The effectiveness of nursing education using immersive virtual reality or augmented reality: Systematic review and meta-analysis

Purpose: This study aims to comprehensively assess the characteristics and effectiveness of immersive virtual reality (VR) or augmented reality (AR) in nursing education among nursing students and nurses.Methods: A thorough search was conducted in seven databases (PubMed, Embase, Cochrane Library, CINAHL, RISS, KMbase, and KoreaMed) for randomized controlled trials (RCTs) published in English or Korean before February 20, 2024. The quality of the included RCTs was assessed using the revised Cochrane Risk of Bias tool for randomized trials. A random-effects model was applied for the meta-analysis using Review Manager 5.4.Results: Out of the 15,840 studies extracted, ten were selected. Of those ten, the majority (six, 60%) were conducted on education dealing with specific nursing situations. In addition to the use of immersive VR or AR during nursing education, lectures, debriefing, and discussion processes were applied together, and device usage orientation was also provided. The meta-analyses showed that immersive VR or AR in nursing education significantly improved knowledge (standardized mean difference, SMD=2.64; 95% confidence interval, 95% CI=1.10~4.17) and skills (SMD=0.58, 95% CI=0.02~1.15).Conclusion: Immersive VR or AR in nursing education can effectively enhance knowledge and skills. However, for their development and implementation, various factors should be considered, and these findings are expected to provide valuable evidence regarding that concern.