5). Twenty studies were included in the final review. Out of 54 records identified through websites and citation searches, 32 could not be retrieved. After assessing the remaining records for eligibility, 10 were excluded due to concept inadequacy (n = 9), and one was excluded because the authors did not provide the required data. The PRISMA flow diagram is presented in Fig. 1.

A total of 31 VR/AR studies were included. Most studies (six each) were from the United States30, 31, 32, 33, 34, 35 and Italy,36, 37, 38, 39, 40, 41 four were published in Spain,42, 42, 43, 44 and three in each − Germany45, 46, 47 and the United Kingdom.48, 49, 50 Eleven studies (36%) focused on pre-licensure students,33, 36, 37, 41, 44, 46, 46, 47, 50, 51, 52, 53, 54 nine (20%) targeted laypersons,31, 32, 34, 35, 40, 43, 55, 56, 57 four (20%) involved healthcare professionals,30, 33, 39, 48 and three (13%) included both laypersons and healthcare professionals.38, 42, 58 One study (3%) specifically addressed duty-to-respond laypersons,59 while three (10%) did not clearly specify the participant group.45, 49, 60 VR was the primary technology used, reported in 23 studies (77%),16, 31, 32, 34, 35, 37, 38, 44, 40, 41, 42, 46, 47, 48, 49, 50, 51, 52, 53, 54, 58, 59, 60 while AR was described in fewer studies, totalling seven (26%).30, 33, 36, 55, 56, 57 One (3%) study utilized both VR and AR technologies.45 In VR/AR studies affective learning outcomes (25/31; 81%)35, 36, 42, 30, 31, 32, 33, 38, 39, 40, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59 and behavioral (22/31; 71%)30, 31, 33, 34, 36, 37, 40, 41, 44, 45, 46, 47, 48, 49, 51, 52, 53, 55, 56, 57 received more emphasis than cognitive (9/31; 29%)34, 41, 42, 44, 52, 53, 57, 59, 60 (Table 1, Table 2).

Fig. 2 summarizes the distribution of VR studies in adult BLS education based on learning outcomes and target populations. Most studies focused on affective learning outcomes (n = 18),31, 32, 35, 38, 40, 42, 58, 46, 47, 48, 49, 50, 51, 52, 53, 54 primarily targeting pre-licensure students (n = 7)46, 47, 50, 51, 52, 53, 54 and laypersons (n = 4).31, 31, 35, 40 Behavioral learning outcomes (n = 16)31, 34, 37, 40, 41, 44, 45, 46, 47, 48, 49, 51, 52, 53 were widely studied across pre-licensure students (n = 9),38, 41, 43, 44, 46, 47, 51, 52, 53 laypersons (n = 4),31, 34, 40, 43 and healthcare professionals (n = 1),48 with some studies addressing both laypersons and healthcare professionals (n = 3).37, 42, 58 Cognitive learning outcomes (n = 8)34, 41, 42, 44, 52, 53, 59, 60 received less attention and were linked to pre-licensure students (n = 4),41, 44, 52, 53 duty-to-respond laypersons (n = 1),59 and unspecified populations (n = 1).60

Fig. 3 summarizes the distribution of AR studies in adult BLS education based on learning outcomes and target populations. Most studies focused on affective learning outcomes (n = 8),30, 33, 36, 39, 45, 55, 56, 57 primarily targeting laypersons (n = 3),55, 56, 57 and healthcare professionals (n = 3).30, 33, 39 Behavioral learning outcomes (n = 7),30, 33, 36, 45, 55, 56, 57 were evenly distributed across laypersons (n = 7),30, 33, 36, 45, 55, 56, 57 healthcare professionals (n = 2),30, 33 and pre-licensure students (n = 1).36 Only one study addressed cognitive learning outcomes, with minimal representation across populations.57

Fig. 4 shows that the VR/AR studies included 12 unique VR/AR headsets and 23 diverse VR/AR software applications to facilitate adult BLS training. VR headsets from HTC Corporation (n = 16)31, 32, 34, 35, 37, 38, 48, 49, 59, 41, 42, 51, 52, 53 were employed in most VR studies.

