Immersive virtual reality in nursing education: A scoping review of components, outcome variables, and interaction modes

Abstract

Background: Immersive virtual reality (IVR)-based nursing education enhances learners' engagement and sense of presence. To optimize learners' experience, it is essential to explore various aspects of IVR-based education.

Objectives: This study aimed to identify the components, outcome variables, and interaction modes, and provide considerations for designing effective IVR-based nursing education.

Methods: This scoping review followed the Joanna Briggs Institute guidelines and explored Academic Search Ultimate, CINAHL, Cochrane Library, Education Source, Embase, ERIC, PubMed, Scopus, and Web of Science. The inclusion criteria were studies involving undergraduate nursing students, virtual patient interactions in IVR, and studies published in English or Korean. The exclusion criteria were studies involving only one-way communication from learners to virtual patients. Outcome variables were categorized using the New World Kirkpatrick Model, and interaction modes were classified based on definitions from previous studies.

Results: Thirty-one studies published since 2021 were included. Virtual patients represented diverse age groups and various health conditions. The scenario settings varied across hospitals, clinics, care facilities, homes, and communities. In all included studies, outcome variables at Level 1 (reaction) or Level 2 (learning) of the New World Kirkpatrick Model were assessed. Controller-based interactions were most frequently utilized, while natural interaction modes, such as speech recognition and gesture-based interactions, were employed in only a few studies.

Conclusions: This review highlights the key aspects of IVR-based nursing education, encompassing diverse virtual humans, scenario settings, outcome variables, and interaction modes. Building on these findings, IVR offers valuable opportunities to enhance learners' engagement and authenticity in nursing education. We suggest that nursing educators carefully consider the components and interaction modes of IVR and employ multiple levels of outcome evaluat