{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:21:28Z","timestamp":1783581688689,"version":"3.55.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cardiopulmonary resuscitation (CPR) is a lifesaving intervention where timely, effective actions improve survival. However, traditional Basic and Advanced Life Support (BLS and ALS) training often lacks realism, limiting preparedness among healthcare students. Extended Reality (XR) technologies, including Virtual, Augmented, and Mixed Reality, offer promising tools to enhance CPR training. The aim is to assess the effects of XR on CPR training outcomes among healthcare students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODOLOGY:<\/jats:title>\n                    <jats:p>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines, PubMed\/MEDLINE, EMBASE, CINAHL, Cochrane, Web of Science, and Scopus were searched for randomized controlled trials and quasi-experimental studies. Two reviewers independently extracted data, with disagreements resolved by a third. Risk of bias was evaluated using Cochrane ROB 2 and ROBINS-I. Due to heterogeneity, findings were synthesized narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Eight studies from six countries were included. Evidence showed mixed outcomes: XR improved confidence and reduced anxiety in Basic Life Support and ALS training, but results on technical performance, including CPR knowledge and quality, were inconsistent. Variability in study design and concerns about bias limited generalizability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>XR shows potential as a valuable complement to traditional CPR training, particularly in blended learning approaches aligned with modern pedagogy. However, inconsistent findings highlight the need for standardized assessments, evaluation of long-term outcomes, and integration of haptic torso simulators to improve technical skills and clarify XR\u2019s role in resuscitation education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/tjem.tjem_373_25","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:01:18Z","timestamp":1783580478000},"page":"223-233","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of extended reality-based cardiopulmonary resuscitation training for healthcare students: A systematic review"],"prefix":"10.4103","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1112-5706","authenticated-orcid":false,"given":"John Raymund P.","family":"Suazo","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain"},{"name":"Department of Global Public Health, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2343-7251","authenticated-orcid":false,"given":"Grasiela","family":"Piuvezam","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Rio Grande do Norte, Natal, Brazil"},{"name":"Graduate Program in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil"},{"name":"Systematic Review and Meta-Analysis Laboratory (Lab-SYS) Research and Health Innovation, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8246-0603","authenticated-orcid":false,"given":"Isac Davidson Santiago Fernandes","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil"},{"name":"Systematic Review and Meta-Analysis Laboratory (Lab-SYS) Research and Health Innovation, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7990-8497","authenticated-orcid":false,"given":"Luc\u00eda L\u00f3pez","family":"Ferr\u00e1ndiz","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Catholic University of Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7965-0134","authenticated-orcid":false,"given":"Manuel Pardo","family":"R\u00edos","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Catholic University of Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9520-656X","authenticated-orcid":false,"given":"Rafael","family":"Castro-Delgado","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain"},{"name":"Research Group on Prehospital Care and Disasters (GIAPREDE), Health Research Institute of the Principality of Asturias, Oviedo, Spain"},{"name":"SAMU-Asturias, Health Service Principality of Asturias, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"R1-20260709","doi-asserted-by":"crossref","first-page":"e001195","DOI":"10.1136\/openhrt-2019-001195","article-title":"Cardiac arrest and sudden cardiac death registries: A systematic review of global coverage","volume":"7","author":"Paratz","year":"2020","journal-title":"Open Heart"},{"key":"R3-20260709","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1097\/EJA.0000000000000675","article-title":"Serious game versus online course for pretraining medical students before a simulation-based mastery learning course on cardiopulmonary resuscitation: A randomised controlled study","volume":"34","author":"Drummond","year":"2017","journal-title":"Eur J Anaesthesiol"},{"key":"R4-20260709","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.resuscitation.2021.02.007","article-title":"European resuscitation council guidelines 2021: Epidemiology of cardiac arrest in Europe","volume":"161","author":"Gr\u00e4sner","year":"2021","journal-title":"Resuscitation"},{"key":"R5-20260709","doi-asserted-by":"crossref","first-page":"e23374","DOI":"10.1097\/MD.0000000000023374","article-title":"Chest compressions quality during sudden cardiac arrest scenario performed in virtual reality: A crossover study in a training environment","volume":"99","author":"Jaskiewicz","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"R6-20260709","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1097\/EJA.0000000000001272","article-title":"Mandatory cardiopulmonary resuscitation competencies for undergraduate healthcare students in Europe: A European Resuscitation Council guidance note","volume":"37","author":"Baldi","year":"2020","journal-title":"Eur J Anaesthesiol"},{"key":"R7-20260709","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1161\/CIR.0000000000000583","article-title":"Resuscitation education science: Educational strategies to improve outcomes from cardiac arrest: A scientific statement from the American Heart Association","volume":"138","author":"Cheng","year":"2018","journal-title":"Circulation"},{"key":"R8-20260709","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1186\/s12909-019-1848-8","article-title":"Nursing students'knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: A randomized controlled trial","volume":"19","author":"Moon","year":"2019","journal-title":"BMC Med Educ"},{"key":"R9-20260709","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1136\/emermed-2017-206748","article-title":"Are final year medical students ready to save lives in Italy? Not yet","volume":"34","author":"Contri","year":"2017","journal-title":"Emerg Med J"},{"key":"R10-20260709","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5847\/wjem.j.1920-8642.2019.02.002","article-title":"Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?","volume":"10","author":"Willmore","year":"2019","journal-title":"World