Strengths, Limitations, and Distinct Characteristics of VR and Actor-Based Simulation in Medical Education: Protocol for a Scoping Review (Preprint)

BACKGROUND Simulated or standardized patients (SP) have long been a cornerstone of medical education, offering controlled, repeatable, and ethically sound training scenarios. With the rise of skills labs and standardization efforts, SPs have become widely implemented across faculties. However, certain limitations—such as the representation of dynamic or complex clinical conditions—remain. Advances in virtual reality (VR) technology now offer new possibilities to complement traditional simulation formats. While both modalities are well established, little is known about their respective strengths and limitations or the potential for mutual substitution or integration in medical education. OBJECTIVE This study investigates the strengths and limitations of VR and SPs in medical education to inform conclusions about their potential complementarity and ability to address training gaps. METHODS This scoping review was conducted in accordance with the JBI methodology and PRISMA 2020 guidelines. A dual search strategy was developed to investigate VR and SP simulations separately across four databases (PubMed, Web of Science, ScienceDirect, and Cochrane Library). Studies were screened independently by multiple reviewers using predefined inclusion criteria. Data extraction and analysis followed a structured, iterative process, with results to be presented in tabular and narrative form. Eligible studies examine the use of VR and SPs in the education of medical students and physicians, with a focus on comparing their respective strengths and limitations across various training contexts. RESULTS The search strategy is expected to identify studies examining the use of virtual reality versus actor-based simulation in medical education. Results will be reported using a PRISMA flow diagram and summarized in structured tables. Findings will be synthesized narratively and categorized according to advantages, limitations, and distinct characteristics of each simulation modality. If feasible, sub-analyses based on study design, educational setting, or outcome type will be conducted. CONCLUSIONS This scoping review will provide a comprehensive overview of the strengths, limitations, and distinct characteristics of virtual reality and actor-based simulation in medical education. The findings are expected to inform educators and curriculum developers about optimal use cases, identify gaps in the literature, and guide future research on simulation-based training methods. CLINICALTRIAL not possible as scoping review