Virtual Reality in Speech Therapy Students’ Training: A Scoping Review
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
This paper presents a scoping review on how VR has been used to support the education and clinical training of speech-language pathology students. It maps the types of VR interventions, educational aims, and reported benefits across 14 included studies, highlighting VR’s potential to improve communication, clinical reasoning, and procedural skills. My comments:
Materials and Methods:
Can the authors clarify whether the study protocol was registered in PROSPERO or another database to ensure transparency and reduce reporting bias?
How many reviewers were involved in the study selection and data extraction process?
What were the specific inclusion and exclusion criteria beyond focusing on speech therapy students? For example, were studies excluded if they involved mixed cohorts (practicing clinicians plus students)?
The Methods mention that a critical appraisal of individual studies was not performed; would the authors discuss how this affects the strength of their conclusions?
Discussion:
Given that most included studies focused on non-immersive VR, could the Discussion better explore why immersive VR is underrepresented and how future research might fill this gap?
I also suggest that the authors provide a clearer table summarizing the main outcomes by VR type (immersive vs. non-immersive) to help readers quickly compare effects on different skill sets.
Author Response
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
2. Questions for General Evaluation
We are responding in the point-by-point section
3. Point-by-point response to Comments and Suggestions for Authors
Comment 1: Can the authors clarify whether the study protocol was registered in PROSPERO or another database to ensure transparency and reduce reporting bias?
Response 1: Dear reviewer, the review protocol was developed prior to the data extraction for the scoping review, but it was not registered on PROSPERO, as stated in paragraph 2.1. While the authors were aware of the recommended practice of publishing the scoping review protocol on PROSPERO, due to tight research development timeline in the context of the special issue deadline, it was agreed that the protocol would have been attached as an appendix (Appendix A) to the scoping review, with a view to publishing it 'afterwards' on an open-source online platform. Taking this comment into account, the authors registered the protocol on the Open Science Framework (osf.io) on 21/07/2025, as this platform is indicated as an example in the PRISMA-ScR guidelines (Andrea C. Tricco, Erin Lillie, Wasifa Zarin, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med.2018;169:467-473. [Epub 4 September 2018]. doi:10.7326/M18-0850) and accepts review protocols after the scoping review has been completed.
The registered protocol, available here (https://archive.org/details/osf-registrations-hy3em-v1), differs from the one attached in the appendix A, only for the "Registration" line in the abstract. Indeed, the sentence "Registration: The current protocol has not been published." has been changed with the following one "Registration: The protocol for this scoping review will be registered on the Open Science Framework (OSF) and made publicly available. The registration DOI and the corresponding link will be added to the document as soon as the registration process is completed." allowing for more clarity in the registration process. The corresponding sentence in appendix A has also been changed. Consequently, as recommended by the PRISMA-ScR guidelines, the registration DOI has been added in the abstract and paragraph 2.1. was changed accordingly.
Changes available: Abstract, page 1, lines 17-18; 2.1. Protocol and registration, page 5, lines 199-201; Appendix A, page 24, lines 815-818.
Comment 2: How many reviewers were involved in the study selection and data extraction process?
Response 2: Dear reviewer, indeed, the number of reviewers for the study extraction process has not been specified. The studies were extracted by one reviewer (FG); respective changes were made to the review in section 2.4. With regard to the process of data extraction, as stated in paragraph 2.5., the first phase of the screening process, i.e. the title and abstract screening stage, data were extracted by two reviewers (FG and EH). In the subsequent phase of screening, in which the full texts of the studies were reviewed, three reviewers were involved. In specific, a single reviewer (FG) screened all articles that had been selected for this phase (n=68), while two additional reviewers (WM and MW) each reviewed half of these (34 articles). In summary, all four authors participated in the data extraction process: FG was involved in all phases, EH was involved in the title and abstract screening phase, and MW and WM were involved in the full-text screening phase.
Changes available: 2.4. Search, page 6, lines 252-253, 255, 261.
Comment 3: What were the specific inclusion and exclusion criteria beyond focusing on speech therapy students? For example, were studies excluded if they involved mixed cohorts (practicing clinicians plus students)?
