Table 2 Intervention

Adhikari et al., 2021 [57]

To investigate the impact of IVR sepsis game on preregistration nurses’ self-efficacy and their perceptions of the acceptability and applicability of IVR sepsis game as an adjunct to nursing simulation education

IVR

(HMD)

Three-dimensional computer-based simulation that portrays a real-life situation in a computerized environment giving the user a sense of being present in the situation

NA

Anbro et al., 2020 [24]

To evaluate changes in communication accuracy during an emergency medical simulation as a function of an interprofessional TeamSTEPPS® training

VR

(HMD)

Provides an immersive audio/visual experience within a virtually simulated environment

• TeamSTEPPS® interprofessional training tool

• HTC Vive VR Headsets with integrated Tobii eye-tracking sensors

• SimMom®

Atthill et al., 2021 [25]

To compare how student self-confidence and anxiety for engaging in CDM was impacted by a virtual asynchronous and face-to-face debriefing strategy after a VSG

VSG, virtual asynchronous debriefing

(screen-based VR)

• VSG — the recreation of a human clinical scenario requiring the response of the learner in an evolving scenario, where they apply their nursing knowledge to determine and select critical nursing actions for a virtual patient

• Virtual asynchronous debriefing — faculty-facilitated asynchronous debrief using 3D debriefing model over 48 h

NA

Blanie et al., 2020 [26]

To compare simulation by gaming versus traditional teaching

SG

(screen-based VR)

Video games were developed specifically with educational purposes. They can be computer based or use more immersive technologies such as virtual reality combined with head-mounted display

• Game developed in collaboration with LabForSIMS (simulation centre of Paris-Sud University), four nursing institutes, and a software designer Interaction Healthcare®, Levallois-Perret, France

• Game developed — LabForGames Warning

Bracq et al., 2021 [27]

To assess “Error recognition in a virtual operating room”, using a simulation scenario designed to improve situation awareness (awareness, subjective workload, anxiety, and user experience)

VR simulation

(HMD)

Low-cost, realistic, easy to use, and easily configurable simulators using head-mounted displays (HMDs) which can be used to assist trainees acquire skills in a safe environment with low levels of anxiety

• HTC Vive System

Carrard et al., 2020 [28]

To explore students’ perspective on the added value of a virtual patient (VP) simulation as part of a breaking bad news training in undergraduate medical education

VP

(screen-based VR)

Computer-generated and manipulated graphical representation of a human (avatar) portraying patients in virtual environments used to train diverse medical competences such as making a diagnosis or therapeutic decisions

• Vizard 5.7 platform

Casler et al., 2022 [29]

To compare the student debriefing experience in two methods of debriefing- automated software-generated performance feedback as the sole method of debriefing or self-review of software-generated feedback followed by an online, asynchronous, group discussion-board debriefing exercise

VS,

faculty-guided asynchronous debriefing discussion

(screen-based VR)

• VS — typically conducted outside of a traditional physical classroom and often involves a computer-based simulation using a virtual patient or avatar. They can also involve strategies such as virtual reality, mixed reality, and augmented reality

• Faculty-guided asynchronous debriefing — debriefing strategy that combined self-review of software-generated feedback followed by an online, asynchronous, group discussion-board debriefing exercise facilitated by faculty

• i-Human (Kaplan Inc., Fort Lauderdale, FL, USA)

Chen and Liou, 2022 [30]

To understand attitudes, perspectives, or beliefs about an AR-based assessment system for infant airway obstruction first aid training

AR

(tablet- and computer-facilitated AR)

Combines computer-generated images, objects, information, or scenarios with the real-world environment and provides interactive experiences to users. Incorporates three features: a combination of real and virtual worlds, real-time interaction, and a requirement for a 3D space

• Unity (cross platform game engine)

• Vuforia AR

Cieslowski and Haas, 2023 [31]

Learner evaluation of VR experiences from student reflections and online survey

IVR

(HMD)

A teaching modality that provides a three-dimensional platform which allows the end user to feel present and interact with the virtual world

• OMEN gaming laptops

• Oculus Quest headsets

Colonna et al., 2022 [32]

To develop a novel trauma VR simulator, which would differentiate competency between participants with increasing levels of training and outcomes measured: time to correct treatments

TVRSim

(HMD)

N/A

• Oculus Quest VR headset

Du et al., 2022 [33]

To create and test a scenario-based, mixed-reality platform suitable for training NTS in battlefield first aid

MR

(HMD)

A platform that can blend real-world objects of training relevance with VR reconstructions of operational contexts

