Table 2.

Main characteristics of the studies included in the systematic review.

Studies (Authors, Year, Country)	Study Design	Participants	Teaching Models	Duration/Content	Outcomes	Results	Methodological Quality (JBI)
Huhn et al. 2013. USA [33]	Randomised mixed-methods study	N = 53 graduate students (Doctoral) CG: 27 EG: 26	CG: Traditional teaching based on large-group discussion EG: Virtual patient simulation through computer software	Six lessons Content: Pathology content and clinical reasoning	Pre-post measurement Health science reasoning test on clinical reasoning; 50-question exam for knowledge acquisition; Objective clinical structured examination to measure the transfer of learning.	There were no significant differences between groups, but EG showed higher results on all objective measures.	6/13
Ulrich et al. 2019. Denmark [34]	Randomised study	N = 81 graduate students G1: 28 G2: 28 G3: 27	G1: VR HMD with 360° video (Samsung Gear VR) G2: Conventional videos via laptop G3: Traditional teaching	One lesson Content: The practical task of performing the correct positioning into the supine position	Pre-post measurement Questionnaire on academic performance, user satisfaction, and perception of learning climate.	Academic performance: all treatment groups were equally effective. User satisfaction: 360° video and conventional video were less effective than traditional teaching. Learning climate: only in the student’s emotions, the 360° video surpassed the conventional video.	7/13
Ferdous et al. 2019. Australia [35]	Randomised crossover study	N = 101 graduate students G1: 24–26 G2: 24–26 G3: 24–26 G4: 24–26	CG: Traditional teaching EG: AR and projection of anatomical images, virtual pencils to create annotations	Two lessons of 1 h Content: different types of movements of the lower limb musculature	Pre-post measurement Standardised questionnaire type test score.	The results show a statistically significant mean increase in the questionnaire score (22.5%) in the EG with respect to the CG. Z-2.666, p-0.008.	7/13
Kurul et al. 2020. Turkey [25]	Randomised controlled study	N = 72 undergraduate students CG: 36 EG: 36	CG: Traditional teaching EG: Immersive VR HMD (Oculus Rift) and “3D Organon Anatomy” software	One lesson of 30 min Content: anatomy and palpation of the cephalic region and neck	Pre-post measurement: Quiz-type questionnaire on anatomy with 15 multiple-choice questions. Likert-type scale on student perception.	Post scores were significantly higher compared to pre-test scores in both EG (p < 0.001) and CG (p < 0.001). The difference between pretest and post-test scores was significantly greater in favour of EG (p < 0.001).	10/13
Favolise 2021. USA [36]	Cohort longitudinal study	N = 297 graduate students (Doctoral) CG: 162 EG: 135	CG: Traditional teaching EG: Visible Body through VR and AR software	N/A Content: Gross anatomy	Post measurement Exams for knowledge acquisition on osteology and cadaver dissection. Survey about self-efficacy.	Positive results were found for the EG group on knowledge acquisition of cadaver dissection, and student’s self-efficacy.	2/11
Kandasamy et al. 2021. United Kingdom [37]	Crossover longitudinal study	N = 74 undergraduate students CG: 37 EG: 37	CG: Traditional teaching EG: Active learning using an AR mobile application	Two weeks Content: Anatomy of spine, and spine pathologies	Post measurement Structured questionnaire about level of understanding and engagement.	Significant results were found for the EG group on level of understanding and engagement.	6/9
Hartstein et al. 2022. USA [38]	Randomised controlled study	N = 59 graduate students (1st year)	CG: Traditional standardised patient instruction EG: Immersive VR learning experience with Oculus Quest 2	One lesson Content: simulation of a patient encounter to enhance clinical decision-making skills	Pre-post measurement Clinical decision-making tool Metacognitive Awareness Inventory Diagnostic accuracy and efficiency Engagement Musculoskeletal objective structured clinical examination	Non-significant differences were found between groups for the clinical decision-making tool, metacognitive awareness inventory, diagnostic accuracy. Only the results for engagement are significant for the EG.	10/13

AR: Augmented reality; CG: control group; EG: experimental group; HMD: head-mounted display; N/A: not available; VR: virtual reality.