A modified Delphi study identifying design priorities, barriers, and implementation requirements for virtual reality–based resilience training for nurses
Nurses face persistent stress, burnout, and psychological strain, highlighting the need for scalable resilience-support interventions. Extended reality (XR) and virtual reality (VR) may enable immersive, skills-oriented stress-management training, but their integration into nursing contexts requires clearer design and implementation guidance. Within the Horizon Europe project XR2ESILIENCE, we conducted a consortium-internal modified Delphi study to identify requirements, barriers, and design principles for VR-based resilience training for nurses. An interdisciplinary expert panel (N = 21) completed an online ranking of 29 statements across six domains. Consensus was assessed using z-standardized dispersion and Kendall’s W. Items with medium or low consensus were further discussed in six mixed-disciplinary groups during an in-person co-design workshop. Results showed moderate consensus for incentives and implementation challenges, and emerging consensus in the remaining domains. Experts emphasized that VR resilience training should demonstrate transfer to everyday work, focus on clinically relevant coping skills, and be supported by protected time, usability-by-design, adequate infrastructure, privacy safeguards, and fair delivery models. The findings provide consortium-informed preliminary design guardrails and should be interpreted as internal prioritization signals for subsequent co-design, feasibility testing, and external validation.
Authors
- C. Ruiz Martín
- E. Ivezic
- S. Hannibal
- P. Barach
- E. de Alves
- V. Reiter
- Yvonne Prinzellner (ORCID: https://orcid.org/0000-0001-9849-4149)
- M. Ernst
- Sebastian Egger-Lampl (ORCID: https://orcid.org/0000-0002-3028-904X)
- I. Domingues Figueira de Faria
- Eva Turk (ORCID: https://orcid.org/0000-0002-4263-6432)
- Dirk Lehr (ORCID: https://orcid.org/0000-0002-5560-3605)
- S. Wanner
- E. Gudelj
- H. Lackner
- A. Häussl
- T. Stross
- N. Dalkner
- E. Reininghaus
- M. Lenger
- I. Zwigl
- M. Wessa
- B. Roszipal
- V. Huber
- Г. Думан (ORCID: https://orcid.org/0000-0002-6593-3587)
- L. Repnik
- Martin Ernst
- K. Laškarin
- L. Guedes De Pinho
- M.A.Dominguez Conde
- R. Rodrigues
- E. Turk
- J.Cabrerizo Fernández
- M. Behrend
- A. Finner
- V. Leung
- Y. Prinzellner
- D.R.Díaz Rodríguez
- D. Lehr
- M.J.Almodovar Carretón
- B. Maier
- D. Ford
- D. Kovačević
- S. Egger-Lampl
- A. Hasch
- J. Wagner-Skacel
- M.A.Sanchez Uriz
- O. Tüscher
- Michèle Wessa
- I.C. Hammel
- Nina Dalkner
- P. Günther
- I. Bahun
- V.M. Foronda
- P. Vrbek
- M. Karlseder
- P.G.Peñaranda Beltrán
- I. Filipčić
- J.Briongos Pastor
- J. Pflegerl
- K. Lieb
- M. Silva
- M. Fernández-González
- C. Fonseca
- C. Pank
- S. Schäfer
- C.Veiras Lorenzo
- A.Sanchís Ruiz
- R. Schlesinger
- N. Dietrich
- A. GómezGómez
- M.P.Ruiz Romera
- C.Noguera Quijada
- B. Kollmann
- F. Folkvord
- C.Báez León
Institutions
- Leuphana University of Lüneburg (DE)
- University of Lisbon (PT)
- Thomas Jefferson University (US)
- Polytechnic Institute of Viana do Castelo (PT)
- Medical University of Graz (AT)
- University of Applied Sciences St Pölten (AT)
- Empresa Municipal de Transportes de Madrid (ES)
- Psychiatric Hospital Sveti Ivan (HR)
- Leibniz Institute for Resilience Research (DE)
- Central Institute of Mental Health (DE)
- Predict (France) (FR)
- Madrid Health Service (ES)
- TeleConsult Austria (Austria) (AT)
Publication Details
- Journal
- Scientific Reports
- Published
- 2026-09-21
- DOI
- https://doi.org/10.1038/s41598-026-72328-x
- Primary Topic
- Healthcare professionals’ stress and burnout
- Type
- article
- Field-Weighted Citation Impact
- 0.00