Virtual Reality in Speech Therapy Students’ Training: A Scoping Review

Abstract

Virtual Reality (VR) is a useful educational tool in healthcare, allowing students to practise and improve practical skills. In speech therapy (ST), the need to revise academic curricula to adapt them to university contexts and integrate them into advanced clinical practices has highlighted the need to analyse the use of VR in this sector. The objective of this scoping review was to investigate whether research has considered using VR to support ST students’ training and highlight potential gaps in the literature. The study followed the JBI methodology for scoping reviews and was reported according to PRISMA-ScR guidelines. A protocol to conduct the current review was developed and registered on the Open Science Framework. The articles considered were retrieved from databases specialising in healthcare, computer science, and education, and were enhanced by results found with the help of AI-based tools. No constraints were applied and all study types were considered. Fourteen studies were included in the review and analysed under four core subjects: VR technology, ST context, training purposes, and main outcomes and assessment methods. The VR types identified in the studies were grouped into four categories, i.e., non-immersive VR (6/14, 42.9%), immersive VR (5/14, 35.7%), non-specified VR type (2/14, 14.3%), and semi-immersive VR (1/14, 7.1%). Most studies (5/14, 35.7%) focused on clinical skills acquisition, others addressed communication and interpersonal collaborative skills (3/14, 21.4%), while the remaining focused on person-centred care and awareness, clinical interviewing or reasoning skills, and performance knowledge (2/14 each, 14.3%). VR is still in its early stages in ST education. Some recent studies suggest VR supports students’ communication, interdisciplinary, and clinical skills. Although still limited in the context of ST education, the increasing affordability and ease of development of VR, along with its growing use in other healthcare fields, suggest that its underuse might be due to institutional barriers and lack of standardised frameworks. Overall, the findings suggest that VR offers promising support for experiential and skills-based learning.

1. Introduction

1.1. Background

In recent decades, the world’s demographic structure has undergone significant changes, characterised by population growth and progressive ageing [1]. Ageing represents a new challenge, as patients’ clinical situations become more complex. Most countries worldwide are experiencing a shortage of health workers, which is expected to worsen in future [2,3,4]. Therefore, innovative care procedures and highly qualified healthcare professionals are needed to meet patient needs.

In addition, the professional and political conditions under which the health professionals operate are undergoing a significant transformation, promoting the transition from a vocational training model to a university-level education, focusing on scientific knowledge, research, and evidence-based practice. This change in education is driven by the necessity to enhance the professionalism of practitioners and improve the quality of care, contributing to enhanced patient outcomes and ensuring alignment with international standards in healthcare education and practice [4,5]. These needs lead to the rethinking of the academic curricula of health professionals to meet the educational requirements of the university system, while ensuring the acquisition of the practical and clinical skills.

Traditionally, practical skills are acquired during training through direct experience in the field, working alongside professionals and performing therapeutic activities on real patients under supervision. However, direct “hands-on” learning has both ethical and organisational limitations, especially when it comes to inexperienced students.

To address these critical issues, the World Health Organisation has recommended the use of reality simulation-based tools [3], recognising the pedagogical value of safe and controlled environments in which students can practise without the risk of accidentally harming patients. Several studies have highlighted the efficacy of simulation-based education compared to traditional learning methods [6] and demonstrated how integrating advanced technologies with traditional learning approaches enhances the acquisition of skills and the training of healthcare professionals [7,8]. Furthermore, the advent of the COVD-19 pandemic made it necessary to develop new distance-learning techniques, both to protect patients and students, and to continue to provide students with adequate and comprehensive training. This has fostered the development of simulation-based technologies, such as virtual reality (VR), in healthcare education and training.

1.1.1. Training in Speech Therapy

As every healthcare field, speech therapy (ST), also known as speech and language therapy (SLT) or speech–language pathology (SLP), is facing the problems previously described. In recent years, the ageing of the population and increasing number of people who have experienced serious health problems, e.g., brain strokes, head and neck cancer, progressive neurologic diseases [9], have led to a significant increase in the number of patients suffering from communication (i.e., apraxia) and swallowing (i.e., dysphagia) disorders.

Recent advancements in the speech therapy field, both from the educational and technical point of view, are resulting in significant improvements in treatment outcomes. In fact, in addition to the shift from vocational to university-based education, the introduction of techniques previously handled by other professionals into the training of speech therapists, such as Flexible Endoscopic Evaluation of Swallowing (FEES), highlights the need for an update of the academic curricula. Moreover, the development of new techniques such as the transcranial Direct-Current Stimulation (tDCS) and the necessity of practicing complex procedures such as Tracheostomy Tube Management, also known as Tracheal Cannula Management (TTM and TCM, respectively), provide the opportunity to reshape the speech therapy curricula.

Moreover, belonging to the healthcare sector, ST also requires students to achieve a certain amount of hours in order to obtain their professional certificate. As an example, in Germany, 1900 h of clinical practice are required, according to LogAPrO, 1980 [10], while in the USA, students are required to complete 375 h of direct clinical placements with patients in order to be certified to practise [11]. In order to provide students with the necessary amount of clinical practice, to reduce the workload of clinical-placement settings, and to address the shortage of licenced clinical educators, some national entities have started recommending the introduction of simulation-based training in speech and language therapy programmes. Indeed, since January 2023, ASHA allows students enrolled in the graduate programme to gain up to 75 direct contact hours through clinical simulation [12]. In Australia, initial efforts to integrate simulation-based learning into speech and language pathology courses can be found in the project led by Dr. A. Hill, within which a Simulation-based Learning Program was developed between 2014 and 2018 [13].

Clinical simulations depict several kinds of situations, aiming to represent reality and let students deal with real-life contexts. Clinical simulations can be categorised into “levels according to how closely the simulation replicates the real-world experience in terms of physical, environmental and psychological elements” [14] (p. 6). The Council of Academic Programs in Communication Sciences and Disorders (CAPCSD) has identified five categories of healthcare simulation, ranging in levels of fidelity: standardised patients, task trainers, manikins, computer-based (gaming), and immersive virtual reality [14].

