Application of Immersive VR, AR, and MR Training Systems in Acupuncture Education: A scoping review (Preprint)

BACKGROUND Acupuncture is one of the most commonly used interventions for pain management, particularly within traditional Chinese medicine (TCM) and Korean medicine (KM). It is a therapeutic technique that involves the insertion of fine needles into anatomically defined points on the body. Accurately locating and needling these acupoints is inherently difficult due to the subtle anatomical variations and the precision required in point identification. OBJECTIVE This scoping review maps the landscape of immersive Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) in acupuncture education, aiming to address the safety and standardization limitations of traditional training. METHODS We conducted a comprehensive search across six databases, including PubMed and CNKI, for studies applying immersive XR technologies to acupuncture training. Twelve primary studies published between 2008 and 2025 were selected for analysis. RESULTS VR and MR were primarily utilized for visualizing needling depth and internal anatomy, whereas AR demonstrated high utility for surface acupoint localization. Recent advancements include markerless tracking and haptic feedback integration, although challenges regarding hardware accessibility and tactile realism persist. CONCLUSIONS Immersive XR technologies provide a safe and interactive environment for standardized acupuncture skills acquisition. Future development should focus on enhancing haptic fidelity and expanding anatomical scope to better bridge the gap between virtual training and clinical practice.