Training in Critical and Emergency Contexts using Virtual and Augmented Reality: A Systematic Review

Abstract

This study investigated the effectiveness, challenges, and implementation opportunities of Virtual Reality (VR) and Augmented Reality (AR) technologies in training individuals exposed to emergencies in critical contexts; to this end, a Systematic Literature Review (SLR) was conducted using the PICOC framework and the PRISMA 2020 protocol, searching Scopus, IEEE Xplore, and Web of Science for articles published between January 2020 and April 2025. A total of 665 records were initially retrieved, from which 60 studies were selected after duplicate removal and PICOC-based screening, with references managed in Mendeley and bibliometric analysis performed using the Bibliometrix package in RStudio. Results showed that VR consistently enhances technical skills, knowledge retention, and error reduction compared to traditional methods; in addition, AR optimizes precision in fine motor tasks via real-time contextual overlay, while Extended/Mixed Reality (XR/MR) solutions emerge as promising hybrid alternatives for collaborative decision-making and cognitive load reduction, albeit constrained by technical complexity and a lack of long-term validation; furthermore, significant methodological heterogeneity and the exclusion of users with disabilities were identified. In conclusion, VR and AR deliver clear benefits for emergency training and XR/MR holds potential for collaborative scenarios, prompting recommendations to standardize evaluation protocols with comparable metrics, promote longitudinal studies to assess learning persistence, and design inclusive interfaces that incorporate advanced haptics and physiological monitoring.