The current scoping review aims at mapping the use of VR (non-immersive, semi-immersive and immersive); hence, among the simulation types individuated by CAPCSD, here only computer-based simulations and immersive virtual reality-based tools are considered relevant.

1.1.2. Virtual Reality-Based Simulation

Among the categories of simulation identified by the CAPCSD, the authors of the current review decided to focus on both VR and computer-based kinds of simulations. Since the title of the review refers to VR, the choice of considering the first category may appear obvious. In contrast, the decision to include computer-based systems may seem less intuitive. However, this choice is justified by the broad definition of virtual reality, which encompasses several kinds of systems from the least immersive ones to the most immersive ones.

VR can be categorised according to several factors such as immersion, presence, and interactivity. In the current review, VR was categorised according to the level of immersion the technology was able to provide. Indeed, VR can provide different degrees of immersion, with the technology capable of “delivering inclusive, extensive, surrounding and vivid illusion of reality to the senses of a human participant” [15] (p. 3).

For this paper, VR has been divided into three macro categories: immersive VR, semi-immersive VR, and non-immersive VR. In this context, we refer to immersive VR when the technology is able to “surround”, i.e., through the use of head-mounted displays (HMDs) or CAVE systems [15]. On the contrary, we categorised the desktop-based VR systems as “non immersive VR” [16], which provide a lower level of immersion with respect to the immersive ones but, through the desktop, mouse, and keyboard, allow the user to interact effectively with the 3D environment represented by the 2D system. An example of this is represented by Virtual Patients. Systems that implement intermediate shades of immersiveness will be categorised as semi-immersive VR; these may include the use of larger screens to provide the user with a higher sense of presence.

Given this explanation, taking into account computer-based tools also aligns with the current conceptual framework of VR and ensures a comprehensive mapping of its applications in speech therapy education.

Virtual reality has been demonstrated to offer immersive, interactive learning environments that promote the acquisition of theoretical knowledge while increasing student engagement and motivation [17]. By simulating a wide range of clinical scenarios, including rare or complex cases, VR allows students to develop and refine practical skills through unlimited, self-paced repetition in a controlled setting [8]. This flexibility fosters the acquisition of expertise without the ethical or logistical challenges associated with treating real patients, thereby reducing stress and enhancing students’ confidence and awareness [6].

1.2. Rationale

Some studies investigated the use of VR systems in the context of medical education and clinical care [18] or in the field of communication disabilities [19] but none focused on the evaluation of these systems specifically for speech therapists’ skills training of clinical procedures. Considering the current orientation towards the simulation-based clinical training in ST, as well as the numerous studies and projects successfully developed using different simulation tools [20,21,22], the integration of virtual reality into speech and language pathology training programmes seems to be a promising strategy to improve clinical preparedness and support the development of essential professional skills. In the absence of dedicated reviews on this topic, in order to support the above assertion, our research team decided to conduct a scoping review to understand and analyse in a clear and structured manner whether and how virtual reality has already been considered as an educational and training tool for speech therapy students.

1.3. Objectives

The objective of this scoping review is to investigate whether existing research has considered the use of virtual reality as a tool to support the training of speech therapy and language pathology students to improve their practical skills and prepare them to perform clinical procedures. The aim of this study is to provide a comprehensive mapping of the integration of this technology within the domain of speech therapy, with a view to highlighting potential gaps in the current literature. In order to achieve these objectives, the following research questions guided the scoping review:

• How is virtual reality being used in the education and clinical training of speech–language pathology students?
• What are the educational, technological, and methodological characteristics of VR-based interventions in speech–language pathology training?
• What outcomes and benefits are reported in the literature regarding the use of VR in the training of speech–language pathology students? How are these assessed?

2. Materials and Methods

This scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis’s Methodology for Scoping Reviews [23] and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines [24].

2.1. Protocol and Registration

A preliminary search of PubMed, PubMed Central, ScienceDirect, EBSCOHost, the Cochrane Database of Systematic Reviews, PROSPERO, and JBI Evidence Synthesis was conducted and no protocol addressing our subject of interest was identified. Consequently, a scoping review protocol was developed (see Appendix A) and published on the Open Science Framework (OSF) [25].

2.2. Eligibility Criteria

In order to perform a comprehensive literature search, the eligibility criteria were kept as broad as possible. Indeed, the search was not constrained by temporal or linguistic limitations. The opportunity for such freedom was determined by two factors. Firstly, the novelty of the topic under consideration, as virtual reality is a relatively recent technology that naturally limits the search over time. Secondly, the resources available nowadays, such as online translators and artificial intelligence-aided tools, enable the possibility to consult and include sources in a wide range of languages. Additionally, sources in any publication status were considered and no restrictions regarding the study design were applied to provide a reliable map of the available literature. To provide a complete overview of the sources, the typology of each study has been made available within the results of this study.

The records retrieved from the search were considered as eligible for the inclusion in the current review if they met all the following criteria:

• The study was targeted towards students or trainees in the speech therapy and language pathology field. The research encompassed studies that either directly targeted ST students or incorporated them within larger mixed cohorts.
• The study involved the use of virtual reality (including immersive, semi-immersive, and non-immersive formats) or it assessed or evaluated the use of the VR technology.
• The purpose was the education and/or training of students. Furthermore, studies analysing the effects of VR-based tools on students from different perspectives (i.e., from educators’ or students’ points of view) were considered as well.

A more detailed overview of the inclusion and exclusion criteria is provided in

Table 1. Inclusion and exclusion criteria.

