The impact of a progressive prompting-based VR learning approach on improving nursing students’ entrustable professional activity competence

Abstract In traditional nursing education, cultivating students' competence in Entrustable Professional Activities (EPAs) is a challenging goal. Virtual reality (VR) simulations have been described as immersive and effective technological tools for clinical practice education and have been widely applied in educational settings to enhance student learning outcomes. However, without effective learning strategies, VR interactions often remain limited to basic student engagement with the virtual environment, restricting the development of competence in EPAs and leading to suboptimal learning outcomes. This study therefore aimed to explore the impact of the progressive prompting-based VR learning approach, which combines VR with progressive guidance to help students engage in authentic learning and develop their competence in EPAs, enabling them to perform professional care activities independently. To evaluate its effectiveness, a quasi-experimental design was employed, involving 60 undergraduate students. The t -test results revealed a significant difference between the progressive prompting-based VR learning approach and traditional VR methods, with the experimental group showing notably higher levels of learning motivation, communication, EPA competence, and learning satisfaction. This study provides empirical insights for the future application of the progressive prompting-based VR learning approach and EPA training in the field of nursing education.