VR/XR-based medical simulation is gaining attention as a training method that allows healthcare professionals to repeatedly experience high-risk clinical situations in an environment that poses no harm to real patients, and to practice decision-making and team-based performance under standardized conditions. Traditional high-fidelity simulation relies on physical resources such as manikins, specialist instructors and simulation centers. As a result, it is difficult to ensure sufficient training frequency and scenario diversity, and individual trainees’ experiences may vary depending on team composition and the proficiency of fellow trainees. In this context, VR/XR-based simulation is being discussed as a complementary training environment that can enhance the repeatability, standardization and accessibility of medical training by utilizing virtual patients, virtual team members, dynamic clinical cues and immediate feedback. This article reviews the characteristics and effectiveness of VR/XR-based medical simulation and examines case studies involving procedural and emergency response training, patient interaction and virtual team member training, and integration with high-fidelity simulators. Furthermore, focusing on Korean Advanced Life Support (KALS) training, it discusses the need for the development of VR/XR-based KALS simulation, along with its scenario design, system implementation, and utilization strategies.