All AR studies used Microsoft HoloLens, with four studies employing version 130, 33, 36, 36 and another four using version 2.45, 55, 56, 57 Eleven VR/AR software applications were available for purchase, whereas ten were not. Thirteen VR/AR software applications were created by external companies, while the remainder were developed by the research groups themselves. The most frequently used VR software applications included VR-CPR (Studio Evil, Italy),37, 38, 41, 52 CPR Simulator (AATE VR, Denmark),43, 54 VIREED Basic Life Support (VIREED, Germany),46, 47 and CPR (Ludus global, Spain)42, 44 (each n = 2). In AR studies, CPReality (BrickSimple LLC, USA),30, 33 AR CPR App55, 56, and Holo-BLSD36, 39 emerged as the most utilized AR software applications (each n = 2). We contacted ten VR/AR study authors to get access to the data not included in the original publication (in Fig. 2 marked with asterisk).34, 37, 46, 47, 43, 44.

The VR/AR studies used headsets released between 2016 and 2021. Five of the twelve were no longer available for purchase, while seven require PC support. AR headsets, priced between 3000€ and 3500€, tend to be more expensive than VR headsets, which range from 100€ to 1400€ (Table 3).

Discussion

Our results highlight that many VR/AR studies concentrated on teaching adult BLS to pre-licensure students and laypersons, while a single study targeted duty-to-respond laypersons. VR was the predominant technology, utilized in most VR/AR studies, whereas AR was used only in a few. Additionally, we observe the considerable heterogeneity of XR technology described in published VR/AR studies, where PC-powered VR headsets were employed in most VR studies and standalone AR headsets were employed in most AR studies. Half of the VR/AR software applications were available for purchase, another half were developed by external companies, and the remaining software applications were created by the research groups themselves. Most VR/AR software applications utilized manikins to teach adult BLS. VR and AR technologies in adult BLS education primarily emphasize affective and behavioral learning outcomes rather than cognitive learning outcomes.

Similar our findings, other VR/AR reviews13, 14 have identified pre-licensure healthcare students, as the most commonly studied populations. This trend likely stems from their accessibility and their strong willingness to participate in research, combined with their intrinsic motivation to improve life-saving skills. However, future VR/AR studies could place greater emphasis on layperson populations, as they represent most potential bystanders in out-of-hospital emergencies. Laypersons often lack both the knowledge and confidence to perform adult BLS and could benefit most from innovative, accessible educational interventions. Laypersons, including schoolchildren, have garnered significant attention in VR/AR studies.34, 61 However, with the global population aging, future research could prioritize exploring the use of VR/AR technology for teaching adult BLS to older adults.62, 63, 64 Such studies could evaluate both the strengths and limitations of employing these technologies in this demographic, considering factors such as their potential for enhancing knowledge retention and skills acquisition, as well as challenges like technology accessibility and usability within an aging population.

In our review we note a shift away from PC-powered headsets, reflecting a broader trend in VR/AR research towards standalone headsets. This transition is propelled by rapid advancements in XR technology, leading to more portable and affordable headsets equipped with advanced features like full-body tracking and pass-through capabilities. Future software applications designed for resuscitation training could integrate actual manikins for adult BLS training, ensuring that learners receive immediate feedback and participate in debriefing sessions. To the best of our knowledge, only one VR software applications currently integrates with manikin hardware to achieve this functionality,35, 59, 65 while others have utilized accelerometers in headsets or controllers as an alternative approach. Such functionality could become more accessible if hardware from well-established (manikin) manufacturers were made open-source. This approach would not only broaden the availability of these technologies but also provide instructors and researchers with valuable data and insights to optimize educational outcomes. In 2017 Resuscitation Council UK developed Lifesaver VR software to raise cardiac arrest awareness among laypersons. This software now enables users to practice CPR on a pillow or manikin while receiving real-time feedback, making hands-on skill acquisition more accessible, even for those without access to formal training.66, 67, 68 Additionally, various DIY alternatives like toilet rolls can be used in place of a pillow.18, 69 For this type of CPR training, a smartphone paired with a simple VR headset, such as Google Cardboard or Samsung Gear, is sufficient and can be used in a home environment. However, it is important for users—particularly parents—to be aware of age restrictions for VR use, especially for young children, as prolonged exposure may impact their developing visual and neurological systems.70, 71 For adults, the most common drawback is cybersickness, which can cause dizziness, nausea, and disorientation, potentially affecting learning effectiveness and user comfort.72 Proper session duration and gradual adaptation to VR can help mitigate these issues.

