Artificial Intelligence and Digital Technologies in Medical Education: A Systematic Review of Effectiveness, Equity, and Future Directions

Abstract Advances in artificial intelligence (AI), virtual reality (VR), augmented reality (AR), and extended reality (XR) are increasingly shaping undergraduate medical education. These technologies offer opportunities to enhance knowledge acquisition, clinical reasoning, diagnostic imaging, and exam preparedness. However, evidence on their effectiveness and equity of implementation remains fragmented. This systematic review aimed to synthesize current findings on the impact of AI, VR, AR, and XR interventions among undergraduate medical students. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, six databases (PubMed, Scopus, Web of Science, ERIC, IEEE Xplore, Cochrane Library) and grey literature were searched for studies published between January 2020 and July 2025. Eligible designs included randomized controlled trials, quasi-experiments, mixed-methods studies, and systematic reviews/meta-analyses. Fourteen studies met the inclusion criteria. VR and AR were the most frequently evaluated interventions, particularly in anatomy and physiology, where they consistently improved test performance, engagement, and learner motivation. Immersive VR/XR simulations enhanced diagnostic reasoning and clinical skills, while AI applications, including ChatGPT-based platforms, demonstrated early promise in orthopedic education, anatomy learning, and objective structured clinical examinations preparation. Simulation-based VR also proved effective for ultrasound and diagnostic imaging training. Despite these encouraging outcomes, most studies were limited by small sample sizes, single-institution settings, and short-term outcome measures. Equity-related challenges, including cost, access to infrastructure, and faculty readiness, were underexplored. Overall, the evidence suggests that VR and AR are well-established as effective educational tools, while AI holds emerging potential. Future research should emphasize multicenter trials, standardized outcomes, and equity-focused approaches to support sustainable curricular integration.