After considering inclusion and exclusion criteria, 44 articles [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63] were included in this study. Figure 1 shows the screening process for the included articles. In addition, Table 2 and Supplementary Table S2 provide a summary of articles which were included in the study.

Article selection process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [64]

As Table 2 shows, in total, 44 systematic reviews were included, of which 37 studies were conducted as systematic reviews [20,21,22,23,24, 26,27,28,29,30,31,32,33,34,35, 37,38,39,40, 42, 44,45,46,47,48,49, 51, 53,54,55,56,57,58,59,60,61,62], 4 studies as meta-analyses [36, 41, 50, 63], and 3 studies as systematic review and meta-analyses [25, 43, 52]. Most of these studies were conducted in the UK (n = 15, 34%) [21, 27, 33, 35, 36, 38, 45,46,47, 49, 50, 54, 56, 59, 62], the USA (n = 9, 20%) [20, 22, 30, 37, 39, 51,52,53, 63], Italy (n = 4, 9%) [24, 26, 34, 48], and Australia (n = 3, 6.8%) [42, 44, 55]. China [25, 32], Denmark [58, 60], and Canada [28, 43] each contributed to publish two studies. Other studies were conducted in Finland [61], the Netherlands [31], Belgium [23], Germany [41], Switzerland [29], Brazil [40], and France [57] each conducting one study. Furthermore, most of the included studies (n = 13, 29.5%) were published in 2023 [20,21,22,23,24,25,26,27,28,29,30,31,32].

In most studies, XR-related technologies were used to improve training in various surgical areas including orthopedics (n = 15) [20, 22, 25, 27,