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Cited by 5Simulation-Based Education in HealthcareCardiac Arrest and ResuscitationAugmented Reality Applications

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

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Fijačko, Nino, Metličar, Špela, Janžekovič, Boža, Abella, Benjamin S., Nadkarni, Vinay M., Chang, Todd P., Greif, Robert·2025·Resuscitation Plus
DOI 10.1016/j.resplu.2025.100927PMC PMC11999490
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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.

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  1. [1]González-Salvado V. Training adult laypeople in basic life support. a systematic review Revista Española De Cardiología (English Edition) 73 2020 53 68 30808611
  2. [2]Greif R. European resuscitation council guidelines 2021: education for resuscitation Resuscitation 161 2021 388 407 33773831
  3. [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 17 2024 100558 PMC10995636 38586864
  4. [5]Fidalgo C.G. A survey on remote assistance and training in mixed reality environments IEEE Trans Vis Comput Graph 29 2023 2291 2303 37027742
  5. [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) 1 2024 e52904 PMC12671302 41341871
  6. [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 35 2022 100429
  7. [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 20 2023 3895 36900904 PMC10001289
  8. [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 67 2024 274 282 38772412 PMC11150988
  9. [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 13 2023 81 37695464 PMC10495307
  10. [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 9 2023 20552076231178619 PMC10259138 37312952
  11. [13]Cheng A. Use of augmented and virtual reality in resuscitation training: a systematic review Resuscitation Plus 18 2024 100643 PMC11053298 38681058
  12. [14]Sun R. Effectiveness of virtual and augmented reality for cardiopulmonary resuscitation training: a systematic review and meta-analysis BMC Med Educ 24 2024 730 38970090 PMC11227211
  13. [15]Trevi R. Chiappinotto S. Palese A. Galazzi A. Virtual reality for cardiopulmonary resuscitation healthcare professionals training: a systematic review J Med Syst 48 2024 50 38748244 PMC11096216
  14. [16]Alcázar Artero P.M. Efficiency of virtual reality for cardiopulmonary resuscitation training of adult laypersons: a systematic review Medicine (Baltimore) 102 2023 e32736 PMC9875948 36705392
  15. [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 6 2021 11 PMC8040758 33845911
  16. [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 99 2025 101672
  17. [19]Levac D. Colquhoun H. O’Brien K.K. Scoping studies: advancing the methodology Implement Sci 5 2010 69 20854677 PMC2954944
  18. [22]Mccloy R. Stone R. Virtual reality in surgery BMJ 323 2001 912 915 11668138 PMC1121442
  19. [23]Won M. Diverse approaches to learning with immersive Virtual Reality identified from a systematic review Comput Educ 195 2023 104701
  20. [27]Library J.W.S.H.S. Searching syntax guide for common database platforms ERA 2015 https://era.library.ualberta.ca/items/95890b83-aa90-4a6d-85c8-7011901432a4 10.7939/R3154DV6G · DOI
  21. [28]Greenhalgh T. Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources BMJ 331 2005 1064 1065 16230312 PMC1283190
  22. [29]Gupta A. How to write a scoping review? – A comprehensive guide Endodontology 35 2023 9
  23. [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 5 2019 e02205 PMC6684477 31406943
  24. [31]Leary M. 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 14 2019 82 30407959
  25. [32]Buckler D.G. Observing the stages of bystander intervention in virtual reality simulation World J Emerg Med 10 2019 145 31171944 PMC6545373
  26. [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 2 2020 PMC8521903 34713015
  27. [35]Min H.J. Virtual reality for basic life support training in high school students: thematic analysis of focus group interviews JMIR XR and Spatial Computing (JMXR) 1 2024 e53212 PMC12671312 41341878
  28. [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
  29. [37]Semeraro F. Virtual reality cardiopulmonary resuscitation (CPR): Comparison with a standard CPR training mannequin Resuscitation 135 2019 234 235 30597133
  30. [38]Semeraro F. Back to reality: a new blended pilot course of basic life support with virtual reality Resuscitation 138 2019 18 19 30844415
  31. [39]Ingrassia P.L. Augmented reality learning environment for basic life support and defibrillation training: usability study J Med Internet Res 22 2020 e14910 PMC7251481 32396128
  32. [40]Buttussi F. Chittaro L. Valent F. A virtual reality methodology for cardiopulmonary resuscitation training with and without a physical mannequin J Biomed Inform 111 2020 103590 33039589
  33. [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 23 2023 50 36690993 PMC9869298
  34. [43]Alcázar Artero P.M. Teaching cardiopulmonary resuscitation using virtual reality: a randomized study Australasian Emergency Care 27 2024 57 62 37666723
  35. [44]Castillo J. Efficacy of virtual reality simulation in teaching basic life support and its retention at 6 months Int J Environ Res Public Health 20 2023 4095 36901106 PMC10001443
  36. [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
  37. [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 29 2021 27 33526042 PMC7851931
  38. [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 22 2022 483 35733135 PMC9214467
  39. [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 14 2019 1 31490865
  40. [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 73 2022 103241 PMC8767287 35079374
  41. [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 99 2020 e23374 PMC7710239 33235109
  42. [53]Chang Y.-T. Effects of different cardiopulmonary resuscitation education interventions among university students: a randomized controlled trial PLoS One 18 2023 e0283099 PMC10013893 36917584
  43. [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 235 2023 607 612 37891299 PMC10611567
  44. [55]Hou L. Comparison of augmented reality-assisted and instructor-assisted cardiopulmonary resuscitation: a simulated randomized controlled pilot trial Clin Simul Nurs 68 2022 9 18 35646196 PMC9126500
  45. [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 10.1089/cyber.2023.0411 38330413 · DOI
  46. [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 24 2024 176 39333990 PMC11438090
  47. [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 52 2023 1428 1438 37593517 PMC10430405
  48. [60]Aksoy E. Performance monitoring via functional near infrared spectroscopy for virtual reality based basic life support training Front Neurosci 13 2019 PMC6920174 31920503
  49. [61]Schroeder D.C. KIDS SAVE LIVES: Basic life support education for schoolchildren: a narrative review and scientific statement from the international liaison committee on resuscitation Circulation 147 2023 1854 1868 37194575
  50. [62]Dolenc E. Kolšek M. Slabe D. Eržen I. Tailoring first aid courses to older adults participants Health Educ Behav 49 2022 697 34350809 PMC9350451
  51. [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 23 2023 134 37950197 PMC10636823
  52. [64]Xiong J. Abstract Su1103: resuscitation reality: a review on current CPR training for older adults Circulation 150 2024 ASu1103–ASu1103
  53. [65]Lee D.K. Development of an extended reality simulator for basic life support training IEEE J Translat Eng Health Med 10 2022 1 7 PMC9342859 35937462
  54. [66]Nas J. 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 9 2019 PMC6886955 31753903
  55. [67]Nas J. 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 10 2021 1 6 PMC7955309 33442988
  56. [68]Nas J. 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 5 2022 e2212964 PMC9121185 35587346
  57. [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 7 2024
  58. [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 26 2022 697 735 34366688 PMC8328811
  59. [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 11 2021 15382 34321504 PMC8319184
  60. [72]Chang E. Billinghurst M. Yoo B. Brain activity during cybersickness: a scoping review Virtual Reality 27 2023 2073 2097 PMC10092918 37360812
  61. [75]González-Pérez L.I. Ramírez-Montoya M.S. Components of education 4.0 in 21st century skills frameworks: systematic review Sustainability 14 2022 1493
  62. [76]Lampropoulos G. Kinshuk Virtual reality and gamification in education: a systematic review Edu Tech Res Dev 72 2024 1691 1785
  63. [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 191 2023 37690735
  64. [80]Tachejian S. Moussa A. 360-degree virtual reality video to teach neonatal resuscitation: an exploratory development study Sci Rep 14 2024 14383 38909130 PMC11193781
  65. [81]Gazzelloni A. 360-degree video for cardiopulmonary resuscitation (CPR) knowledge: preliminary data of a randomized controlled trial Kubincová Z. Methodologies and Intelligent Systems for Technology Enhanced Learning, Workshops - 13th International Conference 2023 Springer Nature Switzerland Cham 280 287 doi:10.1007/978-3-031-42134-1_28 · DOI
  66. [83]Sakr A. Abdullah T. Virtual, augmented reality and learning analytics impact on learners, and educators: a systematic review Educ Inf Technol 2024 10.1007/s10639-024-12602-5 · DOI
  67. [84]Babaita A.O. Face-to-face versus 360° VR video: a comparative study of two teaching methods in nursing education BMC Nurs 23 2024 199 38523319 PMC10962166
  68. [86]Leary M. Comparing bystander response to a sudden cardiac arrest using a virtual reality CPR training mobile app versus a standard CPR training mobile app Resuscitation 139 2019 167 173 31005588
  69. [87]Shatpattananunt B. 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 23 2023 782 37858236 PMC10588006
  70. [88]Semeraro F. Empowering the next Generation: an innovative “Kids Save Lives” blended learning programme for schoolchildren training Resuscitation 194 2024 110088 38101506
  71. [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 7 2019 e13442 PMC6660122 31042153
  72. [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 8 2020 e24166 PMC7725648 33237035

