Journal of Advances in Medical Education & Professionalism

Nursing Students’ Perspectives on the Relationship between Virtual Reality Simulation and Clinical Decision-Making, Confidence, and Anxiety: A Cross-Sectional Study

HAZEM ALFANASH; MAHMOUD AL-KALALDEH; KHALDOON ALNAWAFLEH; WESAM ALMAGHARBEH

Volume 13, Issue 3 , July 2025, , Pages 191-197

https://doi.org/10.30476/jamp.2025.105619.2115

Abstract

Introduction: This study addresses this gap by assessing the relationship of VR simulation with improving clinical decisionmaking, confidence, and anxiety reduction among nursing students. ... Read More Introduction: This study addresses this gap by assessing the relationship of VR simulation with improving clinical decisionmaking, confidence, and anxiety reduction among nursing students. The aim of this study is the relationship between virtual reality simulation and their clinical decision-making, confidence, and anxiety reduction using a cross-sectional study from the perspectives of nursing students.Methods: This cross-sectional study surveyed 200 nursing students enrolled in clinical courses utilizing virtual reality (VR) simulation for educational purposes. A structured questionnairewas used to assess their clinical decision-making, confidence, and anxiety reduction following the VR simulation course. The survey included scales validated through a panel of experts andquestionnaire validation methodologies, using a 5-point Likert scale. Descriptive statistics were used to summarize the data, and inferential statistical tests, including Pearson’s correlation and independent-sample t-tests, were conducted to examine the associations. Multiple linear regression analysis was performed to assess the predictive value of confidence and anxiety on clinical decision-making while controlling demographic variables.Results: A total of 200 nursing students participated in the study. The mean (SD) clinical decision-making score was 3.16 (1.23) out of 5, while confidence and anxiety reduction scores were 2.64 (1.34) and 2.49 (1.32), respectively. No significant correlation was found between decision-making and confidence (r=-0.079, p=0.264) or anxiety scores (r=0.121, p=0.088), but confidence and anxiety scores showed a weak direct correlation (r=0.180, p=0.011). Multiple linear regression analysis revealed that confidence and anxiety were not significant predictors of decision-making, but gender was a significant predictor, with males scoring higher (β=0.19, p=0.041).Conclusions: While VR directly influences decision-making, it has a limited association with changes in nursing students’ confidence and anxiety levels. These findings suggest that VRsimulation alone may not be sufficient for enhancing confidence and reducing anxiety and should be integrated with other instructional strategies to maximize its effectiveness in nursing education. Future studies should explore complementary training methods to improve clinical preparedness.

Developing measures of immersion and motivation for learning technologies in healthcare simulation: a pilot study

CHRIS JACOBS; JACOB M. RIGBY

Volume 10, Issue 3 , July 2022, , Pages 163-171

https://doi.org/10.30476/jamp.2022.95226.1632

Abstract

Introduction: Medical education has benefitted from the introduction of new technology within recent years. Immersivedevices, such as, 360-degree films and virtual reality have become ... Read More Introduction: Medical education has benefitted from the introduction of new technology within recent years. Immersivedevices, such as, 360-degree films and virtual reality have become new ways of simulating clinical experiences. The aim of the study was to validate and test reliability of a new measure of engagement.Methods: A between-participants design of 2 groups viewing a clinical consultation on a 360-degree headset or 2D monitor was conducted following computer random allocation of 40 healthcare professionals recruited from scheduled teaching. Twenty-three were assigned to 360-degree and 17 to 2D Medias. Adapted Immersion Experience Questionnaire (AIEQ) and Abridged Intrinsic Motivation Inventory (AIMI) were modified to match factors relating to clinical encounters. AIEQ and AIMI were utilised as the data collection tool by each group following video viewing. Spearman’s rank correlation was used to assess relationship between immersion and motivation. Comparisons between 360-degree and 2D media responses were made using Wilcoxon’s signed ranks test. Internal reliability coefficients of adapted measures were calculated with Cronbach alpha scores.Results: Total immersion scores were statistically higher in those experiencing 360 (P<0.05), with a median difference of 14.50 (95% CI 6.50-22.00). A positive correlation existed between the total AIEQ and total score of the AIMI in both groups (rs=0.88, n=17, P<0.001). Internal consistency and reliability was demonstrated with a high Cronbach alpha score for the AIEQ (α=0.91). AIMI subscale alpha value was also high at (α=0.95) which shows the measures to be of high internal reliability.Conclusions: Adaptation and validation of existing measures for use in healthcare education can be used to quantify levels of immersion and motivation. Standardising measures for use in evaluating new Technology Enhanced Learning is a step to aid understanding on how we develop these tools in medical education and how we might learn from immersive technology.

Virtual reality-based medical education versus lecture-based method in teaching start triage lessons in emergency medical students: Virtual reality in medical education

SAMAN BEHMADI; FARIBA ASADI; MARYAM OKHOVATI; ROGHAYE ERSHAD SARABI

Volume 10, Issue 1 , January 2022, , Pages 48-53

https://doi.org/10.30476/jamp.2021.89269.1370

Abstract

Introduction: Epidemics such as the recent one, COVID-19, have caused a change in education and its methods. Virtual simulation is one of the types of technology used in medical ... Read More Introduction: Epidemics such as the recent one, COVID-19, have caused a change in education and its methods. Virtual simulation is one of the types of technology used in medical education andrelated sciences. Virtual simulation provides practical and clinical medical education in a safe, cost-effective, reproducible, and flexible learning environment where students can practice over and over in a standard environment. This study was conducted to compare the effect of virtual-based medical education versus lecture-based method in teaching start triage lessons in emergency medical students in educational and medical centers affiliated to Birjand University of Medical Sciences Ferdows, Paramedical School, in 2020.Methods: This is a quasi-experimental study. All 44 students of emergency medicine registered for triage course participated in the study. They were divided into two homogenous groups whichwere matched based on their grade point average. The simple triage and rapid transport (START) triage course was taught in the traditional way- lecture based- from the beginning of the semesterto the middle of the semester; then, the other group (simulationbased) was trained in the second half of the same semester using virtual simulation.Results: The students’ rate of learning was measured by their scores at the end of the course exam in both groups. The mean scores of virtual simulation-based education were slightly higher than those of the lecture-based education, but it was not statistically significant (P>0.05). The students were more satisfied with virtual simulation-based education than the lecture-based and the difference between the mean scores of satisfaction was statistically significant (P>0.05).Conclusion: The results of this study suggest that VR can effectively improve knowledge in undergraduate emergency student’s education, but it was not more effective than traditionaleducational methods. More experimental studies with a larger sample size are needed to confirm that virtual simulation-based education can more effectively improve knowledge in teaching practical lessons such as triage.

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Keywords = Virtual reality

Nursing Students’ Perspectives on the Relationship between Virtual Reality Simulation and Clinical Decision-Making, Confidence, and Anxiety: A Cross-Sectional Study

Abstract

Developing measures of immersion and motivation for learning technologies in healthcare simulation: a pilot study

Abstract

Virtual reality-based medical education versus lecture-based method in teaching start triage lessons in emergency medical students: Virtual reality in medical education

Abstract