	Inclusion Criteria	Exclusion Criteria
Study	All study types	Full-text not available
	All languages
	Every year
	International studies
	Full-text available (with or without a fee)
Population	Students and/or trainees in speech therapy	Students of general medical domain
	Studies with mixed cohorts including speech therapy students and/or trainees	Students of general healthcare domain
		Exclusively speech therapy professionals
Concept	Virtual reality applications (immersive, semi-immersive, non-immersive) involved in the study	Exclusively AR
		Exclusively desktop-based 2D applications
		VR applications used as therapeutic or rehabilitative tool
Context	Education and training of students’ skills	Training of patients

.

2.3. Information Sources

A comprehensive search of the relevant literature was conducted, covering a range of sources including specialised databases, archives, registers, grey literature websites, and artificial intelligence (AI)-driven platforms.

The interdisciplinary nature of the topic under consideration necessitated the consideration of specific databases from the healthcare field, addressing the speech therapy sector; the computer-science field, addressing virtual reality technology; and the educational sector. The following academic databases and research engines were queried: ACM Digital Library, Cochrane Library, EBSCOhost, IEEE Xplore, PubMed, PubMed Central, ScienceDirect, SpeechBite, and Wiley. The PROSPERO register was interrogated to identify ongoing studies and minimise bias risks in our search.

In addition to structured database searches, Google Scholar was consulted to identify grey literature and the AI research assistant Elicit ([26], Pro plan) was used to find further records. We also performed snowballing by manually screening the reference lists of the included articles and reviewing related studies suggested by search engines and online platforms (e.g., Google Scholar, PubMed, etc.), which appeared as “related articles” or algorithm-based recommendations. These were screened manually for relevance and inclusion criteria.

A preliminary search was initiated at the beginning of April 2025, followed by the main investigation in May 2025, which was concluded on 20 May 2025. During this period, information sources were consulted repeatedly in order to refine the search strategies and adapt them to each research system, while maintaining consistency with the guiding research questions.

2.4. Search

A preliminary exploratory search was carried out before the final search by one reviewer (FG). This process allowed the team to identify relevant terminology, e.g., synonyms, and try out different keyword combinations among the previously listed databases. The final keywords, listed in

Table 2. The list of keywords used according to the PCC framework.

Focus	Keywords
Population	speech therapy, speech-language therapy, SLT, speech pathology, speech-language pathology, SLP, logop * (i.e., logopedie, logopaedie, logopedics, logopaedics), student * (i.e., student, students)
Concept	VR, virtual reality
Context	training * (i.e., training, trainings), educat * (i.e., education, educational)

* Truncation symbol in search

, were chosen and agreed by the team based on insights gained during this preliminary phase. In order to avoid the potential loss of pertinent terminology, word roots were employed to encompass their potential variations wherever applicable. As a matter of example, the word “student*” was searched to include publications containing both the terms “student” and “students”.

The search was carried on by one author (FG). During the search, keywords were combined using Boolean operators, and the search symbols specified by each database’s interface were employed. Where feasible, the keyword search was conducted by applying filters to restrict the search to the fields of title, abstract, and keywords. The complete search strategy used for each database is provided in Appendix B.

Although the search strategy illustrated above was applied to most of the information resources, it was necessary to modify the search strategy for some sources of information. Specifically, modifications have been made to the search strategy employed for SpeechBite, Science Direct, Google Scholar, and Elicit. For the initial three sources of information, the search has been adapted to align to the characteristics of the filtering tool available. The Elicit tool, an AI-powered research assistant, was utilised to retrieve further studies by entering the research questions on the platform. A more detailed explanation of the strategies employed for the exceptions is available in Appendix C.

2.5. Selection of Sources of Evidence

All the records resulting from the search were imported into Zotero to identify and remove duplicates. Once the duplicates had been removed, a two-step screening process was initiated. Firstly, a title and abstract screening was conducted, followed by a full-text screening, in order to identify the studies to consider for the review.

The title and abstract screening was performed by two independent reviewers, one specialised in the speech and language pathology sector (EH) and one specialised in the computer-science field (FG). If the reviewers both agreed that an article met the eligibility criteria, it was included and progressed to the next step of the review. Conversely, if both agreed that the article did not meet the criteria, it was excluded from the study. In cases of disagreement between the two reviewers regarding an article’s eligibility or, in the event that the initial title and abstract screening did not clearly indicate whether all three inclusion criteria were met, the study was deemed eligible for full-text screening as well.

The records considered eligible for the full-text screening process underwent independent review by three reviewers. As part of the full-text screening process, one researcher (FG) reviewed all of the studies to ensure consistency. Two additional reviewers, an expert of the speech therapy field (MW) and one expert of the computer-science field (WM), each independently screened half of the total studies. During the second phase, the full-text screening, each article was read in its entirety in order to verify whether it met all the eligibility criteria for inclusion in the review. In cases where there were divergent opinions regarding the inclusion of the study in the review, a discussion was held. If no solution was found, the third reviewer was consulted. After this stage, the articles considered relevant to the research objectives were included in the study categorised according to predefined thematic and methodological criteria.

2.6. Data-Charting Process

Relevant data were extracted from each record during the full-text screening process. Each reviewer (MW, WM, and FG) independently took notes on the points of interest of each study, which FG then summarised in an Excel file. The data-extraction template can be found in Appendix D.

2.7. Data Items

The extracted data included the title, author(s), publication year, country, language, study type (i.e., design), VR type (i.e., non-immersive, semi-immersive, or immersive), VR characteristics (tool used for the VR implementation), the population addressed by the study (e.g., Bachelor’s or Master’s students specialising in speech and language pathology and eventual sub-field), the educational and/or training purpose (e.g., enhancement of communication skills, development of interviewing capacity, etc.), and the main results and findings of the study with the evaluation method used (i.e., direct assessment, interviews, or trial-based perspectives).

2.8. Critical Appraisal of Individual Sources of Evidence

In accordance with the PRISMA-ScR guidelines, the retrieved studies were reviewed with a critical perspective to ensure their alignment with the objectives in the review. Given the limited number of studies retrieved on the topic under focus, an inclusive approach was adopted, considering all types of study designs in order to explore the breadth and scope of available research in this field.

