Resuscitation education science meets virtual and augmented reality: Evolution from potential concept to recommendations.

Aim Of The Study
This study aims to examine the evolution of recommendations for integrating Virtual Reality (VR) and Augmented Reality (AR) into adult Basic Life Support (BLS) education over time.

Data Sources
In December 2024, we conducted a two-phase search. First, we identified and reviewed publications available on the International Liaison Committee on Resuscitation (ILCOR) webpage, focusing on resuscitation education science, specifically addressing VR and/or AR in adult BLS education. In the second phase, we reviewed the references and citations of the included publication to identify relevant publications from the American Heart Association (AHA), European Resuscitation Council (ERC), and ILCOR.

Results
Across both phases, we included 29 AHA, ERC, and ILCOR publications on resuscitation education. These comprised 16 ILCOR CoSTRs, seven AHA/ERC guidelines (four ERC, three AHA), three ILCOR scientific statements, two AHA scientific statements, and one ILCOR review. The first mention of VR appeared in 2003, but the first recommendation was provided in 2020 AHA guidelines, suggesting its use for adult BLS training based on very low-quality evidence. In 2024, the ILCOR CoSTRs issued a weak recommendation supporting AR and a weak recommendation against VR for adult BLS training, both based on very low-quality evidence.

Conclusion
While VR/AR is gaining traction in resuscitation training, its effectiveness remains debated. Initially focused on professionals, it now extends to laypersons and schoolchildren. However, strong evidence is lacking. Future research should assess learning outcomes, guideline adherence, and patient impact to support stronger ILCOR recommendations.