A published review from 202413, 14, 15 on the use of VR for teaching adult BLS highlighted the methodological heterogeneity, a finding consistent with our study. Only a few VR/AR software applications were used across multiple studies. For instance, VR-CPR, developed in collaboration with the Italian Resuscitation Council,37, 38 was included in more studies than other applications.37, 38, 41, 52, 73 This may be due to the timing of its release, as it was developed before the widespread availability of standalone headsets, its public availability for purchase, or because the content was created in partnership with resuscitation experts, enhancing its credibility and adoption in the field.

Our review also presented that affective and behavioral learning outcomes were emphasized more frequently than cognitive outcomes. Researchers placed a stronger focus on how these technologies impact learners' emotions, attitudes, and motivation. Behavioral outcomes, which relate to the practical application of adult BLS skills, received slightly less attention, while cognitive outcomes, such as knowledge retention and understanding, were the least emphasized. Future research could prioritize behavioral and cognitive learning outcomes, as these have the potential to significantly transform educational practices when utilizing immersive technologies like VR and AR. By focusing on how these technologies affect skill development and knowledge retention, educators can better understand their true impact on learning and skill application. Shifting the emphasis toward these outcomes will not only provide a more comprehensive understanding of the effectiveness of immersive technologies but also facilitate the integration of Industry 4.0 technologies with Education 4.0.74, 75, 76, 77 Industry 4.0 technologies, which include advancements like the Internet of Things, artificial intelligence, XR and big data, are aligning with Education 4.0 principles to create more personalized, flexible, and interactive learning environments through digital transformation. This integration will help create an innovative, evidence-based approach to education, preparing learners for the evolving demands of the digital age, particularly in fields like healthcare and resuscitation.

Limitations

We identified a few key limitations in our study. Firstly, our review included only studies published in English. Expanding the scope to include studies in other languages, such as Chinese, where XR technologies are highly developed and more frequently integrated into everyday use, could provide valuable insights. Future reviews could benefit from involving a more diverse group of international authors or being conducted collaboratively by research teams within the International Liaison Committee on Resuscitation, ensuring broader representation and global perspectives. The second limitation is also related to our inclusion criteria. We excluded 360 degrees video-based VR studies66, 67, 68, 78, 79, 80, 81, 82 from our review of resuscitation education, despite their increasing prominence in both resuscitation training, and broader healthcare education.83, 84, 85 Additionally, we excluded VR studies86, 87, 88 that utilized Google Cardboard or Samsung Gear for teaching adult BLS. This decision was made to focus our analysis on a specific spectrum of VR technologies, leaving the exploration of these platforms for future research. Finally, we included 31 VR/AR studies in our analysis. However, the inclusion of additional studies89, 90 was limited by the lack of responses from authors to our email inquiries.

Conclusion

Our review identified several challenges in existing studies, including variability in software and hardware, diverse learning outcomes, and accessibility issues with XR technology. To maximize its effectiveness, XR should be aligned with specific learning objectives rather than used for its novelty. Prioritizing educational efficacy ensures XR enhances learning by addressing precise gaps, ultimately improving understanding and retention of resuscitation skills for both laypersons and healthcare professionals.

CRediT authorship contribution statement

Nino Fijačko: Writing – review & editing, Writing – original draft, Visualization, Supervision, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Špela Metličar: Writing – review & editing, Writing – original draft, Investigation, Formal analysis, Data curation. Boža Janžekovič: Writing – review & editing, Methodology. Benjamin S. Abella: Writing – review & editing, Writing – original draft, Methodology. Vinay M. Nadkarni: Writing – review & editing, Writing – original draft, Methodology. Todd P. Chang: Writing – review & editing, Writing – original draft, Methodology. Robert Greif: Writing – review & editing, Writing – original draft, Methodology.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nino Fijačko is a member of the European Resuscitation Council Basic Life Support Science and Education Committee. Robert Greif is ERC Director of Guidelines and ILCOR, and ILCOR Task Force chair for Education Implementation and Team. Vinay M Nadkarni is the past-board chair of the International Liaison Committee on Resuscitation (ILCOR) and, an emeritus member of the ILCOR Pediatric Task Force. Robert Greig is ERC Director of Guidelines and ILCOR, and ILCOR Task Force chair for Education Implementation and Team; and member of the editorial board of Resuscitation Plus. Other authors declare that they have no conflict of interest.

Acknowledgment

None.