• HTC Vive Pro 2.0 head-mounted device

• HTC controller

• Unreal Engine 4 (epic games)

Fogg et al., 2020 [34]

To evaluate the clinical judgement skills of undergraduate baccalaureate nursing students using VR

VS

(screen-based VR)

Computer-based recreation of reality that places users in an autonomous role controlling the environment

NA

Hu et al., 2022 [35]

To explore the effectiveness of a VR mobile game-based application for teaching disaster evacuation management to nursing students

Immersive VR-MGBA

(screen-based VR — mobile device)

NA

NA

Jayasundera et al., 2022 [36]

To evaluate the usefulness of VR simulation in reviewing pathophysiologic mechanisms of clinical decision-making

VR

(HMD)

Generates a 360-degree experience to replicate a clinical situation via a head-mounted display (HMD)

• Oxford Medical Simulation

• Head-mounted device

Sahin Karaduman and Basak, 2023 [37]

To compare the effects of virtual and human patient simulation methods on performance, simulation-based learning, anxiety, and self-confidence with clinical decision-making scores of nursing students

VPS

(screen-based VR — large tablet simulator)

Computer-based clinical scenarios that are related to real life, where students can learn the necessary knowledge and practices for managing patient care. They generally use video of patients/actors or computer-generated human-like characters known as avatars

• BodyInteract® (Body Interact Inc., Austin, T, USA)

• CAE Juno® (CAE Inc., Sarasota, FL, USA)

Pardue et al., 2022 [38]

To determine nursing students’ learning experiences when engaged in VR simulation and to explore learners’ problem-solving/clinical reasoning approaches after involvement in a VR simulation scenario

VR

(HMD)

Three-dimensional environment using a headset that includes learner immersion or a sense of presence, visual feedback, and interactivity through user input or reactivity to the virtual platform

• Oxford Medical Simulation

Kim et al., 2023 [39]

To determine the impact of mixed simulation on learning how to provide nursing care for patients with arrhythmia

360° VR simulation

followed by HFS

(HMD)

VR involves the creation of three-dimensional type of content for users with a view in all directions. A 360° video (panoramic, spherical, or omnidirectional video/image) provides an immersive experience, allowing the user to explore a three-dimensional world built with 360° videos while they naturally change their viewpoints

• Insta360 Pro 2 (Arashi Vision Inc., Shenzhen, China)

• Unity3D game engine (Unity Technologies, San Francisco, CA, USA)

• YouTube

• Oculus Quest 2 (Meta Platforms Inc., Cambridge, MA, USA)

• SimMen

Kiyozumi et al., 2022 [40]

To create VR content for the Japan Prehospital Trauma Evaluation and Care programme and verify its educational effectiveness

VR

(HMD)

N/A

• IDEALENS K4 (Idealens Technology Co., Ltd., Chengdu, Sichuan, China)

• GoPro Max (GoPro Inc., San Mateo, CA, USA)

• Adobe Premiere (Adobe Inc., Sa Jose, CA, USA)

• VR content creation system (modified CREEK & RIVER scenario branching system; CREEK & RIVER Co., Ltd., Tokyo, Japan)

Kleinheksel, 2014 [41]

A secondary data analysis of nursing students’ performance in the digital clinical experience

VP

(screen-based VR)

Create an objective learning environment by presenting each student with an identical simulation scenario, allowing more uniform opportunity to assess skills and standardize patient actors

• Shadow Health Digital Standardized Patient™ (Digital Clinical Experience)

Lee et al., 2022 [42]

To examine the effectiveness of mental-health nursing using VR simulation on knowledge acquisition, problem-solving ability, and learning satisfaction

360-degree VR

(HMD)

Users can experience a higher sense of presence and engagement allowing them to be immersed in a virtual story

• Oculus Go — VR HMD

• Gear 360 (360-degree camera)

Lee et al., 2023 [43]

To develop a VR-based nursing education programme aimed at improving nursing students’ severity classification competency

VR

(HMD)

Technology that maximizes user’s visual experience and immersion with the synthetic multi-needs of five senses. A representative, realistic media tool that enables users to have a more immersive experience of a given situation

• Oculus Quest 2

Mahling et al., 2023 [44]

To assess the perceptions of a large cohort of students towards VR-based training and to identify the associations between these attitudes and individual factors, such as gender and age

VR

(HMD)

Immerses the user in a completely virtualized world using special head-mounted devices. A special controller allows the user to interact with the VR

• Oxford Medical Simulation

• Oculus Rift S (hand tracking device, Facebook Inc.)