2.9. Synthesis of Results

The extracted data from the records were synthesised during the data-charting process (Section 2.6) and are reported here through descriptive and thematic analyses. Where applicable, data are presented in tables, diagrams, and flowcharts and accompanied by a narrative description to provide a comprehensive overview of the results.

3. Results

3.1. Selection of Sources of Evidence

The identification, screening, and inclusion processes are shown in Figure 1. The database search produced a total of 174 records. Of these, 79 were retrieved through databases and registers, while the remaining 95 were found via other methods, such as grey literature (36) and AI-aided tools (59). After removing duplicates (57), 117 records underwent title and abstract screening. Of these, 75 were deemed ineligible for full-text screening. The remaining 42 were screened in full by the reviewers. In parallel, whenever a related article was suggested or an interesting citation was identified (through snowballing), the article was also screened in terms of its title and abstract. If it was eligible for full-text screening, it was read in full. Twenty-six records were identified in this way and fully reviewed. Therefore, a total of 68 records underwent full-text screening by the reviewers. The reviewers reached a consensus on the eligibility of the articles in the majority of the cases, with a total of four articles resulting in divergent opinions. A consensus was reached by the reviewers regarding the inclusion or exclusion of the record for these four articles. In the course of the study, three of these were included, while one was excluded. Of the 68 records reviewed, 42 were defined as ineligible for the review, 12 were not retrieved, and 14 were deemed appropriate for the review and were included and analysed.

3.2. Characteristics of Sources of Evidence

The included studies characteristics are summarised in

Table 3. Data extraction of study characteristics.

Title and Reference	Year	Country	Language	Study Type
The Virtual Immersion Center for Simulation Research: Interactive Simulation Technology for Communication Disorders [27]	2006	USA (Ohio)	en	Pilot
Virtual Patient Simulation Training in Graduate Dysphagia Management Education—A Research-Led Enhancement Targeting Development of Clinical Interviewing and Clinical Reasoning Skills [28]	2016	USA (Florida)	en	Mixed methods
A Clinical Educator’s Experience Using a Virtual Patient to Teach Communication and Interpersonal Skills [29]	2018	USA (Georgia) Australia	en	Qualitative
Oral Functional Assessment Training in Speech Therapy Students Using Virtual Reality (VR) [30]	2018	Iran	en	Descriptive
Impact of Virtual Simulation and Coaching on the Interpersonal Collaborative Communication Skills of Speech-Language Pathology Students: A Pilot Study [31]	2018	USA (Florida)	en	Pilot, Experimental
The Effects of Computer-Based Simulations on Speech-Language Pathology Student Performance [32]	2019	USA (Georgia)	en	Experimental
Efeitos Do Uso de Diferentes Tecnologias Educacionais Na Aprendizagem Conceitual Sobre o Sistema Miofuncional Orofacial [33]	2019	Brazil	en	Controlled randomised trial, Experimental
What Do Speech Pathology Students Gain from Virtual Patient Interviewing? A WHO International Classification of Functioning Disability and Health (ICF) Analysis [34]	2020	USA (Florida) New Zealand	en	Observational, Descriptive
Virtual Patient Clinical Placements Improve Student Communication Competence [35]	2020	Australia UK	en	Experimental
Effects of a Virtual Reality Dementia Experience on Graduate Communication Disorders Students’ Future Clinical Practice [36]	2021	USA (Kentucky)	en	Mixed methods (MA thesis)
Virtual Reality and Stuttering: A Tool for Experiential Learning in Preservice Speech Therapy Education [37]	2022	Belgium	en	Descriptive, Controlled randomised trial (poster presentation)
Speech Pathology Student Perspectives on Virtual Reality to Learn a Clinical Skill [38]	2023	Australia	en	Qualitative
Virtual Reality in Speech Therapy Training: Scenarios and Prototyping [39]	2025	Germany	en	Mixed methods, Design-based research
The Use of Information and Communication Technologies in Preparing Future Speech Therapists for Professional Practice [40]	2025	Uzbekistan	en	Mixed methods, Descriptive

.

The included studies were published between 2006 and 2025, and were primarily conducted in the USA (n = 7, 50%) and Australia (n = 3, 21.4%). Despite being published in different countries, including non-English-speaking countries, all the included articles are in English (n = 14, 100%). Figure 2 shows the geographical distribution of the included studies.

Overall, a positive trend has been observed in the utilisation of VR in the domain of speech therapy training in recent years. Figure 3 shows the number of articles published per year and country of the authors’ institutions.

The typology of records included is broad. The included records predominantly consisted of mixed-methods studies (n = 4, 28.6%), descriptive studies (n = 4, 28.6%), and experimental studies (n = 4, 28.6%). A further series of studies was identified, including pilot studies (n = 2, 14.3%), qualitative studies (n = 2, 14.3%), randomised controlled trials (n = 2, 14.3%), observational studies (n = 1, 7.1%), and design-based studies (n = 1, 7.1%). It is worth highlighting that the total sum exceeds 14, as some of the articles implement more than one typology. Moreover, in consideration of the objective of the present research, which is to map the present state of the literature, the following sources were included: journal articles, peer-reviewed publications, poster presentations, and master theses.

3.3. Critical Appraisal Within Sources of Evidence

The objective of the current scoping review was to explore, map, and objectively describe the types of virtual reality technologies that have been developed and applied within the educational context of future speech therapists. The focus was deliberately not on assessing the effectiveness of the respective interventions or the methodological rigour of the studies. Instead, the full-text screening enabled the reviewers to make a critical judgement based on their personal knowledge and experience to determine whether a study was relevant to addressing the specific objectives of this review. This approach underscores the intention to provide a comprehensive overview without conducting a systematic quality assessment of the studies. The full-text screening phase of the search allowed the reviewers to determine critically whether a study was relevant to address the objectives of the current review.

