Development and Effectiveness Evaluation of a CAVE-based Immersive Virtual Reality Emergency Cart Training Program for New Nurses with Less Than Three Years of Experience : A Pilot Study

Purpose: This study aimed to develop a CAVE(Cave Automatic Virtual Environment)-based immersive virtual reality emergency cart training program and verify its effects on clinical nurses’ emergency nursing competency. The program was designed to strengthen on-site responsiveness through immersive simulation that reflects actual clinical environments, aiming to enhance practical competencies and ensure educational validity in clinical settings. Methods: The educational content was designed and developed according to the ADDIE(Analysis, Design, Development, Implementation, Evaluation) model and the CAVE simulation environment was applied. Fifteen nurses with less than three years’clinical experience at a tertiary hospital participated in the program. The 50-minute training included team-based lectures, individual immersive simulation practice, quiz games, and feedback sessions. Emergency Nursing Knowledge, Performance Speed, and Accuracy were measured before and after training; immersion was assessed post-intervention. Results: Following the program, Emergency Nursing Knowledge scores significantly increased from 9.73 to 12.73 (t=-4.86, p<.001). Performance Speed decreased significantly from 160.67 seconds to 104.87 seconds (t=5.91, p<.001). The Accuracy significantly dropped from 21 to 5.13 (t=12.82, p<.001). Immersion levels reported post-training were high, with an average score of 25.13. Conclusion: The CAVE-based emergency cart training program effectively enhanced clinical nurses’ Emergency Nursing Knowledge, Performance Speed and Accuracy in emergency nursing. Realistic spatial memory and item recognition methods improved rapid and precise decision-making. This training system overcomes practical limitations in clinical environments and elevates the quality of practice-centered nursing education. It provides foundational data for broader clinical application and suggests potential for adaptation across various health care domains.