Table 5 Summary of the included studies for learning outcome

Afonso et al. (2020) [79]

OL (Virtual Respiratory Case-Based Module); UG medical students

Online questionnaire

Traditional learning

For OL method, 93% improved their telemedicine communication, 84% in the interpretation of physical exams, 95% in the development of differential diagnosis, and 93% in seeing the correlation between clinical and basic science content

3

Amer & Nemenqani (2020) [80]

OL; UG medical students from College of Medicine, Taif University

Online questionnaire

Traditional learning

72% preferred OL, 61.5% believed that OL was very helpful, especially during pandemic situations, and 72% agreed that OL could help them imagine the structure

3

Atli et al. (2021) [25]

OL; UG medical students at University Hospitals Cleveland Medical Center in Cleveland, Ohio, USA

Online questionnaire

Traditional learning

Students (100%) reported increased confidence in analyzing patients' cases and interpreting lab results. 50% agreed that VR helps them understand neuroanatomy and neurosurgery, and 66% agreed that VR helps them retain surgical skills throughout this course

3

Co et al. (2021) [26]

OL; UG medical students in Hong Kong university

Online questionnaire

Traditional learning

Students can do a proper surgical knot via instrumental tie. The mean score obtained for the control groups was 4.8 out of 5, while for case groups were 4.7 out of 5

3

Elzainy et al. (2020) [69]

OL; UG medical students from College of Medicine Qassim University

Online questionnaire

Traditional learning

A significant increase of PBL marks during online sessions compared to f2f learning

2

Fischbeck et al. (2020) [64]

OL; UG medical psychology and medical sociology from university in Mainz

Online questionnaire

Traditional learning

91% agreed that OL help them become more familiar with medical conservation practice. 76% agreed that the OL exercise helped develop communication skills

3

Higgins et al. (2020) [71]

Online training (RiTe module); UG students Bachelor of Science Honors from Northwest England Region University

Online questionnaire

Traditional training

Students felt that the application of RiTe was very positive, They strongly agreed that RiTe was very relevant to their practice and agreed that they could also learn to master their skills from the module

2

Jaap et al. (2021) [29]

OL; UG medical students from UK medical school

Online questionnaire

Traditional learning

Year 4 students performed better during the online exam (76.53%) compared to f2f exam (72.81%), while for Year 5students the online exam results (76.02%) were almost the same as to f2f exam (77.25%)

2

Jiménez-Rodríguez et al. (2020) [47]

OL; UG nursing students from the University of Spain

Online questionnaire

Traditional learning

62.5% agreed that the OL simulation has improved their clinical skills

3

Kim et al. (2020) [48]

OL; UG medical students from Seoul National University

Online questionnaire

Traditional learning

No significant differences in student academic achievement

1

Mahdy (2020) [50]

OL; UG veterinary students from 92 different countries

Online questionnaire

Traditional learning

96.7% agreed that OL during pandemic affected their academic performance

1

Martinez et al. (2020) [30]

OL; UG medical students from Florida Atlantic University

Online questionnaire

Traditional learning

Students’ performance during virtual OSCE (93%) was similar to f2f OSCE (93.5%)

2

Schoenfeld-Tacher & Dorman (2021) [31]

OL; UG veterinary students from North Carolina State University

Online questionnaire

Traditional learning

Students scored higher in diagnostic toxicology quiz online (2020) compared to f2f learning (2019)

2

Suppan et al. (2021) [24]

OL; UG medical students University of Geneva Faculty of Medicine

Online questionnaire

Traditional learning

Students who participated in OL performed very well compared to f2f

2