3.4. Results of Individual Sources of Evidence

A range of outcomes has been reported in studies examining the use of VR in speech therapy training. The studies included in this analysis are consistent with the established criteria for the search, and each of them combines the three key focus points (virtual reality, population, and training purposes) in a different way. The subsequent table (

Table 4. Results of individual sources of evidence.

Author(s) and Reference	VR Type	VR Characteristics	Population	Training Purposes (and Sub-Fields)	Main Outcomes and Assessment Methods
(Williams, 2006) [27]	Immersive VR	CAVE	Graduate SLP (and patients with communication disorders)	clinical skills	predicts increased competency and transfer of skills
		projection-based technology		(communication disorders)
(Sia et al., 2016) [28]	Non-immersive VR	Virtual Patients (VPP); immersive VP simulation	Graduate SLP	clinical interviewing and clinical reasoning skills	improvement of diagnosis competencies, reasoning and empathy; positive feedback
				(stuttering)
(Banszki et al., 2018) [29]	Non-immersive VR	Virtual Patients; immersive VP simulation	Undergraduate (3rd year); CE point of view	communication and interpersonal skills	improvement of CE confidence and pedagogical skills as educator
(Moradi et al., 2018) [30]	Immersive VR	3D glasses + monitor + gloves	SLP students (5th term)	oral organs assessment training	increase in students’ scores
(Towson et al., 2018) [31]	Semi-immersive VR	mixed-reality real-time simulator TeachLivE	Graduate SLP (3rd semester)	interpersonal collaborative communication skills when delivering information regarding a singular patient to different stakeholders	performance enhancement (2nd attempt); collaborative
					communication
					(Situation–
					Background–
					Assessment–
					Recommendation–
					Communication
					[SBAR-C]), high
					acceptability
(Carter, 2019) [32]	Non-immersive VR	Virtual Patients; SimuCase; immersive VP simulation	Graduate SLP (2nd semester)	performances in paediatric language disorders	improved clinical skills, high levels of improvement on the SCSI and CTCSD
(Rondon-Melo & Andrade, 2019) [33]	Non-immersive VR	2D interactive computer game (Anatesse 2.0); interactive 3D computational model (Primal Pictures)	Undergraduate students in Speech–Language and Hearing Sciences (SLHS)	anatomy and physiology of the orofacial myofunctional system	students’ performance in the knowledge assessment was similar, regardless of the learning method applied
(Miles et al., 2020) [34]	Non-immersive VR	Virtual Patients	Graduate final year	interviewing skills using WHO-ICF	ICF respected, matching health literacy; VP interviews and findings as assessment
				(dysphagia)
(Robinson et al., 2020) [35]	Non-immersive VR	3D (computerised) high fidelity digital patients; immersive VP simulation	Undergraduate SLP (2nd year)	communication skills	improved communication competence; CCIS, PRQs as assessment method
				(dementia)
(Blaydes, 2021) [36]	VR (non specified)	non specified	Graduate SLP (2nd year)	understanding the importance of providing person-centred care	small margin for score improvement; increased levels of empathy
				(dementia)
(Deman et al., 2022) [37]	Immersive VR	not specified	BA SLP students	understanding stuttering-related anxiety	students reported fear and physiological fear responses
(Kelly et al., 2023) [38]	Immersive VR	VR-OMA application; Oculus Quest 1	Undergraduate SLP (2nd year)	clinical skills	positive reaction of students’ intrinsic and extrinsic value for the training experience
				(oral musculature assessment)
(Gentile et al., 2025) [39]	Immersive VR	Meta Quest 3 applications implementing different scenarios	SLP	clinical skills	prototype development to be assessed through usability, presence, acceptance, user experience
				(FEES, TTM, tDCS)
(Xonbabayeva Madinabonu Asqarjon kizi, 2025) [40]	VR (non specified)	not specified	SLP students and educators	practical skills	enhanced understanding, skill acquisition, confidence and competence; interviews assessment

) provides a concise overview of the primary conclusions derived from each record that was covered in the review.

3.5. Synthesis of Results

On the basis of the purpose of our scoping review, the findings have been analysed under four major cores: (1) VR type and characteristics, (2) population, (3) training purposes (and sub-field of application), and (4) main outcomes and assessment methods.

3.5.1. Virtual Reality—Type and Characteristics

As outlined in the eligibility criteria that were applied in the selection of studies for inclusion, the focus was exclusively on studies that incorporated VR as a technological element. In the current review, VR was categorised according to the level of immersion the technology was able to provide. Indeed, VR can provide different degrees of immersion, with the technology capable of “delivering inclusive, extensive, surrounding and vivid illusion of reality to the senses of a human participant” [15] (p. 3).

For this paper, VR has been divided into three macro categories: immersive VR, semi-immersive VR, and non-immersive VR. In this context, we refer to immersive VR when the technology is able to “surround”, i.e., through the use of head-mounted displays (HMDs) or CAVE systems [15]. On the contrary, we categorised the desktop-based systems as “non immersive VR”, which can be interacted with through the use of mouse and keyboard, such as Virtual Patients. Systems that implement intermediate shades of immersiveness will be categorised as semi-immersive VR, these may include the use of larger screens to provide the user with a higher sense of presence.

The simple categorization “VR” has been used to identify the studies in which the kind of virtual reality used was not specified. From now on, VR references will target the general use of VR, unless it is specified otherwise.

Some of the included studies also take into account or evaluate other technologies such as AR or MR that are not outlined here. Figure 4 and Figure 5 represent the VR types of the included studies and their characteristics, respectively.

In the included studies, six (42.9%) [28,29,32,33,34,35] of them implemented a non-immersive VR simulation. The primary objective of these studies is to furnish SLP students with screen-based simulations and the opportunity to interact with virtual patients to foster conversation and train communication [29,31,35], interpersonal [29,31], interviewing [28,34], and reasoning [28] skills.

Immersive VR systems were analysed in five (35.7%) [27,30,37,38,39] studies. These systems aim to immerse the user into a realistic environment within which the user can move and interact with the objects with physical body movements, providing them with a high sense of presence.

