JMIR Publications

ABSTRACT

Background:

The utilization of immersive technology for simulation-based learning in the realm 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. Also, immersive technology enables students to access the clinical environments without threatening patient safety and allows instructors to interact with students actively. Despite the advantages of immersive technology, there are claims suggesting that immersive technology-based teaching methods may not be notably effective compared to traditional teaching methods. Therefore, verifying the effectiveness of immersive technology in simulation learning 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 over traditional teaching methods

Methods:

The methodology of this study adhered to the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Randomized controlled trials and quasi-experimental studies in English or Korean were searched across four databases. The quality assessment was assessed using Version 2 of the Cochrane risk of bias tool (RoB 2) and the risk of bias assessment tool for non-randomized studies (ROBANS). Meta-analysis was conducted utilizing RevMan 5.4 software, and the main outcomes were based on New World Kirkpatrick Model(NKWM).

Results:

A total of 23 studies were found. 4 studies used augmented reality (AR) and 19 used virtual reality (VR), covering various nursing scenarios in settings like disaster training, resuscitation, health assessments, and home healthcare. Approximately 70% of scenarios involved virtual patients. Based on Kirkpatrick’s evaluation model, the main outcome variables were 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 has demonstrated effectiveness across various domains, including knowledge attainment (standard mean difference(SMD)=0.63, 95% confidence interval(CI)= 0.30-0.97, P=.00002, I2=91%), self-efficacy (SMD=0.86, 95% CI= 0.42-1.31; P=0.0001, I2=63%), and performance (SMD=1.41, 95% CI= 0.36-2.46; P=.0008, I2=92%), while confidence (SMD=-0.06, 95% CI= -1.68-1.57; P=0.95, I2=98%) did not show significant results.

Conclusions:

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