A QUANTITATIVE STUDY TEACHING DE-ESCALATION WITH VIRTUAL REALITY SIMULATION TO ASSOCIATE NURSING STUDENTS MEASURING EFFECTIVENESS, LEARNING, AND CONFIDENCE

Workplace violence against nurses is a critical global public health issue, with one in four nurses reportedly experiencing physical assault by patients. This quantitative quasi-experimental, pretest-posttest study aimed to assess the effectiveness of virtual reality simulation as a teaching strategy for de-escalation education in associate nursing students (N = 29) perception in learning and confidence. The study utilized the Simulation Effectiveness Tool-Modified (SET-M) instrument to measure outcomes guided by Kolb's experiential learning theory and the NLN Jeffries simulation theory. The learning variable demonstrated significant improvement as confirmed by paired t-test analysis (p < .01). For the effectiveness and confidence variables, which violated assumptions of normality, a comprehensive statistical approach was implemented. Analysis included parametric testing via paired t-tests, supplemented by nonparametric methods (Wilcoxon Signed-ranks test and Sign test) to ensure statistical rigor. The cumulative results across all three statistical tests consistently demonstrated significant improvements (p < .001). Effect size calculations revealed medium to large significance for all variables measured by Cohen’s d. The conclusive findings of this research to reject all three null hypotheses suggest that virtual reality simulation is an effective teaching strategy for developing de-escalation skills, enhancing both learning and confidence among associate nursing students. Future studies are needed to further validate and expand upon the findings of the current research, potentially leading to more widespread adoption of virtual reality simulation in nursing education for teaching de-escalation. Keywords: Nursing education associate degree, de-escalation, virtual reality simulation, work-place violence