Response 3: Dear reviewer, to determine the inclusion of studies, the inclusion criteria were developed based on the PCC framework (population, concept, and context). Studies were included if all criteria were met. With regard to population, the study had to include speech therapy students (directly or indirectly, e.g. within larger cohorts). With regard to the concept, the study was considered if it included the use of virtual reality as a tool for education and skills training in the field of speech therapy. With regard to the context, the study had to focus on educational or training contexts (e.g. clinical or university). Furthermore, studies that focused on analysing the views, considerations and perceptions of multiple groups of people (educators, students, trainees) regarding the use of VR technology as an educational tool for future speech therapists were considered. The section 2.2. of the scoping review has been slightly modified to better clarify the inclusion criteria for the studies to be included. A table representing the criteria has been included as well. Since this new table was added, all the table numbers have been modified accordingly in the manuscript.
Changes available: 2.2. Eligibility criteria, pages 5-6, lines 217-218, 222-227.
Comment 4: The Methods mention that a critical appraisal of individual studies was not performed; would the authors discuss how this affects the strength of their conclusions?
Response 4: Dear reviewer, we understand that the statements written in paragraphs "2.8. Critical appraisal of individual sources of evidence" and "3.3. Critical appraisal within sources of evidence" may have led to ambiguity or misinterpretation. The paragraphs mentioned above have been rephrased in order to better express the considerations made. In fact, all studies were critically reviewed specifically with respect to the relevance of papers and findings related to the research questions. However, since 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 rigor of the studies. We consider this to be in alignment with established scoping review frameworks, which do not demand a formal assessment of the methodological quality of included studies. We think, however, that the overall conclusions of the review remain unaffected by the absence of a formal critical appraisal of these aspects.
Changes available: 2.8. Critical appraisal of individual sources of evidence, page 8, lines 314-318; 3.3. Critical appraisal within sources of evidence, page 12, lines 386-397.
Comment 5: Given that most included studies focused on non-immersive VR, could the Discussion better explore why immersive VR is underrepresented and how future research might fill this gap?
Response 5: Dear reviewer, thank you for highlighting this aspect. To address this question we have enhanced the “Discussion”paragraph providing deeper insight regarding our considerations on this matter. Additionally, we have broadened some paragraphs to suggest new potential ways to fill this gap.
Changes available: 4.1.3. VR-based learning and speech therapy, pages 20-21, lines 672-679, 701-722.
Comment 6: I also suggest that the authors provide a clearer table summarizing the main outcomes by VR type (immersive vs. non-immersive) to help readers quickly compare effects on different skill sets.
Response 6: Dear reviewer, thank you for your suggestion. Indeed, we have acknowledged that the correlation between VR-based technologies and the training purposes these aim at addressing might haven't been evaluated sufficiently enough. We have added an exploratory paragraph in the "Discussion" section (subsection 4.1.2.) that enhances the correlations among these factors. An additional reference has been added and, therefore, all the reference numbers shifted by one position.
Changes available: 4.1.2. VR and training purposes, page 19, lines 607-624.
Reviewer 2 Report
Comments and Suggestions for Authors
The article is a scoping review aimed at analysing existing research on the application of virtual reality (VR) technologies in the education of speech-language pathology students, with the objective of identifying current trends, methodological approaches, and potential gaps in the literature. The topic is highly relevant, given the rapid development of VR technologies in medical education and the pressing need to adapt speech-language pathology curricula to the contemporary requirements of practice-oriented training. The structure of the article conforms to the standards adopted by MDPI for scoping review articles (core components: Introduction, Materials and Methods, Results, Discussion, Conclusions, Supplementary Materials), including the mandatory PRISMA-ScR elements and the JBI methodology. The level of English is acceptable. The article reads fluently, with clear and scholarly language, and only minor syntactic and lexical inaccuracies. The figures presented are of acceptable quality. The article cites 38 sources, all of which are relevant and appropriate to the research theme, including regulatory documents, methodological sources, recent academic publications, and data from professional associations.
The following comments and recommendations may be formulated in relation to the article:
- The article constitutes a synthesis of existing publications without offering an original theoretical model, a critical analysis of the effectiveness of the technologies, or a systematic typology of VR tools. The content of the “Discussion” section largely duplicates the descriptive results and lacks an in-depth interpretation of the causes of the identified gaps in the literature.
- Despite the stated objective to explore the educational, technological, and methodological characteristics of VR-based interventions, the authors limit themselves to descriptive tables and figures, without attempting to correlate VR types with specific educational outcomes in a systematic manner—for example, through correlation matrices or logical modelling.
