Table 1.

Summary of findings table: virtual reality compared with traditional learning.

Outcomesa	Illustrative comparative risks (95% CI)	Participants (n)	Studies (n)	Quality of evidence (GRADEb)	Comments
Postintervention knowledge scores: measured via MCQsc or quiz. Follow-up: immediate postintervention only	The mean knowledge score in the intervention group was 0.44 SDs higher (0.18 to 0.69 higher) than the mean score in the traditional learning group	603	8	Moderated	1 study [36] reported mean change scores within the group, and hence, the study data were excluded from the pooled analysis
Postintervention skill scores: measured via survey and OSCEe. Follow-up duration: immediate postintervention only	The mean skill score in the intervention group was 1.12 SDs higher (0.81 to 1.43 higher) than the mean score in the traditional learning group	235	4	Moderated	3 studies were excluded from the analysis as 1 study reported incomplete outcome data [29], 1 study assessed mixed outcomes [36], and 1 study reported self-reported outcome data [24]
Postintervention attitude scores: measured via survey. Follow-up duration: immediate postintervention only	The mean attitudinal score in the intervention group was 0.19 SDs higher (−0.35 lower to 0.73 higher) than the mean score in the traditional learning group	83	2	Moderated	N/Af
Postintervention satisfaction scores: measured via survey. Follow-up duration: immediate postintervention only	Not estimable	100	1	Lowd,g	5 studies [24,29,33,48,52] reported incomplete outcome data or lacked comparable data. Therefore, these studies were excluded from the analysis.

^aPatient or population: health professionals; settings: universities and hospitals; intervention: virtual reality; comparison: traditional learning (face-to-face lecture, textbooks, etc).

^bGRADE (Grading of Recommendations, Assessment, Development and Evaluations) Working Group grades of evidence. High quality: further research is very unlikely to change our confidence in the estimate of effect; moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; and very low quality: we are very uncertain about the estimate.

^cMCQs: multiple choice questions.

^dDowngraded by 1 level for study limitations: the risk of bias was unclear or high in most included studies (−1).

^eOSCE: objective structured clinical examination.

^fN/A: not applicable.

^gDowngraded as results were obtained from a single small study (−1).