• Alienware m15R3 (high-performance laptop, Dell computers)

Mascarenhas et al., 2023 [45]

To create an accessible and feasible methods of educating healthcare professionals about situational awareness in the hospital

Enhanced 360-degree video technology

(screen-based VR — tablet)

Improves 360-degree video technology by measuring space and adding 360-degree photos to a mesh that it creates from the dimensions, allowing the user to independently navigate through the composite images

• Matterport™ (Sunnyvale, CA, USA)

McCallum et al., 2011 [58]

To explore nursing students’ decision-making skills through the use of a 3D virtual environment such as second life

3D virtual environment

(screen-based VR)

Residents of the virtual world can socialize, participate in individual and group activities, and create and trade virtual property in real time

• Second Life Clinical Simulation Laboratory

Michelet et al., 2020 [46]

To focus on the impact of computer debriefing on learning acquisition and retention after a screen-based simulation training on neonatal resuscitation designed for midwifery students

Screen-based simulation

Computer debriefing

(screen-based VR)

NA

• Périnatsims (designed by Medusims)

Middeke et al., 2018 [47]

To compare a serious game, the virtual accident and emergency department “EMERGE” to small-group problem-based-learning regarding student learning outcome on clinical reasoning in the short term

Serious games

(screen-based VR)

Computer games designed for a serious purpose rather than pure entertainment

• EMERGE (PatientZero Games GmbH®)

Mills et al., 2020 [48]

To compare the simulation efficacy of a bespoke VR mass casualty incident triage training simulation against a comparable live simulation scenario

VR

(HMD)

A simulated environment which uses digital sound and visual effects to create an authentic experience

• Purpose-built OZO VR camera (Nokia Pty Ltd., Espoo, Finland)

• Oculus Rift (Oculus, Irvine, USA)

• HTC Vive Headset (HTC Corporation, New Taipei City, Taiwan)

• HTC Vive Controller

Park et al., 2022 [49]

To compare the learning effects of a virtual simulation and high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. To obtain evidence to support decision-making regarding the most effective way to utilize simulation strategies

VS

(screen-based VR)

Provides a realistic world on the computer screen offering dynamic and consistent experiences in a safe, reproducible, accessible, and standardized clinical environment

• vSim® (Laerdal Medical)

Rim and Shin, 2022 [50]

To develop a multiuser virtual simulation program for metacognition and to evaluate the students’ satisfaction, clinical judgement, and nursing competencies

VS

(screen-based VR)

Clinical simulation offered on a computer, the Internet, or in a digital learning environment, including single or multiuser platforms

NA

Rogers, 2011 [51]

To investigate how a simulation could be optimized in Second Life to encourage teamwork and collaborative problem-solving based on the habits, experiences, and perceptions of nursing students towards Second Life as a simulation platform

CBCS

(screen-based VR)

Enables learners to interact with and manipulate information and representations of an environment and synchronously communicate with other people via a digital representation known as an avatar, regardless of their location

• Second Life (Linden Laboratories)

Saab et al., 2021 [52]

To explore nursing students’ perspectives of incorporating VR in nurse education

VR

(HMD)

A wide variety of computer-based applications commonly associated with immersive, highly visual, 3D characteristics to allow the participant to look about and navigate within a seemingly real or physical world

• Wireless VR headset

• Headphones

• Handheld controllers with haptic/vibrational feedback

Sara et al., 2021 [53]

To evaluate the effects of two different simulation games using a one-group pretest–posttest design

Simulation games

(HMD & screen-based VR)

Artefacts (software) that replicate clinical reasoning processes in real-world situations. They can be used with different technologies, including mobile phones, tablets, computers, and virtual reality headsets

• HTC Vive Pro headset

Watari et al., 2020 [54]

To clarify the effectiveness of virtual patient simulations for improving clinical reasoning skills among medical students and to compare improvements in knowledge or clinical reasoning skills relevant to specific clinical scenarios

VPS

(screen-based VR)

NA

• Body Interact®, Coimbra, Portugal

• TurningPoint® clicker, Tokyo, Japan

Williams et al., 2020 [55]

To determine if VR supports the development of interprofessional competency knowledge

Virtual learning

(screen-based VR)

Computer- or Internet-based learning environment that includes virtual worlds with avatars

• Clinispace® VR platform

Yang and Oh, 2022 [56]

To examine the effects of a neonatal resuscitation gamification programme using immersive VR based on Keller’s ARCS model

IVR gamification program

(HMD)

NA

• High-fidelity simulator (for simulation group) — Laerdal® Premature Anne