Background: The integration of virtual reality (VR) in nursing education has emerged as a transformative approach to bridge gaps in clinical training, particularly where traditional hands-on opportunities are limited. This study investigates the effectiveness of VR-based simulation on improving clinical competency and self-efficacy among undergraduate nursing students. Methods: A quasi-experimental, pre-test/post-test design was employed with 60 final-year nursing students divided into control (traditional training) and experimental (VR training) groups. Participants underwent Objective Structured Clinical Examinations (OSCE) and self-efficacy assessments before and after the intervention. The VR module simulated emergency care and nursing procedures in a high-fidelity immersive environment. Data were analyzed using paired t-tests and ANOVA to assess statistical significance. Results: Students in the VR group demonstrated a statistically significant improvement in OSCE scores (mean difference: 15.4, P < .001) compared to the control group. Self-efficacy scores also increased substantially in the experimental group post-intervention (P < .01). Graphical and tabular data confirmed consistent performance enhancement across all competency domains. Conclusion: VR-based simulation significantly enhances clinical skills acquisition and learner confidence in nursing students. These findings support VR’s integration into nursing curricula as a scalable, immersive tool for developing clinical competence in a risk-free environment. Further longitudinal studies are recommended to evaluate long-term retention and cost-effectiveness.

Keywords: Virtual reality, nursing education, clinical simulation, self-efficacy, OSCE, immersive learning, competency development

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1. Padilha JM, Machado PP, Ribeiro A, Ramos J, Costa P. Clinical virtual simulation in nursing education: Randomized controlled trial. J Med Internet Res. 2019;21(3):e11529. https://www.jmir.org/2019/3/e11529/
2. Kyaw BM, Saxena N, Posadzki P, et al. Virtual reality for health professions education: Systematic review and meta-analysis by the digital health education collaboration. J Med Internet Res. 2019;21(1):e12959. https://www.jmir.org/2019/1/e12959/
3. Al-Elq AH. Simulation-based medical teaching and learning. J Family Community Med. 2010;17(1):35–40.
4. Foronda C, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. Virtual simulation in nursing education: A systematic review spanning 1996 to 2018. Simul Healthc. 2020;15(1):46-54.
5. Shorey S, Ang E, Yap J, Ng ED, Lau ST, Chui CK. Virtual reality simulation in nursing education: A systematic review. Nurs Educ Today. 2021;98:104662.
6. Makransky G, Lilleholt L. A structural equation modeling investigation of the emotional value of immersive virtual reality in education. Educ Technol Res Dev. 2018;66(5):1141-1164.
7. Mayer RE. Multimedia Learning. 2nd ed. Cambridge University Press; 2009.
8. Bandura A. Self-efficacy: The exercise of control. W.H. Freeman and Company; 1997.
9. Liaw SY, Wong LF, Chan SW, Ho JT, Mordiffi SZ, Ang SB. Designing and evaluating a serious game for clinical decision making in nursing education: A randomized controlled trial. Nurse Educ Today. 2020;84:104211.
10. Bloomfield JG, Jones A. Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nursing students: A mixed method study. Nurse Educ Today. 2013;33(12):1605–1611.
11. Koivisto JM, Haavisto E, Niemi H, Katajisto J, Multisilta J. Learning by playing: A cross-sectional descriptive study of nursing students’ experiences of learning clinical reasoning. Nurse Educ Today. 2016;45:22–28.

Background: The integration of virtual reality (VR) in nursing education has emerged as a transformative approach to bridge gaps in clinical training, particularly where traditional hands-on opportunities are limited. This study investigates the effectiveness of VR-based simulation on improving clinical competency and self-efficacy among undergraduate nursing students. Methods: A quasi-experimental, pre-test/post-test design was employed with 60 final-year nursing students divided into control (traditional training) and experimental (VR training) groups. Participants underwent Objective Structured Clinical Examinations (OSCE) and self-efficacy assessments before and after the intervention. The VR module simulated emergency care and nursing procedures in a high-fidelity immersive environment. Data were analyzed using paired t-tests and ANOVA to assess statistical significance. Results: Students in the VR group demonstrated a statistically significant improvement in OSCE scores (mean difference: 15.4, P < .001) compared to the control group. Self-efficacy scores also increased substantially in the experimental group post-intervention (P < .01). Graphical and tabular data confirmed consistent performance enhancement across all competency domains. Conclusion: VR-based simulation significantly enhances clinical skills acquisition and learner confidence in nursing students. These findings support VR’s integration into nursing curricula as a scalable, immersive tool for developing clinical competence in a risk-free environment. Further longitudinal studies are recommended to evaluate long-term retention and cost-effectiveness.

Keywords: Virtual reality, nursing education, clinical simulation, self-efficacy, OSCE, immersive learning, competency development

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Padilha JM, Machado PP, Ribeiro A, Ramos J, Costa P. Clinical virtual simulation in nursing education: Randomized controlled trial. J Med Internet Res. 2019;21(3):e11529. https://www.jmir.org/2019/3/e11529/
2. Kyaw BM, Saxena N, Posadzki P, et al. Virtual reality for health professions education: Systematic review and meta-analysis by the digital health education collaboration. J Med Internet Res. 2019;21(1):e12959. https://www.jmir.org/2019/1/e12959/
3. Al-Elq AH. Simulation-based medical teaching and learning. J Family Community Med. 2010;17(1):35–40.
4. Foronda C, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. Virtual simulation in nursing education: A systematic review spanning 1996 to 2018. Simul Healthc. 2020;15(1):46-54.
5. Shorey S, Ang E, Yap J, Ng ED, Lau ST, Chui CK. Virtual reality simulation in nursing education: A systematic review. Nurs Educ Today. 2021;98:104662.
6. Makransky G, Lilleholt L. A structural equation modeling investigation of the emotional value of immersive virtual reality in education. Educ Technol Res Dev. 2018;66(5):1141-1164.
7. Mayer RE. Multimedia Learning. 2nd ed. Cambridge University Press; 2009.
8. Bandura A. Self-efficacy: The exercise of control. W.H. Freeman and Company; 1997.
9. Liaw SY, Wong LF, Chan SW, Ho JT, Mordiffi SZ, Ang SB. Designing and evaluating a serious game for clinical decision making in nursing education: A randomized controlled trial. Nurse Educ Today. 2020;84:104211.
10. Bloomfield JG, Jones A. Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nursing students: A mixed method study. Nurse Educ Today. 2013;33(12):1605–1611.
11. Koivisto JM, Haavisto E, Niemi H, Katajisto J, Multisilta J. Learning by playing: A cross-sectional descriptive study of nursing students’ experiences of learning clinical reasoning. Nurse Educ Today. 2016;45:22–28.