Table 1 Databases and according search strategy

Medline

1. ((((virtual reality[MeSH Terms]) OR virtual realt*[Title/Abstract]) OR computer simulation[MeSH Terms]) OR virtual simulat*[Title/Abstract]) OR vr[Title/Abstract]

2. (((((orthopedic[MeSH Terms]) OR arthroplasty[MeSH Terms]) OR arthroplasty, replacement, hip[MeSH Terms]) OR arthroplasty, replacement, knee[MeSH Terms]) OR shoulder[MeSH Terms]) OR spine[MeSH Terms]

3. Surgery

4. (((((((activities, training[MeSH Terms]) OR academic training[MeSH Terms]) OR training) OR activities, educational[MeSH Terms]) OR education) OR trainees) OR task performances, analysis[MeSH Terms]) OR clinical competence[MeSH Terms]

5. #1 AND #2 AND #3 AND #4

167

Cochrane Library

1. MeSH [Virtual Reality] explode all trees

2. MeSH [Computer Simulation] this term only

3. MeSH [Orthopedics] explode all trees

4. MeSH [Arthropathy, Neurogenic] in all MeSH products

5. VR OR Computer Instruction

6. Shoulder OR knee OR hip OR spine OR elbow

7. Surgery

8. #1 OR #2 OR #5

9. #3 OR #4 OR #6

10. #8 AND #9 AND #7

152

Embase

1. Virtual reality

2. Virtual reality simulator

3. Computer simulation

4. VR

5. Ortho*

6. Arthro*

7. Knee

8. Shoulder

9. Elbow

10. Spine

11. Ankle

12. Training or Surgical training or Simulation training

13. Trainees or student or resident

14. Task performance

15. Virtual reality OR virtual reality simulator OR computer simulation OR VR

16. Orthop* OR arthro* OR knee OR shoulder OR elbow OR spine OR ankle

17. Training or surgical training or simulation training OR trainees or student OR task performance

18. #15 AND #16 AND #17

300