As early as 2006, the Virtual Immersion Center for Simulation Research (VICSR) highlighted the potential of providing computerised training in a safe, controlled, learner-centred environment for the field of speech–language pathology that could promote the transfer of skills into real-world settings [27]. Indeed, the VICSR aimed to develop an immersive virtual reality CAVE able to provide speech pathology students with a simulation environment to practice real-life scenarios.

Later on, other studies investigated the use of a more recent technology, i.e., head-mounted display (HMD). In 2018, Moradi et al. [30] investigated the use of a system composed of 3D glasses with an additional monitor and a pair of gloves while others proposed to use the Oculus Quest 1 [38] and the Meta Quest 3 [39].

The study conducted by Towson et al. [31] was classified as semi-immersive since it involves the use of a real-time mixed-reality simulator, TechLivE, as well as a “large television screen, which features a virtual conference room and one adult avatar. There is a desk and chair in front of the screen in which the participant sits, with additional chairs around the perimeter of the room for observers.” [31] (p. 5).

Two studies were classified as generic VR [36,40] since they do not specify which level of immersion the VR provides to the user.

3.5.2. Population

As outlined in the eligibility criteria that were applied in the selection of studies for inclusion, the focus was exclusively on studies that were targeting the population of speech and language pathology students. The selected studies involved students from both the graduate and undergraduate courses, who were enrolled in different academic years. Figure 6 represents the target population of the included studies.

All studies considered have speech therapy students as their target population. The target population is characterised by homogeneity with regard to undergraduate and graduate students. Rondon-Melo & Andrade [33] concentrate their study on hearing sciences students, given that Speech–Language and Hearing Sciences (SLHS) students are enrolled in a unique course. In addition to conducting these studies to verify the effectiveness of VR in academic curricula, some researchers have addressed their search to clinical educators to assess their point of view regarding this innovation [29]. Xonbabayeva Madinabonu Asqarjon kizi also conducted a structured survey among both SLP and educators to assess the use and effectiveness of ICT in the SLP training programmes [40]. Finally, the study conducted by Williams [27] also presents its technology as a valid tool for training patients with communication disorders, as well as a positive educational tool for training students.

3.5.3. Training Purposes (And Sub-Fields of Application)

As outlined in the eligibility criteria that were applied in the selection of studies for inclusion, the focus was exclusively on studies that aimed at providing or enhancing SLP students’ skills. Five main kinds of skills emerged: (1) communication and interpersonal collaborative skills, (2) clinical interviewing or reasoning skills, (3) performance knowledge, (4) clinical skills, and (5) person-centred care intervention and awareness. Figure 7 illustrates the training purposes of the included studies.

Among the included studies, three (21.4%) [29,31,35] addressed the communication and interpersonal collaborative skills training being a core capacity for speech therapists. Indeed, communication is fundamental to understand patients’ necessities and to exchange information with different stakeholders, i.e., patients’ families and other clinicians. Two studies (14.3%) [28,34], focused on clinical interviewing or clinical reasoning processes, aimed to enhance students’ capacity of investigating and diagnosing the correct disease and to find the correct therapy to treat the patient.

The other two studies (14.3%) were thematically focused on performance knowledge [32,33]. In 2019, Carter et al. [32] utilised the non-immersive SimuCase platform to facilitate students practising with virtual patients, with the objective of enhancing their performance in the domain of paediatric language disorders. In the same year, Rondon-Melo et al. [33] conducted an experiment comparing the level of knowledge students gained from three different educational methods on the subject of the anatomy and physiology of the orofacial myofunctional system.

Two studies (14.3%) highlight how essential it is for students to understand the importance of delivering person-centred care to patients [36,37]. Blaydes et al. and Deman et al., independently, describe in their studies how letting students feel what patients experience in everyday life is helpful in fostering empathy and, therefore, allows them to be more focused on delivering a patient-centred care therapy and cure.

A total of five studies (35.7%) focused on training and enhancing the clinical skills of students [27,30,38,39,40]. These studies aimed at using VR as a tool to train speech-therapy-specific procedures, the knowledge of which is fundamental but which are difficult to train prior to clinical placements. As early as 2006, the authors had thought about providing a simulated environment (i.e., CAVE) to students to let them train clinical procedures related to communication diseases [27]. Later, in 2018, Moradi et al. [30] described an immersive VR-based technology to let students train with oral organs. In 2023, Kelly at al. [38] described the positive perspectives of SLP students regarding training Oral Musculature Assessment (OMA) through the use of the Oculus Quest 1. The most recent studies, conducted in 2025, also propose the training of practical skills [40] and of specific speech therapy clinical skills related to complex techniques such as TTM, FEES, and tDCS [39].

The majority of the included studies, in addition to focusing on the type of skill to be trained, consider a particular clinical practice and/or clinical condition as an example. The following subfields emerge from the analysis of the available studies: dysphagia, dementia, OMA, communication disorders, FEES, TTM, tDCS, oral organs assessment, stuttering-related anxiety, and stuttering.

3.5.4. Main Outcomes and Assessment Methods

The included studies reported a range of outcomes related to the effectiveness of VR-based training in the field of speech therapy. These outcomes were assessed in different ways, based on the necessities of each study.

Overall, the studies reported positive results both in terms of soft skills and hard skills. In line with the prediction that Williams made in 2006 in his study, VR systems foster the increase in competencies [27,28,29,35,40] and skills transfer [27]. Different studies assessed the acquisition and enhancement of skills [32,40] and, therefore, enhancements in the performance [30,31]. Additionally, there are also improvements in reasoning, empathy [28,36] and confidence [29,40]. Deman et al. [37], stated that students reported fear and physiological fear due to the aim of the VR experience to let users feel the anxiety usually felt by people who stutter.

VR is generally well accepted and considered as a valid tool to simulate real-life situations that are difficult to face and to train for before clinical placements. Indeed, the included studies report high acceptability [31], positive reaction of students’ intrinsic and extrinsic value for the training experience [38] and positive feedback [28].

