Effect of Virtual Reality Simulation on Anatomy Learning Outcomes: A Systematic Review

Anatomy education serves as a foundational pillar in medical training, equipping students with critical knowledge of human structure and function essential for clinical practice. Traditional pedagogical approaches, such as cadaveric dissection, anatomical models, and textbook-based learning, have been the cornerstone of medical education for decades. However, these methods face challenges, including limited accessibility (e.g., resource-intensive setups), ethical concerns (e.g., participant privacy), and difficulties in visualizing complex three-dimensional structures (e.g., dynamic systems). Recent advancements in immersive technologies, particularly virtual reality (VR), present a transformative opportunity to enhance anatomy education by offering interactive, scalable, and engaging learning experiences. This systematic review aimed to comprehensively evaluate the efficacy of VR simulation in improving medical students' learning outcomes in anatomy education, comparing its effectiveness to conventional teaching methodologies. This systematic review was conducted in strict accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane guidelines to ensure methodological rigor. A comprehensive literature search was performed across six major medical databases, including PubMed, Cochrane Library and Web of Science, encompassing studies published between January 2019 and February 2024. The search strategy employed a combination of MeSH terms and keywords related to "virtual reality", "anatomy education", and "medical students". Study selection was guided by the Population, Intervention, Comparison, Outcome and Study (PICOS) framework, with inclusion criteria focusing on randomized controlled trials, quasi-experimental studies, and comparative analyses evaluating VR-based anatomy instruction for medical students. The Cochrane risk-of-bias tool was used to assess study quality and potential bias. Due to significant heterogeneity in study designs and outcome measures, a narrative synthesis approach was adopted to integrate findings thematically rather than through meta-analysis. The review included 14 studies with a total of 961 participants, predominantly medical students across various training stages. Among the included studies, 71% demonstrated statistically significant improvements in anatomy learning outcomes with VR compared to traditional methods, including enhanced spatial understanding, knowledge retention, and learner engagement; 21% of the studies reported no significant difference in learning efficacy between VR and conventional approaches, while only 7% found VR simulation only partially effective, citing technical limitations and a steep learning curve as barriers. Subgroup analyses suggested that VR was particularly beneficial for visualizing complex anatomical regions (e.g., neuroanatomy, musculoskeletal structures) and for students with limited prior exposure to cadaveric dissection. However, variability in VR platform design, assessment tools and instructional integration underscored the need for standardized implementation frameworks. The review generally indicated the benefits of VR simulation in anatomy education, but larger studies are needed to fully explore its potential in medical anatomy training. Future studies should rigorously evaluate VR implementation in anatomy education to provide more comprehensive evidence of its strengths and weaknesses for medical teaching.