Funding

Nino Fijačko is supported NextGenerationEU and MVZI (C3330-22-953012). Nino Fijačko is also supported by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education. Vinay Nadkarni has research grants to his institution from the National Institutes of Health, Agency for Healthcare Quality and Safety, Department of Defense, Zoll Medical, Laerdal Foundation, RQI Partners, Nihon Kohden Inc., and volunteers on the Society of Critical Care Medicine Council, Society of Simulation in Healthcare Board of Directors, and Citizen CPR Foundation Board of Directors. Benjamin S Abella receives grant funding from NIH, Avive, and Becton Dickinson, serves as a consultant or receives honoraria from Becton Dickinson, Stryker, and Neuroptics, and holds equity in Neuroptics and MDAlly. Other authors declare that they have no conflict of interest.

Footnotes

Appendix A

Supplementary data to this article can be found online at https://doi.org/10.1016/j.resplu.2025.100927.

Appendix A. Supplementary material

The following are the Supplementary data to this article:

Supplementary Data 1
mmc1.pdf (499.1KB, pdf)
Supplementary Data 2
mmc2.docx (19KB, docx)

References

  • 1.González-Salvado V., et al. Training adult laypeople in basic life support. a systematic review. Revista Española De Cardiología (English Edition) 2020;73:53–68. doi: 10.1016/j.rec.2018.11.013. [DOI] [PubMed] [Google Scholar]
  • 2.Greif R., et al. European resuscitation council guidelines 2021: education for resuscitation. Resuscitation. 2021;161:388–407. doi: 10.1016/j.resuscitation.2021.02.016. [DOI] [PubMed] [Google Scholar]
  • 3.Rauschnabel P.A., Felix R., Hinsch C., Shahab H., Alt F. What is XR? towards a framework for augmented and virtual reality. Comput Hum Behav. 2022;133 [Google Scholar]
  • 4.Fijačko N., Štiglic G., Gsaxner C., Chang T.P., Greif R. Rethinking realities: a call for accurate terminology in eXtended Reality studies. Resusc Plus. 2024;17 doi: 10.1016/j.resplu.2024.100558. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Fidalgo C.G., et al. A survey on remote assistance and training in mixed reality environments. IEEE Trans Vis Comput Graph. 2023;29:2291–2303. doi: 10.1109/TVCG.2023.3247081. [DOI] [PubMed] [Google Scholar]
  • 6.Egger J., Gsaxner C., Kleesiek J., Puladi B. What is diminished virtuality? a directional and layer-based taxonomy for the reality-virtuality continuum. JMIR XR and Spatial Computing (JMXR) 2024;1 [Google Scholar]
  • 7.Neges M., Adwernat S., Abramovici M. Augmented virtuality for maintenance training simulation under various stress conditions. Procedia Manuf. 2018;19:171–178. [Google Scholar]
  • 8.Tang Y.M., Chau K.Y., Kwok A.P.K., Zhu T., Ma X. A systematic review of immersive technology applications for medical practice and education - Trends, application areas, recipients, teaching contents, evaluation methods, and performance. Educ Res Rev. 2022;35 [Google Scholar]
  • 9.Kim H.-Y., Kim E.-Y. Effects of medical education program using virtual reality: a systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20:3895. doi: 10.3390/ijerph20053895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Antonovics E., Boitsios G., Saliba T. Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses. Clin Exp Pediatr. 2024;67:274–282. doi: 10.3345/cep.2023.00388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Kanschik D., Bruno R.R., Wolff G., Kelm M., Jung C. Virtual and augmented reality in intensive care medicine: a systematic review. Ann Intensive Care. 2023;13:81. doi: 10.1186/s13613-023-01176-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Helou S., Khalil N., Daou M., El Helou E. Virtual reality for healthcare: a scoping review of commercially available applications for head-mounted displays. Digital Health. 2023;9 doi: 10.1177/20552076231178619. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Cheng A., et al. Use of augmented and virtual reality in resuscitation training: a systematic review. Resuscitation Plus. 2024;18 doi: 10.1016/j.resplu.2024.100643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Sun R., et al. Effectiveness of virtual and augmented reality for cardiopulmonary resuscitation training: a systematic review and meta-analysis. BMC Med Educ. 2024;24:730. doi: 10.1186/s12909-024-05720-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Trevi R., Chiappinotto S., Palese A., Galazzi A. Virtual reality for cardiopulmonary resuscitation healthcare professionals training: a systematic review. J Med Syst. 2024;48:50. doi: 10.1007/s10916-024-02063-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Alcázar Artero P.M., et al. Efficiency of virtual reality for cardiopulmonary resuscitation training of adult laypersons: a systematic review. Medicine (Baltimore) 2023;102 doi: 10.1097/MD.0000000000032736. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Kuyt K., Park S.-H., Chang T.P., Jung T., MacKinnon R. The use of virtual reality and augmented reality to enhance cardio-pulmonary resuscitation: a scoping review. Adv Simul. 2021;6:11. doi: 10.1186/s41077-021-00158-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Dubreucq E., Barlocco De La Vega S., Bouaoud J., Philippon A.-L., Thiebaud P.-C. Impact of virtual, augmented or mixed reality in basic life support training: a scoping review. Clin Simul Nurs. 2025;99 [Google Scholar]
  • 19.Levac D., Colquhoun H., O’Brien K.K. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. doi: 10.1186/1748-5908-5-69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Tricco A.C., et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169:467–473. doi: 10.7326/M18-0850. [DOI] [PubMed] [Google Scholar]
  • 21.Azuma, R. T. A Survey of Augmented Reality.
  • 22.Mccloy R., Stone R. Virtual reality in surgery. BMJ. 2001;323:912–915. doi: 10.1136/bmj.323.7318.912. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Won M., et al. Diverse approaches to learning with immersive Virtual Reality identified from a systematic review. Comput Educ. 2023;195 [Google Scholar]
  • 24.VRcompare - The Internet’s Largest VR & AR Headset Database. VRcomparehttps://vr-compare.com/.
  • 25.Vlachopoulos D., Makri A. The effect of games and simulations on higher education: a systematic literature review. Int J Educ Technol High Educ. 2017;14:22. [Google Scholar]
  • 26.Brůža V. Education in Collaborative Immersive Virtual Reality. (Masaryk University, Faculty of Informatics, 2022).
  • 27.Library J.W.S.H.S. Searching syntax guide for common database platforms. ERA. 2015 doi: 10.7939/R3154DV6G. https://era.library.ualberta.ca/items/95890b83-aa90-4a6d-85c8-7011901432a4 [DOI] [Google Scholar]
  • 28.Greenhalgh T., Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005;331:1064–1065. doi: 10.1136/bmj.38636.593461.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Gupta A., et al. How to write a scoping review? – A comprehensive guide. Endodontology. 2023;35:9. [Google Scholar]
  • 30.Balian S., McGovern S.K., Abella B.S., Blewer A.L., Leary M. Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers. Heliyon. 2019;5 doi: 10.1016/j.heliyon.2019.e02205. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Leary M., et al. Using an immersive virtual reality system to assess lay provider response to an unannounced simulated sudden cardiac arrest in the out-of-hospital setting. Simul Healthc. 2019;14:82. doi: 10.1097/SIH.0000000000000338. [DOI] [PubMed] [Google Scholar]
  • 32.Buckler D.G., et al. Observing the stages of bystander intervention in virtual reality simulation. World J Emerg Med. 2019;10:145. doi: 10.5847/wjem.j.1920-8642.2019.03.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Leary M., McGovern S.K., Balian S., Abella B.S., Blewer A.L. A pilot study of CPR quality comparing an augmented reality application vs. a standard audio-visual feedback manikin. Front Digital Health. 2020;2 doi: 10.3389/fdgth.2020.00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Gent L., Sarno D., Coppock K., Axelrod D.M. Abstract 396: successful virtual reality cardiopulmonary resuscitation training in schools: digitally linking a physical manikin to a virtual lifesaving scenario. Circulation. 2019;140:A396–A. [Google Scholar]
  • 35.Min H.J., et al. Virtual reality for basic life support training in high school students: thematic analysis of focus group interviews. JMIR XR and Spatial Computing (JMXR) 2024;1 [Google Scholar]
  • 36.Strada F., Bottino A., Lamberti F., Mormando G., Ingrassia P.L. Holo-BLSD – A holographic tool for self-training and self-evaluation of emergency response skills. IEEE Trans Emerg Top Comput. 2019:1. [Google Scholar]
  • 37.Semeraro F., et al. Virtual reality cardiopulmonary resuscitation (CPR): Comparison with a standard CPR training mannequin. Resuscitation. 2019;135:234–235. doi: 10.1016/j.resuscitation.2018.12.016. [DOI] [PubMed] [Google Scholar]
  • 38.Semeraro F., et al. Back to reality: a new blended pilot course of basic life support with virtual reality. Resuscitation. 2019;138:18–19. doi: 10.1016/j.resuscitation.2019.02.034. [DOI] [PubMed] [Google Scholar]