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Authors
Fijačko, N., Metličar, Š., Janžekovič, B., Abella, B. S., Nadkarni, V. M., Chang, T. P., & Greif, R.
Affiliations
  • University of Maribor (SI)
  • Ljubljana University Medical Centre (SI)
  • Icahn School of Medicine at Mount Sinai (US)
  • Children's Hospital of Philadelphia (US)
  • University of Southern California (US)
  • University of Bern (CH)
Corresponding author
Fijačko, Nino
ORCID
Venue
Resuscitation Plus
Publisher
Elsevier BV
Published
2025-05
Volume
23
Pages
100927
ISSN
2666-5204 (ISSN-L)
DOI
10.1016/j.resplu.2025.100927
PMC
PMC11999490
OpenAlex
W4408422796
Cited by
5
References
3
Citations by year
2026: 2 · 2025: 3
FWCI
0.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Resuscitation Plus (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Open Access CRIS of the University of Bern
Funders
  • University of Maribor
  • The Slovenian Research and Innovation Agency (ARRS N3-0307, ARRS BI-US/22-24-138, ARRS P2-0057)
  • Laerdal Foundation for Acute Medicine
  • U.S. Department of Defense
  • ZOLL Medical Corporation
  • Bureau of Educational and Cultural Affairs
  • Institute of International Education
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Augmented Reality Applications
Keywords
extended reality, virtual reality, augmented reality, adult basic life support, resuscitation training, lay rescuers, nursing students, affective learning outcomes, cognitive learning outcomes, virtual reality headsets, augmented reality headsets, educational software, skill retention

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