Effectiveness of virtual reality-based training in clinical skills for newly graduated nurses

Abstract

Aim: This study compares the impact of virtual reality (VR) training versus conventional e-learning on newly graduated nurses (NGNs) learning six core clinical skills. We primarily assessed self-efficacy, along with secondary outcomes including knowledge, skills and satisfaction, while also identifying factors that influence self-efficacy.

Background: NGNs need strong self-efficacy and skills for clinical transitions. VR's immersive training potential is promising, but its long-term impact versus traditional methods is unclear due to mixed evidence.

Design: Quasi-experimental pre-test/post-test with a comparison group and three-month follow-up.

Methods: 150 NGNs at a Taiwanese medical center were assigned to VR (n = 75) or e-learning (n = 75) groups via alternating cohorts. Both received physical skills training post-online modules. Outcomes were assessed at baseline (T1), post-physical training (T2) and three months (T3) using the General Self-Efficacy Scale, cognitive questionnaire, Direct Observation of Procedural Skills and satisfaction scale. Mixed-design ANOVA and regression analyzed data, with last observation carried forward for attrition.

Results: No significant Time*Group interactions were found for self-efficacy (p = 0.970), cognitive knowledge (p = 0.459), clinical skills (p = 0.741), or satisfaction (p = 0.245), showing VR was not superior. Significant Time effects (p < 0.001) indicated T1-to-T2 gains, with declines at T3 for self-efficacy and cognition. Baseline self-efficacy and T3 satisfaction predicted T3 self-efficacy (R²=0.215). Attrition was 42.7 % by T3.

Conclusions: VR training did not outperform e-learning over three months. Both supported short-term gains, but sustaining these requires further strategies. Baseline self-efficacy and satisfaction are key predictors. Future studies should address attrition and optimize VR designs for NGNs.

Keywords: Clinical skills; Newly graduated nurses; Nursing education; Self-efficacy; Virtual reality.