- The article does not present empirical or experimental data. There is no attempt to synthesise quantitative findings from various sources, such as through statistical meta-analysis. This diminishes the evidentiary value of the conclusions, particularly concerning the effectiveness of specific VR tools.
- A further shortcoming is the authors’ explicit declaration that no critical appraisal of the included studies was conducted (“Critical appraisal was not performed”), which undermines the validity of the findings and is a debatable decision even in the context of a scoping review.
- The issue of integrating the review findings into the educational process is insufficiently addressed: there is no analysis of the barriers, economic factors, technical requirements, or institutional constraints involved in implementing VR in speech-language pathology education.
Author Response
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
2. Questions for General Evaluation
We are responding in the point-by-point section
3. Point-by-point response to Comments and Suggestions for Authors
Comment 1: The article constitutes a synthesis of existing publications without offering an original theoretical model, a critical analysis of the effectiveness of the technologies, or a systematic typology of VR tools. The content of the “Discussion” section largely duplicates the descriptive results and lacks an in-depth interpretation of the causes of the identified gaps in the literature.
Response 1: Dear reviewer, thanks for pointing this aspect out. We completely agree that these focus points, i.e effectiveness of the technologies and the creation of a theoretical model, may be beneficial for the development of a future systematic review on the topic; however, these aspects were not the objectives of this scoping review. Additionally, in consideration of the paucity of retrieved studies and the considerable heterogeneity of the data collected, the evaluation of the effectiveness of the technologies and the development of a theoretical model, would have been difficult to realise. With respect to a more in-depth analysis of the causes of the gaps in the literature, we have enhanced the "Discussion" section, providing more exhaustive explanations.
Changes available: 4.1.3. VR-based learning and speech therapy, page 21, lines 701-722.
Comment 2: Despite the stated objective to explore the educational, technological, and methodological characteristics of VR-based interventions, the authors limit themselves to descriptive tables and figures, without attempting to correlate VR types with specific educational outcomes in a systematic manner—for example, through correlation matrices or logical modelling.
Response 2: Dear reviewer, thank you for highlighting this aspect. As you correctly outlined, our objective was to explore and map the educational, technological and methodological outcomes of the VR-based interventions identified. However, it was not our objective to correlate the VR types with specific educational outcomes. Indeed, in accordance with Clark and Kozma's Debate on Learning with Media (Clark, 1983 and 1994 ; Kozma, 1994) and the difficulty to attribute effects on educational outcomes to a Media type alone (in this case: VR), we refrained from putting a focus on this. Rather, we focus on training purposes and how these can be implemented for VR technologies. In order to stress this matter, which probably was weakly expressed in the previous version of the manuscript, we added a paragraph in the "Discussion" section to strengthen our statements. Additionally, we integrated a figure to highlight the correlation identified between the VR tools and the training purposes those aim at addressing.
Changes available: 4.1.2. VR and training purposes, page 19, lines 603-624.
Comment 3: The article does not present empirical or experimental data. There is no attempt to synthesise quantitative findings from various sources, such as through statistical meta-analysis. This diminishes the evidentiary value of the conclusions, particularly concerning the effectiveness of specific VR tools.
Response 3: Dear reviewer, thank you for the comment. In line with the PRISMA guidelines for scoping reviews (PRISMA-ScR), our intent was neither to present empirical or experimental data, nor to synthesize quantitative findings from various sources. Indeed, the objectives of our scoping review are to provide an overview on how virtual reality has been applied in the education and clinical training of speech-language pathology students, to identify the VR tools adopted and their characteristics, and to report the outcomes, the benefits and evaluation methods associated with retrieved applications. Specifically, our conclusions don't address the efficacy of the VR tools employed. To be consistent with the aforementioned statements and to avoid misunderstandings, we went through the entire document to ensure ourselves not to have given the impression that our objective was to analyse the effectiveness of the VR tools. Additionally, to strengthen this aspect, we enhanced the "Discussion" section and have proposed the evaluation of the specific VR tools as a focus aspect for future search.
Changes available: 5. Conclusions, page 22, lines 767-769.
Comment 4: A further shortcoming is the authors’ explicit declaration that no critical appraisal of the included studies was conducted (“Critical appraisal was not performed”), which undermines the validity of the findings and is a debatable decision even in the context of a scoping review.
