Statement of Purpose Almost 25,000 children experience unintentional pedestrian-related injuries annually. Use of virtual reality (VR) to teach children the complex cognitive task of pedestrian safety is steadily rising. We conducted a systematic literature review evaluating the status and progress of research using VR to teach children pedestrian safety.

Methods/Approach We searched PsychInfo, PubMed, and Scopus using the following: (child* and (pedestrian* or street*) and (‘virtual reality’ or simulation) and (training or intervention or prevention)). Efforts were made to uncover unpublished and gray literature. Inclusion criteria included: (1) VR use as training/teaching strategy, (2) purpose to teach children pedestrian safety, (3) training/intervention-focused research, (4) children <18 in sample.

Results Initial searches yielded 93 results following deduplication. Screening occurred in Covidence. The full text of 34 articles was reviewed; 18 met inclusion criteria. Publication dates ranged from 1987–2020. Seven countries were represented. All 18 studies demonstrated VR pedestrian safety training was effective (p<.05), though mixed findings emerged for specific safety aspects (e.g., hits/close calls, start delays to enter traffic). A variety of VR styles were studied, generally demonstrating temporal evolution in both realism and immersion. Child ages ranged from 4–11, with most aged 7–9. Mixed findings emerged concerning age and gender differences. Quality of research varied. Some interventions followed rigorous RCT approaches; others used pre-post or case comparison designs. There also was wide variety in extent of training, ranging from a single 1.5-hour session to multiple sessions over weeks.

Conclusion VR appears promising for child pedestrian safety training. We plan a meta-analysis and further examination of covarying factors that may relate to training success.

Significance Child pedestrian injuries are a significant public health challenge. These findings indicate VR interventions shows promise to reduce pedestrian injury rates. As technology improves and research evidence grows, efforts to disseminate interventions should be prioritized.