Effect of virtual reality training on clinical skills of nursing students: A systematic review and meta-analysis of randomized controlled trials

Aim: To assess the effects of virtual reality training on the cognitive, affective and psychomotor domains in nursing education among nursing students.

Background: The use of virtual reality in nursing education immerses students in realistic and interactive environments, greatly enhancing their learning experiences. However, research on its effectiveness in nursing education has shown inconsistent results, particularly regarding its impact on learner emotions related to clinical skills.

Design: Systematic review and meta-analysis.

Method: Related studies were sourced from PubMed, Cochrane, Web of Science and Embase databases from their inception until October 3, 2024. Comprehensive Meta-Analysis software was used for data analysis and the risk of bias was assessed using the Risk of Bias Tools.

Results: Eight randomized controlled trials met our inclusion criteria. The results revealed that virtual reality training significantly enhanced the development of clinical skills, having a positive impact on the cognitive, affective and psychomotor learning domains in nursing students. The following effect sizes were obtained: (1) knowledge: 0.237 (95 % CI: 0.054-0.421, p = 0.011); (2) skill: 0.682 (95 % CI: 0.299-1.064, p < 0.001); (3) self-confidence: 0.287 (95 % CI: 0.008-0.567, p = 0.044); and (4) learning satisfaction: 0.458 (95 % CI: 0.256-0.661, p < 0.001).

Conclusion: Virtual reality nursing training enriches students' cognitive, emotional and psychomotor skills; provides a secure setting for honing critical skills, thus boosting student confidence; and increases students' overall learning satisfaction, but shows limited impact on improving self-efficacy. Integrating virtual reality into pre-departure nursing technology education and training can enhance students' understanding of the nursing process, improve the accuracy of technical operations and promote overall learning effectiveness.