The studies used both qualitative and quantitative evaluation methods to evaluate the VR under several aspects in the context of ST training. Some authors preferred to evaluate their systems using standard questionnaires and/or standardised minimum-requirements scales; some examples are International Classification of Functioning Disability and Health (ICF) [34]; Situation—Background—Assessment—Recommendation—Communication (SBAR-C) [31]; Communication Competence in Interpersonal Settings (CCIS); Patient Relationship Questionnaire (PRQ) [35]; usability, presence, acceptance, user experience questionnaires [39]; Standardized Clinical Skills Inventory (SCSI); and Critical Thinking in Clinical Skill Development (CTCSD) [32]. Additionally, qualitative interviews with SLP students and educators were carried out to record their thoughts regarding the use of VR in ST training [28,29,34,38,40].

4. Discussion

4.1. Summary of Evidence

4.1.1. General Overview

The number of records found that regard the use of VR in SLP training is limited, with only fourteen studies retrieved during the review process. As stated in several studies [20,30,38], there is a lack of search for simulation-based systems for SLP students, and this is clearly reflected in the VR context as well. This paucity of records suggests that the topic is still in its infancy, with VR-based systems representing a new potential subject of search within speech therapy.

In speech therapy education and training, the use of simulation has increased significantly over time, with numerous studies evaluating its effectiveness in enhancing students’ learning outcomes and clinical readiness [30,31,32,35,36,41]. Despite the absence of constraints in the current review, the included studies span a period of almost 20 years, with only one study published in 2006 [27] and the others in the last nine years. This trend may suggest that, as early as 2006, the potential of this technology was emerging. Indeed, the study by Williams [27] focuses on a CAVE system, an immersive technology that is both expensive and difficult to manage in terms of implementation, distribution, and cost. These limits probably prevented the promotion and the diffusion of this technology on a large scale. Nevertheless, it can be deduced that this study explored the use of the VR in the context of ST, becoming a precursor of the studies conducted from 2016 onwards. In the last decade, the reduction in hardware costs, the easier content development, and the portability of stand-alone portable devices brought about an increase in the implementation of VR technologies. As revealed by Figure 3, interest in VR within the field of SLP has grown since 2016, probably driven by the extensive range of applications that VR may have and the positive outcomes reported in education and training contexts. Additionally, in recent years, the SLP field has been undergoing significant changes in terms of university curricula, reflecting the evolving demands of clinical practice and the integration of simulation-based educational technologies.

4.1.2. VR and Training Purposes

During the screening process conducted for this review, various forms of simulation were identified, including the use of mannequins, virtual learning environments (VLEs), standardised patients, role-playing activities, and computer-based scenarios. However, given the objective of the current review, only the studies specifically focusing on the use of VR were included.

Within the considered studies, the training purposes identified span from soft-skills to hard skills, communication and interpersonal collaborative skills, clinical interviewing or reasoning ones, performance knowledge, clinical skills, and person-centred care intervention and awareness.

The educational outcomes registered by the included studies are several and heterogeneous. The paucity of studies, their different methodologies, and the conclusions to which those lead prevent us from identifying a scheme or a correlation between the VR-tools and the educational outcomes measured. This observation, strengthened by the debate carried on by R. E. Clark and R. Kozma [42,43,44,45,46,47], led our discussion, focusing on the correlation between VR tools and training purposes rather than the link between VR-based technologies and educational outcomes. In Figure 8, the correlations between the VR tools and the training purposes in the studies included are shown.

Although the limited number of studies, our team identified some common features and emerging patterns across the included research. Analysing the data, it emerges that, in most cases, non-immersive and semi-immersive VR are primarily employed to train communication, interpersonal, and collaborative skills while immersive VR is used to develop practical and clinical skills. Moreover, while the purpose of training the first kind of systems is more homogeneous, the skills that immersive VR applications aim to train are practical and procedure-specific.

On the one hand, the first kinds of systems often feature virtual patients or avatars that simulate realistic clinical scenarios, allowing users to engage in interview-based interactions (mainly chat-based) and practice clinical reasoning in a structured yet flexible and controlled environment. These have resulted in being effective for students in practicing dialogues with patients while investigating the diagnosis and reasoning on the following steps to perform. In addition to the enhancement of these soft skills, VR turned out to be a useful tool to improve awareness with regard to patients’ clinical situations and foster empathy towards them, allowing for a more dedicated approach to the patient’s conditions. On the other hand, immersive VR systems have been investigated for training procedures that usually require a direct hands-on approach toward the patient. Except for the cave-based immersive system [27], which provides an environment in which to practice communicative skills, and the system described by Deman [37], which aims at letting the users experience stuttering-related social anxiety, the other three studies describe systems focusing on very specific and different topics. Indeed, these tools provide specific scenarios to gain practical experience in specific clinical procedures, i.e., oral functional assessment [30], FEES, TTM, and tDCS [39], and OMA [38]. It is worth noting that only Moradi and colleagues [30] managed to assess the effectiveness of the system, registering an increase in students’ scores through independent-T test, while Kelly et al. [38] qualitatively assessed the perspectives of VR-OMA across ST students. The project carried out by Gentile et al. [39] is still in its prototype phase and has not been tested yet. To the best of the authors’ knowledge, these observations led to the thought that the effectiveness of recent technologies, i.e., Oculus Quest 1 (Oculus VR/Meta, Menlo Park, CA, US) and Meta Quest 3 (Meta, Menlo Park, CA, US), have not been tested yet in ST training contexts, therefore highlighting a gap in the literature. Given Moradi’s opinion that “Virtual Reality technology results in increase in attention, concentration, and motivation” and that “Virtual Reality structure is so flexible in training and lets the students know this technology in different situations and sometimes new situations to choose, each one can be a type of learning.” [30] (p. 89), the authors of this review believe that it is worth investigating this sector.

