Table 2.
Outcomesa | Illustrative comparative risks (95% CI) | Participants (n) | Studies (n) | Quality of evidence (GRADEb) | Comments |
Postintervention knowledge score: measured via MCQsc and questionnaires. Follow-up duration: immediate postintervention to 6 months | The mean knowledge score in the intervention group was 0.43 SDs higher (0.07 to 0.79 higher) than the mean score in the other digital education interventions | 608 | 8 | Lowd,e | 1 study (32 participants) presented mean change score and favored VR group compared with the control group [53], and 1 study (172 participants) compared VR with computer-based video (2D) and presented incomplete outcome data [44] |
Postintervention skills score: measured via scenario-based skills assessment. Follow-up duration: immediate postintervention only | The mean skill score in the intervention group was 0.5 SDs higher (0.32 to 0.69 higher) than the mean score in the other digital education interventions | 467 | 2 | Moderated | N/Af |
Postintervention attitude: measured via survey and questionnaire. Follow-up duration: immediate postintervention only. | Not estimable | 21 | 1 | Lowd,g | 4 studies [38,40,46,50] reported incomplete outcome data or lacked comparable data. Therefore, these studies were excluded from the analysis. |
Postintervention satisfaction: measured via MCQs, survey, and questionnaire. Duration: immediate postintervention only | The mean satisfaction score in the intervention group was 0.2 SDs higher (−0.71 lower to 1.11 higher) than the mean score in the other digital education interventions | 218 | 2 | Lowd,e | 2 studies [37,53] 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: Other digital education interventions (such as online learning, computer-based video, 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 (−1): the risk of bias was unclear or high in most included studies.
eDowngraded by 1 level for inconsistency (−1): the heterogeneity between studies is high with large variations in effect and lack of overlap among confidence intervals.
fN/A: not applicable.
gDowngraded as results were obtained from a single small study (−1).