JMIR Publications

ABSTRACT

Background:

The use of immersive technology for simulation-based learning in the field of nursing has grown significantly over the years. Immersive technology can reduce the limitation of resources which are needed to immerse the students in simulation. Additionally, immersive technology enables students to access the clinical environments without threatening patient safety. Despite the advantages of immersive technology, some studies suggest that immersive technology-based teaching methods may not be notably effective compared to traditional teaching methods. Therefore, verifying the effectiveness of immersive technology in nursing education is necessary for continuing the future educational programs.

Objective:

The objective of this study was to systematically review the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods.

Methods:

The methodology of this study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines: The PRISMA 2020 updated guideline for reporting systematic reviews. Studies for this review were searched across four databases. The inclusion criteria were as follows: studies in which target participants were undergraduate nursing students, those in Korean or English and designed as randomized controlled trials or non-randomized studies, and those utilizing virtual reality (VR), augmented reality (AR), mixed reality, and extended reality. Version 2 of the Cochrane risk of bias tool and the risk of bias assessment tool for non-randomized studies were used for quality assessment. The main outcomes of the included studies were classified as the New World Kirkpatrick Model (NKWM). Meta-analysis was conducted using RevMan 5.4 software.

Results:

A total of 23 studies were included for this review: 19 adopted VR covering various nursing scenarios in settings such as disaster training, resuscitation, health assessments, and home healthcare; and 4 used AR. Approximately 70% of scenarios involved virtual patients. Based on NKWM, the main outcome variables included satisfaction, anxiety, knowledge, confidence, self-efficacy, performance, and clinical reasoning, which were included in Levels 1 to 3. The meta-analysis revealed that immersive technology-based nursing education was effective across various domains, including knowledge attainment (standard mean difference (SMD)=0.71, 95% confidence interval (CI)= 0.39-1.06, P<.001, I2=87%), confidence (SMD=0.70, 95% CI= 0.05-1.35, P=.03, I2=82%), and self-efficacy (SMD=0.86, 95% CI= 0.42-1.30; P<0.001, I2=63%).

Conclusions:

These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies be conducted to evaluate the effects of immersive technology-based nursing education on the NWKM Level 4.