Additionally, SLP-related studies [48,49], which were not included in the review due to inclusion and exclusion criteria restrictions, highlight the effectiveness of VR training systems for professionals and providers. This may suggest that the inclusion of such tools into the SLP student’s training could have positive effects on future speech therapists, if adequately adapted to educational contexts.

Future searches may investigate the outcomes derived from the use of immersive, new and cutting-edge VR training systems in ST training and define a framework for the development of specific scenarios to train with.

4.1.3. VR-Based Learning and Speech Therapy

Although the number of identified studies is lower compared to other healthcare fields, such as nursing, it remains consistent with other reviews. Speech therapy is indeed a specific and evolving field that is still in the process of establishing clear guidelines for introducing simulation-based learning into its educational curricula. Furthermore, the diversity techniques that ST addresses, along with the need to collaborate with other fields, e.g., computer science, to develop tailored simulation tools, makes the integration of simulation-based tools, and more specifically VR-technologies, into the ST field both costly and less accessible.

The included studies were conducted in various countries, with a particularly high concentration in the USA and Australia. A deeper insight of the data reveals a rise in interest towards the use of VR for ST education and training, with a significant increase observed beginning in 2016 for the USA and in 2018 for Australia. This increase may be associated with institutional support and guidance provided by national associations such as ASHA in the USA and SPA in Australia. Indeed, both ASHA and SPA have actively supported the integration of simulation-based training in ST curricula. In the USA, up to 75 h of mandatory practicum can be delivered through simulation based systems while, in Australia, an inter-university research was carried out to develop simulation-integrated curricula. These suggestions and recommendations at the national level probably fostered the interest of universities in conducting research in this direction.

In Europe, research in this area remains limited, which may be due to the decentralised nature of professional regulation and the absence of guidelines from a pan-European body such as the European Speech and Language Therapy Association (ESLA). To the best of the authors’ knowledge, there are no specific guidelines or recommendations for simulation-based learning in the field of speech and language therapy. Within the European context, the authors are aware of more general recommendations, such as the “SimNAT Pflege Leitlinie Simulation als Lehr-Lernmethode.”

In other regions of the world, such as Asia or Africa, research in this field is rare or even non-existent. The paucity of studies in these regions can be attributed to several factors. In low- and middle-income countries, the shortage of professionals which results in the task shifting and, hence, the lack of professional differentiation may be a reason for the absence of regulatory frameworks. Furthermore, although VR technologies are becoming more accessible with regard to both cost and implementation ease, these may still represent an unaffordable technology for low-income regions.

These considerations highlight the necessity and the importance of developing adequate educational plans for the field of speech therapy. Considering the limited number of studies found worldwide, the authors of the current review assume that the reasons behind this lack are not to be found only in technological or economical limitations, but rather in specific institutional barriers. Indeed, on the one hand, thanks to the increasing spread of VR technology, it is plausible to argue that technological barriers are dropping and are expected to become increasingly accessible in future. On the other hand, the establishment of regulatory frameworks and standardised guidelines supporting the integration of simulation-based training in speech therapy, such as those proposed by ASHA and SPA, could provide a foundation for further research and technological advancement in this field. Furthermore, the promotion of international initiatives to foster a structured advancement may also contribute to the SDGs’ goal for inclusivity and quality education, and lifelong opportunities (in health) for all.

4.2. Limitations

Although the intention was to make this review a faithful representation of the current literature by conducting unrestricted research, the authors acknowledge its limitations.

Firstly, some potentially relevant articles may not have been identified due to limited academic access to certain databases and subscription-based journals, which could have affected the comprehensiveness of the review. Secondly, although Google Scholar was used as an additional information source, some relevant articles may not have been retrieved due to the constraints introduced in the query. Indeed, because of the large number of studies retrieved (15,800) using the query used for other databases, some restrictions were imposed on the search. Some recurrent words referring to irrelevant topics such as “rehabilitation” were excluded from the search to reduce the number of records to be screened. Future studies in this context could broaden this search even more, including all the sources we were not able to access.

Additionally, during the keyword search, particularly the preliminary search, it was observed that the duties of speech therapists sometimes overlap with those of other healthcare professionals. Moreover, this overlap is difficult to delineate since speech therapy regulations differ from country to country. As a result, some speech therapy-related practices may have been developed and studied under other allied health disciplines, and thus may not have been identified using our search keywords. Future research could expand the scope to investigate the use of VR technology in the training of speech therapy allied professions or for speech-therapy specific procedures.

5. Conclusions

The importance of practice-based learning in promoting the acquisition of skills, the situated learning approach, and the potential of immersive virtual reality to support this learning paradigm have been known for more than two decades. Several reviews assessed the lack of VR systems for specific healthcare fields [50] and, more specifically, in the field of speech therapy [36,51]. Indeed, only 14 studies were found to be relevant in the context of ST training through a VR-based tool. VR in speech therapy training is generally used to enhance the communication competencies of ST students towards different stakeholders, improve their empathy and awareness regarding the importance of providing patient-centred care, and fostering the acquisition of clinical and practical skills. Most of the studies included a focus on the effects of non-immersive VR, though there are no concrete results yet regarding the use of immersive VR-based tools, except from the positive perspectives of students regarding their integration into curricula [38] and the literature-based evidence provided by other healthcare fields [36]. Overall, the results reported by the included studies generally indicate the positive impact of VR in the domain of speech therapy training.

In conclusion, this scoping review provides a general overview of the utilisation of VR in the training context of speech therapy. Despite the paucity of literature in this field, a lack of studies and applications based on immersive virtual reality to train future speech therapists has been identified. We expect that this analysis may pave the way for future research and studies regarding the inclusion of immersive virtual reality in the domain of speech therapy training to facilitate the acquisition of practical skills for specific-oriented ST clinical procedures. Corresponding research should not only address the design of ST training scenarios and their effectiveness, but also aim to extract guidelines for the meaningful application of VR tools in the ST field.