Effectiveness of extended reality‑based cardiopulmonary resuscitation training for healthcare students: A systematic review
John Raymund P. Suazo1,2
, Grasiela Piuvezam3,4,5, Isac Davidson Santiago Fernandes Pimenta4,5, Lucía López Ferrándiz6, Manuel Pardo Ríos6, Rafael Castro‑Delgado1,7,8
1Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
2Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
3Department of Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
4Graduate Program in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
5Systematic Review and Meta-Analysis Laboratory (Lab-SYS) Research and Health Innovation, Federal University of Rio Grande do Norte, Natal, Brazil
6Faculty of Nursing, Catholic University of Murcia, Murcia, Spain
7Research Group on Prehospital Care and Disasters (GIAPREDE), Health Research Institute of the Principality of Asturias, Oviedo, Spain
8SAMU-Asturias, Health Service Principality of Asturias, Oviedo, Spain
Keywords: Basic and advanced life support, cardiopulmonary resuscitation, extended reality, healthcare education, virtual reality
Abstract
BACKGROUND: 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.
METHODOLOGY: 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.
RESULTS: 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.
CONCLUSION: 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’s role in resuscitation education.
How to cite this article: Suazo JR , Piuvezam G, Pimenta ID, Ferrándiz LL, Ríos MP, Castro‑Delgado R. Effectiveness of extended reality‑based cardiopulmonary resuscitation training for healthcare students: A systematic review. Turk J Emerg Med 2026;26:223-33.