Current State, Challenges, and Future Directions for Extended Reality in Pediatric Medical Education

Abstract

Introduction: Extended reality (XR) is an innovative tool in pediatric medical education, critical for neonatal resuscitation and emergencies. This study critically synthesizes current evidence on its effectiveness, implementation barriers, and impact on clinical skill acquisition and retention.

Objective: To map the impact of XR technologies on the acquisition and retention of clinical skills in pediatric medical education, identifying key determinants of effectiveness and adoption in various learning contexts.

Method: A rigorous scoping review following PRISMA-ScR was conducted. Search covered PubMed, Scopus, and Google Scholar (2018-2024), selecting original studies and reviews on XR in pediatric education. Two independent reviewers extracted and categorized data: effectiveness, limitations, and applications.

Results: Of 22 studies, XR improved theoretical retention, clinical confidence, and non-technical skills. In low-resource settings, studies on neonatal resuscitation using XR achieved Objective Structured Clinical Examination (OSCE) pass rates of up to 76%, demonstrating effectiveness comparable or superior to traditional methods in certain populations. Contradictory evidence on psychomotor skills, high cybersickness incidence (up to 40%), lack of metric standardization, and significant qualitative research deficiency (5.33% of included studies) were identified. Mobile XR in limited-resource highlighted gaps in infrastructure and equitable access gaps.

Discussion: XR offers valuable safe simulation, accessibility, and motivation. However, its implementation faces challenges like inconsistent evidence for psychomotor skills, adverse effects, high costs, lack of evaluation standardization, and scarcity of longitudinal and qualitative studies.

Conclusions: XR is a promising complement. Its successful adoption requires standardized pedagogical frameworks, longitudinal studies, equitable curricular integration, mitigation of technical barriers, and synergistic combination with traditional methodologies to maximize its potential.