Abstract
BACKGROUND: Over the past two decades, the use of Metaverse-enhanced simulations in medical education has witnessed significant advancement. These simulations offer immersive environments and technologies, such as augmented reality, virtual reality, and artificial intelligence that have the potential to revolutionize medical training by providing realistic, hands-on experiences in diagnosing and treating patients, practicing surgical procedures, and enhancing clinical decision-making skills. This scoping review aimed to examine the evolution of simulation technology and the emergence of metaverse applications in medical professionals' training, guided by Friedman's three dimensions in medical education: physical space, time, and content, along with an additional dimension of assessment. METHODS: In this scoping review, we examined the related literature in six major databases including PubMed, EMBASE, CINAHL, Scopus, Web of Science, and ERIC. A total of 173 publications were selected for the final review and analysis. We thematically analyzed these studies by combining Friedman's three-dimensional framework with assessment. RESULTS: Our scoping review showed that Metaverse technologies, such as virtual reality simulation and online learning modules have enabled medical education to extend beyond physical classrooms and clinical sites by facilitating remote training. In terms of the Time dimension, simulation technologies have made partial but meaningful progress in supplementing traditional time-dependent curricula, helping to shorten learning curves, and improve knowledge retention. As for the Content dimension, high-quality simulation and metaverse content require alignment with learning objectives, interactivity, and deliberate practice that should be developmentally integrated from basic to advanced skills. With respect to the Assessment dimension, learning analytics and automated metrics from metaverse-enabled simulation systems have enhanced competency evaluation and formative feedback mechanisms. However, their integration into high-stakes testing is limited, and qualitative feedback and human observation remain crucial. CONCLUSION: Our study provides an updated perspective on the achievements and limitations of using simulation to transform medical education, offering insights that can inform development priorities and research directions for human-centered, ethical metaverse applications that enhance healthcare professional training.