Bodily Engagement in Virtual Reality Nursing Simulation: Implications for Students’ Declarative and Procedural Learning

BACKGROUND: Virtual reality (VR) nursing simulations have often limited learner movement through seated or movement-restricted formats to support safety and reduce cybersickness. However, the value of nursing students' bodily engagement during VR procedural and declarative learning remains unclear. PURPOSE: This study examined whether bodily engagement in VR medication-administration simulation was associated with knowledge acquisition, cognitive load, and cybersickness. METHODS: A 2-group quasi-experimental design compared free-movement and restricted seated VR among 72 first-year baccalaureate nursing students during 2025. Automated motion detection measured hand, head, and torso movements during declarative and procedural learning. Knowledge and cybersickness were assessed pre- and postsimulation, and cognitive load was assessed during learning. RESULTS: Free-movement students showed greater task-relevant movement and higher procedural knowledge scores. Declarative knowledge, cognitive load, and cybersickness did not differ significantly. CONCLUSION: Supporting task-relevant, free movement in VR simulation may enhance nursing students' procedural learning without increasing cognitive load or cybersickness.