  • 39.Ingrassia P.L., et al. Augmented reality learning environment for basic life support and defibrillation training: usability study. J Med Internet Res. 2020;22 doi: 10.2196/14910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Buttussi F., Chittaro L., Valent F. A virtual reality methodology for cardiopulmonary resuscitation training with and without a physical mannequin. J Biomed Inform. 2020;111 doi: 10.1016/j.jbi.2020.103590. [DOI] [PubMed] [Google Scholar]
  • 41.Giacomini F., Querci L., Samolsky Dekel B.G. Mixed reality versus mass or self-directed training for adolescents’ basic life support instruction: a prospective, randomized pilot study. Open Anesthesia J. 2023;17 [Google Scholar]
  • 42.Figols Pedrosa M., Barra Perez A., Vidal-Alaball J., Miro-Catalina Q., Forcada Arcarons A. Use of virtual reality compared to the role-playing methodology in basic life support training: a two-arm pilot community-based randomised trial. BMC Med Educ. 2023;23:50. doi: 10.1186/s12909-023-04029-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Alcázar Artero P.M., et al. Teaching cardiopulmonary resuscitation using virtual reality: a randomized study. Australasian Emergency Care. 2024;27:57–62. doi: 10.1016/j.auec.2023.08.002. [DOI] [PubMed] [Google Scholar]
  • 44.Castillo J., et al. Efficacy of virtual reality simulation in teaching basic life support and its retention at 6 months. Int J Environ Res Public Health. 2023;20:4095. doi: 10.3390/ijerph20054095. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Yigitbas, E., Krois, S., Renzelmann, T. & Engels, G. Technical Report: Comparative Evaluation of AR-based, VR-based, and Traditional Basic Life Support Training. Preprint at 10.48550/arXiv.2207.03306 (2022). [DOI]
  • 46.Issleib M., Kromer A., Pinnschmidt H.O., Süss-Havemann C., Kubitz J.C. Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students: a randomized controlled trial. Scand J Trauma Resusc Emerg Med. 2021;29:27. doi: 10.1186/s13049-021-00836-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Moll-Khosrawi P., Falb A., Pinnschmidt H., Zöllner C., Issleib M. Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students during COVID-19 pandemic: a randomised controlled trial. BMC Med Educ. 2022;22:483. doi: 10.1186/s12909-022-03533-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Bench S., Winter C., Francis G. Use of a virtual reality device for basic life support training: prototype testing and an exploration of users’ views and experience. Simulat Healthcare: J Society Simulat Healthcare. 2019;14:1. doi: 10.1097/SIH.0000000000000387. [DOI] [PubMed] [Google Scholar]
  • 49.Hubail D., Mondal A., Al Jabir A., Patel B. Comparison of a virtual reality compression-only Cardiopulmonary Resuscitation (CPR) course to the traditional course with content validation of the VR course – A randomized control pilot study. Ann Med Surg. 2022;73 doi: 10.1016/j.amsu.2022.103241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Arthur T., et al. Examining the validity and fidelity of a virtual reality simulator for basic life support training. BMC Digital Health. 2023;1:16. [Google Scholar]
  • 51.Jaskiewicz F., Kowalewski D., Starosta K., Cierniak M., Timler D. Chest compressions quality during sudden cardiac arrest scenario performed in virtual reality: A crossover study in a training environment. Medicine. 2020;99 doi: 10.1097/MD.0000000000023374. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52.Liu Q., Tang Q., Wang Y. The effects of pretraining intervention in immersive embodied virtual reality cardiopulmonary resuscitation training. Behav Inform Technol. 2021;40:1265–1277. [Google Scholar]
  • 53.Chang Y.-T., et al. Effects of different cardiopulmonary resuscitation education interventions among university students: a randomized controlled trial. PLoS One. 2023;18 doi: 10.1371/journal.pone.0283099. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 54.Bjelovucic R., Bak J., Wolff J., Taneja P. Dental students’ attitudes on cardiopulmonary resuscitation training via virtual reality: an exploratory study. Br Dent J. 2023;235:607–612. doi: 10.1038/s41415-023-6388-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55.Hou L., et al. Comparison of augmented reality-assisted and instructor-assisted cardiopulmonary resuscitation: a simulated randomized controlled pilot trial. Clin Simul Nurs. 2022;68:9–18. doi: 10.1016/j.ecns.2022.04.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Hou L., et al. Effectiveness of a novel augmented reality cardiopulmonary resuscitation self-training environment for laypeople in China: a randomized controlled trial. Int Nurs Res. 2022;1:43. [Google Scholar]