J Emerg Med"},{"key":"R11-20260709","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ijcard.2019.07.016","article-title":"Final-year medical students'knowledge of cardiac arrest and CPR: We must do more!","volume":"296","author":"Baldi","year":"2019","journal-title":"Int J Cardiol"},{"key":"R13-20260709","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13049-022-01056-8","article-title":"Preparing medical first responders for crises: A systematic literature review of disaster training programs and their effectiveness","volume":"30","author":"Baetzner","year":"2022","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"R14-20260709","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1111\/j.1553-2712.2010.00728.x","article-title":"Virtual reality triage training provides a viable solution for disaster-preparedness","volume":"17","author":"Andreatta","year":"2010","journal-title":"Acad Emerg Med"},{"key":"R15-20260709","first-page":"320","article-title":"Models of international emergency medical service (EMS) systems","volume":"25","author":"Al-Shaqsi","year":"2010","journal-title":"Oman Med J"},{"key":"R16-20260709","doi-asserted-by":"crossref","first-page":"378","DOI":"10.4103\/0974-2700.70758","article-title":"Simulation in resuscitation teaching and training, an evidence based practice review","volume":"3","author":"Sahu","year":"2010","journal-title":"J Emerg Trauma Shock"},{"key":"R17-20260709","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00431-016-2702-1","article-title":"An innovative pedagogic course combining video and simulation to teach medical students about pediatric cardiopulmonary arrest: A prospective controlled study","volume":"175","author":"Drummond","year":"2016","journal-title":"Eur J Pediatr"},{"key":"R18-20260709","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1186\/s12909-022-03533-1","article-title":"Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students during COVID-19 pandemic: A randomised controlled trial","volume":"22","author":"Moll-Khosrawi","year":"2022","journal-title":"BMC Med Educ"},{"key":"R19-20260709","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13049-021-00836-y","article-title":"Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students: A randomized controlled trial","volume":"29","author":"Issleib","year":"2021","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"R20-20260709","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"R21-20260709","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"R23-20260709","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"R25-20260709","doi-asserted-by":"crossref","first-page":"105464","DOI":"10.1016\/j.nedt.2022.105464","article-title":"The effects of neonatal resuscitation gamification program using immersive virtual reality: A quasi-experimental study","volume":"117","author":"Yang","year":"2022","journal-title":"Nurse Educ Today"},{"key":"R26-20260709","first-page":"281","article-title":"The use of immersive and virtual reality technologies to enable nursing students to experience scenario-based, basic life support training-exploring the impact on confidence and skills","volume":"38","author":"Rushton","year":"2020","journal-title":"Comput Inform Nurs"},{"key":"R27-20260709","doi-asserted-by":"crossref","first-page":"e46964","DOI":"10.2196\/46964","article-title":"Comparing the outcomes of virtual reality-based serious gaming and lecture-based training for advanced life support training: Randomized controlled trial","volume":"11","author":"Aksoy","year":"2023","journal-title":"JMIR Serious Games"},{"key":"R28-20260709","doi-asserted-by":"crossref","first-page":"4095","DOI":"10.3390\/ijerph20054095","article-title":"Efficacy of virtual reality simulation in teaching basic life support and its retention at 6 months","volume":"20","author":"Castillo","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"R30-20260709","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.medin.2023.09.002","article-title":"New communication tool for basic life support training: Smart glasses. A quasi-experimental study","volume":"48","author":"Aranda-Garc\u00eda","year":"2024","journal-title":"Med Intensiva (Engl Ed)"},{"key":"R31-20260709","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.resuscitation.2018.07.033","article-title":"Effectiveness of digital resuscitation training in improving knowledge and skills: A systematic review and meta-analysis of randomised controlled trials","volume":"131","author":"Lau","year":"2018","journal-title":"Resuscitation"},{"key":"R32-20260709","doi-asserted-by":"crossref","first-page":"e36423","DOI":"10.2196\/36423","article-title":"The effectiveness of technology-based cardiopulmonary resuscitation training on the skills and knowledge of adolescents: Systematic review and meta-analysis","volume":"24","author":"Lim","year":"2022","journal-title":"J Med Internet Res"},{"key":"R33-20260709","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1186\/s12909-024-05720-8","article-title":"Effectiveness of virtual and augmented reality for cardiopulmonary resuscitation training: A systematic review and meta-analysis","volume":"24","author":"Sun","year":"2024","journal-title":"BMC Med Educ"},{"key":"R34-20260709","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s10916-024-02063-1","article-title":"Virtual reality for cardiopulmonary resuscitation healthcare professionals training: A systematic review","volume":"48","author":"Trevi","year":"2024","journal-title":"J Med Syst"},{"key":"R35-20260709","doi-asserted-by":"crossref","first-page":"e32736","DOI":"10.1097\/MD.0000000000032736","article-title":"Efficiency of virtual reality for cardiopulmonary resuscitation training of adult laypersons: A systematic review","volume":"102","author":"Alc\u00e1zar Artero","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"R36-20260709","doi-asserted-by":"crossref","first-page":"e28595","DOI":"10.2196\/28595","article-title":"Viewpoint: Virtual and augmented reality in basic and advanced life support training","volume":"10","author":"Ricci","year":"2022","journal-title":"JMIR Serious Games"},{"key":"R37-20260709","first-page":"172","article-title":"Emotional experiences in simulated classroom training environments","volume":"33","author":"Stavroulia","year":"2016","journal-title":"Int J Inf Learn Technol"}],"container-title":["Turkish Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/tjem.tjem_373_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:01:22Z","timestamp":1783580482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/tjem.tjem_373_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/tjem.tjem_373_25","relation":{},"ISSN":["2452-2473","2452-2473"],"issn-type":[{"value":"2452-2473","type":"print"},{"value":"2452-2473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-09-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}