Response 4: Dear reviewer, we understand that the statements written in paragraphs "2.8. Critical appraisal of individual sources of evidence" and "3.3. Critical appraisal within sources of evidence" may have led to ambiguity or misinterpretation. The paragraphs mentioned above have been rephrased in order to better express the considerations made. In fact, all studies were critically reviewed specifically with respect to the relevance of papers and findings related to the research questions. However, since 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 rigor of the studies. We consider this to be in alignment with established scoping review frameworks, which do not demand a formal assessment of the methodological quality of included studies. We think, however, that the overall conclusions of the review remain unaffected by the absence of a formal critical appraisal of these aspects.
Changes available: 2.8. Critical appraisal of individual sources of evidence, page 8, lines 314-318; 3.3. Critical appraisal within sources of evidence, page 12, lines 386-397.
Comment 5: The issue of integrating the review findings into the educational process is insufficiently addressed: there is no analysis of the barriers, economic factors, technical requirements, or institutional constraints involved in implementing VR in speech-language pathology education.
Response 5: Dear reviewer, thanks for pointing this aspect out. We agree that these aspects had to be deepened to provide a more comprehensive overview of the matter. To address your note, we have enhanced the discussion section proposing new facets with regard to the presence of VR applications in speech therapy education.
Changes available: 4.1.3. VR-based learning and speech therapy, pages 20-21, lines 672-679, 701-722.
Reviewer 3 Report
Comments and Suggestions for Authors
Thank you for the opportunity to review this manuscript. The article is well-written, addresses an important topic, and has many merits. However, I have some comments that the authors should address.
1) The abstract would benefit from greater quantitative clarity. Please specify the number of studies using immersive versus non-immersive VR, and provide examples of the specific training goals (e.g., clinical procedures) explored
2) The abstract refers to "other sources," while the results specify that these include grey literature (36 records) and AI-aided tools (59 records), contributing to the 95 records identified through "other methods." Although the methods section provides clarification, including a brief explanation of these sources in the abstract would offer clearer context from the outset.
3) The authors clearly acknowledge that "a critical appraisal of individual sources of evidence included was not conducted." While this approach aligns with standard scoping review methodology, it inherently limits the ability to assess the quality or strength of the included evidence. Although this limitation is transparently stated, it is still important for readers to recognize that conclusions about the robustness of the findings cannot be drawn from this review.
4) The abstract's interchangeable use of 'Speech and Language Therapy (SLT)' and 'SLP,' alongside the full text's additional use of 'speech therapy' and 'speech-language pathology,' needs clarification. This inconsistency in terminology could be confusing for international readers.
5) While the methods section is commendably detailed, consider streamlining its presentation. Specific elements, such as extensive appendix references and the detailed AI search explanation, could be tightened or moved entirely to appendices to enhance overall readability.
6) While the paper defines immersion levels, the distinction between computer-based simulations and VR remains unclear. Please clarify how a standard screen-based interaction, lacking a 3D interface, is still categorized as Virtual Reality.
Author Response
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
2. Questions for General Evaluation
We are responding in the point-by-point section
3. Point-by-point response to Comments and Suggestions for Authors
Comment 1: The abstract would benefit from greater quantitative clarity. Please specify the number of studies using immersive versus non-immersive VR, and provide examples of the specific training goals (e.g., clinical procedures) explored
Response 1: Dear reviewer, thank you for your feedback. The abstract has been enhanced by the incorporation of quantitative data concerning the distribution of studies identified according to the category of VR and the competencies trained.
Changes available: Abstract, page 1, lines 24-30.
Comment 2: The abstract refers to "other sources," while the results specify that these include grey literature (36 records) and AI-aided tools (59 records), contributing to the 95 records identified through "other methods." Although the methods section provides clarification, including a brief explanation of these sources in the abstract would offer clearer context from the outset.
Response 2: Dear reviewer, thanks for pointing this out. Indeed, the sentence "other source" results to be overly generic. The abstract has been revised to highlight the use of AI-aided tools to retrieve additional articles.
Changes available: Abstract, page 1, lines 19-21.
Comment 3: The authors clearly acknowledge that "a critical appraisal of individual sources of evidence included was not conducted." While this approach aligns with standard scoping review methodology, it inherently limits the ability to assess the quality or strength of the included evidence. Although this limitation is transparently stated, it is still important for readers to recognize that conclusions about the robustness of the findings cannot be drawn from this review.
