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Beyond Simulation: Extended Reality as a Systems-Level Solution to Pediatric Resuscitation Skill Decay in Emergency Departments
Journal article   Open access   Peer reviewed

Beyond Simulation: Extended Reality as a Systems-Level Solution to Pediatric Resuscitation Skill Decay in Emergency Departments

Mohammed A Alsabri
Current Emergency and Hospital Medicine Reports, v 14(1), Forthcoming
03 Jun 2026
DOI: https://doi.org/10.1007/s40138-026-00349-x
Featured in Collection :   Research Supported by Drexel Libraries' OA Programs
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https://doi.org/10.1007/s40138-026-00349-xView
Published, Version of Record (VoR) Open Access via Drexel Libraries Read and Publish Program 2026 Open CC BY V4.0

Abstract

Pediatric resuscitation Extended reality (XR) Emergency department training Skill decay Simulation-based education
Purpose of Review Pediatric resuscitation is a high-stakes, low-frequency clinical challenge disproportionately encountered in community emergency departments. This review evaluates Extended Reality (XR) - encompassing Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) - as a scalable adjunct to traditional simulation-based training for supporting pediatric resuscitation readiness and mitigating the limitations of episodic training in low-volume emergency settings. Recent Findings Emerging evidence suggests VR supports cognitive rehearsal and algorithm fluency, with studies demonstrating acceptable performance on selected CPR metrics, high learner acceptability, and short-term knowledge retention. AR shows promise for anatomical visualization and procedural guidance in airway management training. However, the evidence base remains heterogeneous, predominantly involving laypersons, undergraduate learners, and adult CPR contexts, with limited pediatric emergency department-specific data. Fully immersive VR systems demonstrate insufficient haptic fidelity for psychomotor skill acquisition, and no established link to patient-level outcomes has yet been demonstrated. Summary Extended reality represents a promising adjunct - not a replacement - in the landscape of pediatric resuscitation training. In low-volume emergency settings where traditional simulation is insufficient to maintain competency at the required frequency, VR and AR may complement existing approaches by supporting cognitive rehearsal, algorithm fluency, and procedural familiarity. Integration into clinical workflows, competency frameworks, and quality improvement systems warrants further structured evaluation. Future research should prioritize objective performance metrics, pediatric clinician populations, and patient-level outcomes to guide broader adoption.

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