Table 8 Advantages of VR simulations in medical education as reported by included reviews. Linked to RQ6.

 Availability/accessibility (e.g., low-cost models for low-income countries, no time restriction, easy setup, little space required)

22

[11, 19, 34, 35, 39, 44, 46,47,48, 58, 64, 65, 71, 72, 84, 92, 100, 102, 104, 109, 112, 113]

 Repeatability

21

[11, 19, 29, 30, 34,35,36,37, 44, 46, 48, 75, 84, 86, 96, 99, 100, 102, 103, 105, 112]

 Cost-effectiveness

11

[30, 32, 35, 36, 46, 48, 50, 69, 72, 113, 115]

 Ethical acceptability (less use of animal and human corpses)

9

[29, 35, 37, 38, 41, 47, 97, 112, 115]

 No supervision needed, reduced workload of instructors

7

[30, 32, 34, 47, 50, 76, 104]

 Portability

5

[34, 40, 92, 104, 112]

 No biological hazards by transmission of diseases

3

[29, 35, 112]

USER EXPERIENCE

 Improves satisfaction, self-confidence, educational experience, is fun

6

[64, 84, 86, 99, 108, 116]

 Tactile realism by real-time haptic feedback inclusion, multimodal sensorial stimuli

6

[41, 65, 70, 96, 98, 104]

 Satisfaction by user-friendliness

5

[34, 70, 86, 104, 109]

 Emotional impact

2

[11, 111]

SKILL DEVELOPMENT

 Hands-on training, hand-eye coordination, psychomotor skills, technical skills, theory to practise

13

[11, 19, 29, 34, 46, 64, 75, 86, 92, 96, 99, 104, 108]

 Competence training efficiency (reduced operating times, minimising medical errors)

12

[3, 29, 43, 46, 50, 58, 63, 69, 84, 96, 99, 104]

 Improve judgement, critical thinking, decision-making, creativity, conceptual and procedural learning

8

[29, 48, 50, 61, 64, 75, 89, 96]

 Training of soft skills (communication, interpersonal skills, teamwork)

7

[40, 44, 50, 61, 64, 84, 116]

 Improve situational awareness, attention span

4

[40, 50, 66, 86]

CONTENT

 Safe, controlled environment (learn from errors, stress-free, no time constraints)

17

[29, 39, 41, 44, 47, 49, 58, 63, 64, 66, 77, 84, 89, 99, 105, 108, 115]

 Variability by many use cases

13

[29, 32, 35, 41, 47, 48, 58, 65, 84, 89, 99, 100, 112]

 Training of high-pressure (complex, unexpected) & low frequency scenarios

7

[11, 34, 44, 48, 89, 92, 99]

 Realistic immersive environments, higher authenticity

7

[34, 37, 44, 45, 72, 84, 111]

 High degree of spatial understanding and visualisation

4

[19, 44, 86, 106]

 Versatile multi-user scenarios

1

[40]

CLINICAL TRANSFER

 Patient safety

16

[29, 30, 32, 36, 38, 47, 49, 50, 55, 63, 69, 77, 84, 89, 98, 103]

 Better clinical outcome

5

[43, 66, 69, 96, 108]

 Possibility of including patient specific information

4

[29, 41, 106, 111]

ASSESSMENT AND FEEDBACK

 Automatic, bias-free measurement and performance assessment (vision and sensor-based tracking)

11

[29, 37,38,39, 46,47,48, 92, 99, 100, 104]

 Instant, embedded real-time feedback

7

[38, 48, 64, 84, 100, 104, 114]

 Standardised, reproducible feedback and simulation

6

[47, 58, 98, 109, 113, 114]

 Possibility of recording training data for evaluation feedback

5

[11, 29, 92, 99, 100]

DIDACTIC ASPECTS

 Addresses more effective self-directed / self-paced / individual/ student-centred learning and deliberate practice

8

[48, 84, 89, 92, 99, 102, 104, 115]

    Experiential learning possible (e.g., dementia)

1

[49]