Response 3: Dear reviewer, we understand that the statements written in paragraphs "2.8. Critical appraisal of individual sources of evidence" and "3.3. Critical appraisal within sources of evidence" may have led to ambiguity or misinterpretation. The paragraphs mentioned above have been rephrased in order to better express the considerations made. In fact, all studies were critically reviewed specifically with respect to the relevance of papers and findings related to the research questions. However, since 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 rigor of the studies. We consider this to be in alignment with established scoping review frameworks, which do not demand a formal assessment of the methodological quality of included studies. We think, however, that the overall conclusions of the review remain unaffected by the absence of a formal critical appraisal of these aspects.
Changes available: 2.8. Critical appraisal of individual sources of evidence, page 8, lines 314-318; 3.3. Critical appraisal within sources of evidence, page 12, lines 386-397.
Comment 4: The abstract's interchangeable use of 'Speech and Language Therapy (SLT)' and 'SLP,' alongside the full text's additional use of 'speech therapy' and 'speech-language pathology,' needs clarification. This inconsistency in terminology could be confusing for international readers.
Response 4: Dear reviewer, thanks for pointing this out. We have revised the abstract and the introduction in order to be more consistent with the title of the scoping review and to minimise the possibility of misunderstandings for international readers. We are now using the more generic term "speech therapy" in the abstract. In paragraph 1.1.1., synonyms such as "speech and language pathology" and "speech and language therapy" are highlighted and, from that paragraph on, these terms are used interchangeably.
Changes available: Abstract, page 1, line 11; 1.1.1. Training in Speech Therapy, page 2, lines 80-81; 2.4. Search, page 6, line 253-254.
Comment 5: While the methods section is commendably detailed, consider streamlining its presentation. Specific elements, such as extensive appendix references and the detailed AI search explanation, could be tightened or moved entirely to appendices to enhance overall readability.
Response 5: Dear reviewer, thanks for noticing the effort in the description of the methodology part. Your recommendation has been welcomed and the section “2.4.1 Exceptions” has been removed and its content integrated into Appendix C to improve the overall readability of the section. Consequently, the final paragraph of section 2.4.has been revised accordingly.
Changes available: 2.4. Search, page 7, lines 266-273.
Comment 6: While the paper defines immersion levels, the distinction between computer-based simulations and VR remains unclear. Please clarify how a standard screen-based interaction, lacking a 3D interface, is still categorized as Virtual Reality.
Response 6: Dear reviewer, thank you for this comment. In fact, we distinguish between immersive and non-immersive VR. By non-immersive VR we refer to desktop VR, i.e. computer-based 3d systems that allow a certain level of immersion despite the use of interactions via mouse or keyboard. To strengthen this distinction, we have added a relevant reference and made slight revisions to paragraph 1.1.2. to enhance clarity. It is true that we are also referring to (computer-based) simulations in the paper. We went through the paper to ensure that this term is not being mixed-up with our distinction of VR types.
Changes available: 1.1.2. Virtual Reality-based Simulation, pages 3-4, lines 143-146.
Reviewer 4 Report
Comments and Suggestions for Authors
I have finished the review of the manuscript entitled "virtual Reality in Speech Therapy Students’ Training: a Scoping Review" it is novel and interesting, while it opens the discussion on how VR is employed in training, it also provides a geographical and chronologic description.
Comments for improvement: The abstract includes the aim of the study but is not clear when including conclusions to the main objective, because acceptance was not part of the objective.
Please decide if acceptance was an objective and clearly state.
Lines 156 and 527, I could not understand what "extant" means. Do you refer to ongoing, recently published or new protocols?
There is a 10-year gap between a first pilot in 2006 and a mixed-method design in 2016, so, please mention why is the paucity in reporting important? how can we know it is not the simple result of terminology shifts? are keywords consistent?
How do you believe reporting could be more structured?
Inequities in access to VR training across the globe need to be recognized, do you think that these inequities affect training or education? how can the gaps be reduced? how can SDG approach orient to reduce these gaps?
Author Response
1. Summary
Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.
2. Questions for General Evaluation
We are responding in the point-by-point section
3. Point-by-point response to Comments and Suggestions for Authors
Comment 1: The abstract includes the aim of the study but is not clear when including conclusions to the main objective, because acceptance was not part of the objective. Please decide if acceptance was an objective and clearly state.
