Immersive learning in critical care: first experiences in Intensive Care Units for nursing students through low-cost virtual reality

Abstract This study explores the use of a low-cost, 360-degree VR environment to simulate an Intensive Care Unit (ICU) for nursing students with limited prior ICU experience. It investigates student perceptions of situational awareness, engagement, usability, cognitive workload, and perceived learning usefulness. The VR environment replicates a high-fidelity ICU with realistic medical equipment and interactive predefined hotspots; 42 students experiences were assessed using validated instruments, including the NASA-Task Load Index (NASA-TLX), Situation Awareness Rating Technique (SART), User Engagement Scale-Short Form (UES-SF), and the System Usability Scale (SUS). Data were collected from the students after completing the simulation of a clinical case in a seminar. Participants rated the VR simulation positively for engagement (median= 3.96 out of 5 in UES-SF), usability (mean = 70.8 in SUS), and perceived educational value (mean over 4 out of 5 in all educational purpose related questions). However, moderate mental demand (median = 4.00 out of 7 in NASA-TLX), high concentration level and arousal (median = 5.00 and 4.00 respectively out of 7 in SART) and occasional frustration (median = 4.00 out of 7 in NASA-TLX) were reported, due to technical issues or the difficulty of the clinical case. Overall, students found the simulation useful for learning purposes. This study demonstrates the potential of low-cost VR environments experiential learning in nursing education. While positively received, several areas for improvement were identified, including adjustments to the teaching seminar organization, which practitioners are encouraged to consider in other specialized VR healthcare training contexts.