  • 57.Sungur H., van Berlo Z.M.C., Lüwa L.M. Enhancing cardiopulmonary resuscitation training with mixed reality: improving cardiopulmonary resuscitation performance and enjoyment. Cyberpsychol Behav Soc Netw. 2024 doi: 10.1089/cyber.2023.0411. [DOI] [PubMed] [Google Scholar]
  • 58.Wiltvank I.L., Besselaar L.M., van Goor H., Tan E.C.T.H. Redesign of a virtual reality basic life support module for medical training – a feasibility study. BMC Emerg Med. 2024;24:176. doi: 10.1186/s12873-024-01092-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 59.Kim E.-A., Cho K.-J. Comparing the effectiveness of two new CPR training methods in Korea: medical virtual reality simulation and flipped learning. Iran J Public Health. 2023;52:1428–1438. doi: 10.18502/ijph.v52i7.13244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 60.Aksoy E., et al. Performance monitoring via functional near infrared spectroscopy for virtual reality based basic life support training. Front Neurosci. 2019;13 doi: 10.3389/fnins.2019.01336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61.Schroeder D.C., et al. KIDS SAVE LIVES: Basic life support education for schoolchildren: a narrative review and scientific statement from the international liaison committee on resuscitation. Circulation. 2023;147:1854–1868. doi: 10.1161/CIR.0000000000001128. [DOI] [PubMed] [Google Scholar]
  • 62.Dolenc E., Kolšek M., Slabe D., Eržen I. Tailoring first aid courses to older adults participants. Health Educ Behav. 2022;49:697. doi: 10.1177/10901981211026531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 63.Dolenc Šparovec E., Slabe D., Eržen I., Kovačič U. Evaluation of a newly developed first aid training programme adapted for older people. BMC Emerg Med. 2023;23:134. doi: 10.1186/s12873-023-00907-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 64.Xiong J., et al. Abstract Su1103: resuscitation reality: a review on current CPR training for older adults. Circulation. 2024;150 [Google Scholar]
  • 65.Lee D.K., et al. Development of an extended reality simulator for basic life support training. IEEE J Translat Eng Health Med. 2022;10:1–7. doi: 10.1109/JTEHM.2022.3152365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Nas J., et al. Rationale and design of the Lowlands Saves Lives trial: a randomised trial to compare CPR quality and long-term attitude towards CPR performance between face-to-face and virtual reality training with the Lifesaver VR app. BMJ Open. 2019;9 doi: 10.1136/bmjopen-2019-033648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 67.Nas J., et al. Optimal combination of chest compression depth and rate in virtual reality resuscitation training: a post hoc analysis of the randomized lowlands saves lives trial. J Am Heart Assoc. 2021;10:1–6. doi: 10.1161/JAHA.120.017367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Nas J., et al. Long-term effect of face-to-face vs virtual reality cardiopulmonary resuscitation (CPR) training on willingness to perform CPR, retention of knowledge, and dissemination of CPR awareness: a secondary analysis of a randomized clinical trial. JAMA Netw Open. 2022;5 doi: 10.1001/jamanetworkopen.2022.12964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.van Duijn T., Sabrah N.Y.A., Pellegrino J. Do-it-yourself devices for training CPR in laypeople: a scoping review. Int J First Aid Ed. 2024;7 [Google Scholar]
  • 70.Kaimara P., Oikonomou A., Deliyannis I. Could virtual reality applications pose real risks to children and adolescents? a systematic review of ethical issues and concerns. Virtual Reality. 2022;26:697–735. doi: 10.1007/s10055-021-00563-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71.Yoon H.J., Moon H.S., Sung M.S., Park S.W., Heo H. Effects of prolonged use of virtual reality smartphone-based head-mounted display on visual parameters: a randomised controlled trial. Sci Rep. 2021;11:15382. doi: 10.1038/s41598-021-94680-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 72.Chang E., Billinghurst M., Yoo B. Brain activity during cybersickness: a scoping review. Virtual Reality. 2023;27:2073–2097. doi: 10.1007/s10055-023-00795-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 73.Tang Q., Liu Q., Liu Z., Jiang S. Virtual reality or video-based self-instruction: comparing the learning outcomes of cardiopulmonary resuscitation training. Becтник Южнo-Уpaльcкoгo Гocyдapcтвeннoгo Yнивepcитeтa. Cepия: Oбpaзoвaниe. Пeдaгoгичecкиe Нayки. 2021;13:53–62. [Google Scholar]