Response 1: Dear reviewer, as you have correctly observed, the evaluation of the acceptance was not an objective of our study. However, this aspect emerged during the analysis and was considered worthy of highlighting. We acknowledge that inserting this statement in the abstract might cause confusion among readers. To address this potential issue, the final sentence of the abstract has been revised to ensure greater alignment with the stated objectives of the present study.
Changes available: Abstract, page 1, lines 32-36.
Comment 2: Lines 156 and 527, I could not understand what "extant" means. Do you refer to ongoing, recently published or new protocols?
Response 2: Dear reviewer, thank you for the comment. With the term "extant" we referred to all the situations you described.The objective of this scoping review is to provide a comprehensive overview of studies conducted and the developments made thus far in the domain of VR in speech therapy. To achieve this, we included studies that have been published, are ongoing, or are planned for the future. Consequently, our scoping review encompassed all studies including those at various stages of development (completed, planned or ongoing). We understand the misunderstanding that the use of this specific term might cause, therefore the term "extant" has been substituted with the terms "existing" and “available”.
Changes available: 1.3. Objectives, page 4, line 177; 3.5.3. Training purposes (and sub-fields of application), page 17, line 539.
Comment 3: There is a 10-year gap between a first pilot in 2006 and a mixed-method design in 2016, so, please mention why is the paucity in reporting important? how can we know it is not the simple result of terminology shifts? Are keywords consistent?
Response 3: Dear reviewer, we have elaborated the paragraph addressing this 10-years gap (4.1.1.) to provide better clarity regarding our hypothesis on this issue. Specifically, we attribute the scarcity of results to the technological transition from a CAVE to other kinds of VR-based tools. To the best of our knowledge, in view of the findings and the absence of any indicators, we have no reason to believe that the absence of studies in this time window is due to terminology shifts or keywords inconsistencies.
Changes available: 4.1.1. General overview, pages 18-19, lines 588-598.
Comment 4: How do you believe reporting could be more structured?
Response 4: Dear reviewer, given your question we have taken the opportunity to reorganise the “Discussion” section in order to improve readability and smoothness. In addition to reorganising the section in a more organic way, as you will notice, we have enhanced some parts to incorporate other reviewers' comments and suggestions as well.
Changes available: 4. Discussion, pages 18-21, lines 573-722.
Comment 5: Inequities in access to VR training across the globe need to be recognized, do you think that these inequities affect training or education? How can the gaps be reduced? How can SDG approach orient to reduce these gaps?
Response 5: Dear reviewer, thank you for pointing this aspect out. We agree that economic, social, and contextual inequalities contribute to an imbalance in learning and training provision. Due to the scarcity of articles, we also noticed a heterogeneous distribution of countries of origin, particularly between high- and low-income countries. Therefore, we believe that institutional barriers are also a contributing factor. We believe that developing structured frameworks and standardised guidelines could help fill the current literature gap by bringing new developments in this field. We have strengthened the “Discussion” paragraph (4.3.1) to address this topic.
Changes available: 4.1.3. VR-based learning and speech therapy, pages 20-21, lines 672-679, 701-722.
Round 2
Reviewer 1 Report
Comments and Suggestions for Authors
The authors have well addressed my concerns and I have no further comments.
Reviewer 2 Report
Comments and Suggestions for Authors
The authors have responded thoughtfully to the provided recommendations and, overall, have presented a convincing justification for the chosen scope and boundaries of their research, as is characteristic of a scoping review. In response to the reviewer’s comments, the discussion section has been substantially revised and strengthened, specifically:
– the analysis of the limited implementation of VR in speech-language therapy education has been expanded, with consideration of institutional and economic factors (Section 4.1.3);
– a visual representation of the relationship between VR types and educational objectives has been added, allowing for a more nuanced understanding of the current approaches (Figure 8);
– the methodological stance regarding the absence of formal critical appraisal has been clarified, aligning it with the adopted research strategy (Sections 2.8 and 3.3);
– potentially misleading conclusions about the effectiveness of VR have been avoided, and the authors consistently emphasise the descriptive nature of their findings.
While certain analytical possibilities remain inherently limited due to the heterogeneity of the sources and the aims of a scoping review, the authors have demonstrated methodological rigour, interdisciplinary awareness, and responsiveness to critique within the chosen framework. The findings offer relevant implications for educational policy and may serve as a foundation for future empirical research in the field of speech-language therapy education involving VR technologies.