  • 74.Napoleon D., Ramanujam V. Industry 4.0 Technologies for Education. Auerbach Publications; 2022. Education 4.0: curriculum development for the educational framework. [Google Scholar]
  • 75.González-Pérez L.I., Ramírez-Montoya M.S. Components of education 4.0 in 21st century skills frameworks: systematic review. Sustainability. 2022;14:1493. [Google Scholar]
  • 76.Lampropoulos G., Kinshuk Virtual reality and gamification in education: a systematic review. Edu Tech Res Dev. 2024;72:1691–1785. [Google Scholar]
  • 77.Wei Z., Yuan M. Research on the current situation and future development trend of immersive virtual reality in the field of education. Sustainability. 2023;15:7531. [Google Scholar]
  • 78.Barsom E.Z., et al. Cardiopulmonary resuscitation training for high school students using an immersive 360-degree virtual reality environment. Br J Educ Technol. 2020;51:2050–2062. [Google Scholar]
  • 79.Fijačko N., Creber R.M., Metličar Š., Dokl I., Chang T.P. Usability study of using interactive 360° video-based virtual reality for teaching adult basic life support. Resuscitation. 2023;191 doi: 10.1016/j.resuscitation.2023.109960. [DOI] [PubMed] [Google Scholar]
  • 80.Tachejian S., Moussa A. 360-degree virtual reality video to teach neonatal resuscitation: an exploratory development study. Sci Rep. 2024;14:14383. doi: 10.1038/s41598-024-65299-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 81.Gazzelloni A., et al. In: Methodologies and Intelligent Systems for Technology Enhanced Learning, Workshops - 13th International Conference. Kubincová Z., editor. Springer Nature Switzerland; Cham: 2023. 360-degree video for cardiopulmonary resuscitation (CPR) knowledge: preliminary data of a randomized controlled trial; pp. 280–287. doi:10.1007/978-3-031-42134-1_28. [Google Scholar]
  • 82.Curran V., et al. A phenomenological study of the use of 360° virtual reality (VR) video in pediatric and neonatal resuscitation training. Health Technol. 2022;12:151–159. [Google Scholar]
  • 83.Sakr A., Abdullah T. Virtual, augmented reality and learning analytics impact on learners, and educators: a systematic review. Educ Inf Technol. 2024 doi: 10.1007/s10639-024-12602-5. [DOI] [Google Scholar]
  • 84.Babaita A.O., et al. Face-to-face versus 360° VR video: a comparative study of two teaching methods in nursing education. BMC Nurs. 2024;23:199. doi: 10.1186/s12912-024-01866-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 85.Alammary M.A., Halliday L., Konstantinidis S.T. 360-Degree virtual reality utilising head-mounted devices in undergraduate nursing and midwifery education: a scoping review. Virtual Worlds. 2023;2:396–421. [Google Scholar]
  • 86.Leary M., et al. Comparing bystander response to a sudden cardiac arrest using a virtual reality CPR training mobile app versus a standard CPR training mobile app. Resuscitation. 2019;139:167–173. doi: 10.1016/j.resuscitation.2019.04.017. [DOI] [PubMed] [Google Scholar]
  • 87.Shatpattananunt B., et al. Development and evaluation of a virtual reality basic life support for undergraduate students in Thailand: a project by Mae Fah Luang University (MFU BLiS VR) BMC Med Educ. 2023;23:782. doi: 10.1186/s12909-023-04764-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 88.Semeraro F., et al. Empowering the next Generation: an innovative “Kids Save Lives” blended learning programme for schoolchildren training. Resuscitation. 2024;194 doi: 10.1016/j.resuscitation.2023.110088. [DOI] [PubMed] [Google Scholar]
  • 89.Aksoy E. Comparing the effects on learning outcomes of tablet-based and virtual reality–based serious gaming modules for basic life support training: randomized trial. JMIR Serious Games. 2019;7 doi: 10.2196/13442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 90.Aksoy M.E. Comparing basic life support serious gaming scores with hands-on training platform performance scores: pilot simulation study for basic life support training. JMIR Serious Games. 2020;8 doi: 10.2196/24166. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Data 1
mmc1.pdf (499.1KB, pdf)
Supplementary Data 2
mmc2.docx (19KB, docx)

Articles from Resuscitation Plus are provided here courtesy of Elsevier

RESOURCES