Purpose This scoping review aimed to explore the characteristics and educational effects of game-based virtual reality (VR) programs used in nursing education, providing foundational insights for future instructional design and research. Methods: Following the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, a comprehensive literature search was conducted across eight databases for studies published between April 2014 and March 2025. Studies were screened and selected using the population, concept, context framework. Twenty-four studies met the inclusion criteria and were analyzed. Results: Most of the 24 included studies targeted nursing students, with some involving practicing nurses. Interventions primarily employed immersive VR head-mounted displays and incorporated diverse game elements such as mission-based scenarios, challenges, feedback loops, and virtual patient interactions. Educational effects were categorized into cognitive, affective, and psychomotor domains. Improvements in knowledge acquisition, self-efficacy, learning motivation, and skill performance were consistently reported. Additionally, most studies reported enhanced learner satisfaction, engagement, and emotional immersion. However, limited evidence was found regarding teamwork and communication skills. Conclusion: Game-based VR programs show substantial potential as effective instructional strategies in nursing education. Their design features—including immediate feedback, repeatable immersive scenarios, and engaging game mechanics—support learner-centered and self-directed learning. Nevertheless, the current evidence base largely focuses on nursing students and short-term outcomes. Future studies should encompass diverse nursing populations and assess long-term effects and real-world applicability, particularly in team-based and clinical practice contexts.
Purpose This study was a scoping review aimed at evaluating Simulation-Based Education for recognizing and responding to deteriorating patients within Korean nursing school curricula, and at developing educational strategies for these competencies. Methods A literature search was conducted from April 1 to April 30, 2024. The review followed the scoping review framework by Arksey and O’Malley and the manual by the Joanna Briggs Institute. Relevant studies were identified through databases such as the Korean Medical Database, Korean Studies Information Service System, DataBase Periodical Information Academic, Research Information Sharing Service, ScienceOn, and the Cumulative Index to Nursing and Allied Health Literature. Results Eleven studies published from 2010 to 2019 were reviewed. The simulations typically included several lectures and practice sessions on advanced cardiopulmonary life support before the simulation exercises, which were then repeated.
Cardiac arrest was frequently used as a scenario subject. The learning outcomes focused on the cognitive and psychomotor domains, as well as self-efficacy. Conclusion Although simulation for recognizing and responding to deteriorating patients was available in Korean nursing school curricula, it was infrequently incorporated as a regular part of the training. Future initiatives should include adding educational content to enhance nursing students' competencies in recognizing and responding to deteriorating patient simulations. Subsequent studies should assess the effectiveness of these educational methods.
Purpose The purpose of this study was to identify the moderating effect of teaching effectiveness and students’ anxiety in the relationship between simulation design characteristics and clinical reasoning competence among nursing students.
Methods: The participants were 123 nursing students who underwent simulation practice. Data were collected from September 1 to October 30, 2020 using self-report questionnaires. The collected data were analyzed using descriptive statistics, independent t-test, Pearson’s correlation coefficient, and SPSS PROCESS Macro program (to study the multiple additive moderation effect).
Results: Significant positive correlations were observed between clinical reasoning competence and simulation design characteristics (r=.57, p<.001), clinical reasoning competence and teaching effectiveness (r=.49, p<.001), while negative correlations were observed between clinical reasoning competence and students’ anxiety (r=-.33, p<.001). Teaching effectiveness and students’ anxiety had a multiple additive moderating effect on the relationship between simulation design characteristics and clinical reasoning competence among the nursing students (F=15.10, p<.001).
Conclusion: The relationship between simulation design characteristics and clinical reasoning competence differed depending on the students’ anxiety. To improve the clinical reasoning competence of nursing students in simulation practice, developing interventions and techniques to manage students’ anxiety levels are important.
Citations
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The influence of clinical simulation on anxiety in nursing students: A scoping review Francisco Marcelo Leandro Cavalcante, Francisca Carla dos Angelos Santos, Odézio Damasceno Brito, Ana Clécia Silva Monteiro, Vanessa Emille Carvalho de Sousa Freire, Ana Railka de Souza Oliveira Kumakura, Natasha Marques Frota, Lívia Moreira Barros Nurse Education in Practice.2026; 90: 104622. CrossRef
The Effect of Digital Collaboration Problem-Solving Competency on Online Simulation Training in the COVID-19 Era: Mediating Effect of Flipped Learning Jung Eun Shin Journal of Digital Contents Society.2025; 26(9): 2635. CrossRef
The mediating role of flow in the relationship between simulation design and simulation educational satisfaction in korean nursing students: a cross-sectional study Eun-Kyung Lee, Eun-Joo Ji BMC Nursing.2024;[Epub] CrossRef
Factors Related to the Problem-solving Ability of Nursing Students Who Experienced Simulation Training Ji-Won Han Journal of Korea Society for Simulation in Nursing.2023; 11(2): 17. CrossRef
PURPOSE The aim of this study was to verify the effect of simulation and examine the effect of within-team debriefing for cardiac arrest emergency nursing education. METHODS A non-equivalent control group quasi-experimental design was used. The participants in this study were 199 senior nursing students from one nursing school in Daegu, Korea. Data were analyzed using χ² test, t-test, Fisher's exact test with SPSS 22.0 program. RESULTS Developed simulation protocol in this study increased the learning immersion (t=12.19, p < .001, t=5.07, p < .001), learning confidence (t=−10.36, p < .001, t=−5.99, p < .001) and clinical performance ability (t=−10.88, p < .001, t=−3.84, p=.002) among nursing students. In addition to this, learning immersion (t=2.66, p=.008), learning confidence (t=−2.78, p=.006), simulation satisfaction (t=−3.15, p=.002) and clinical performance (t=−3.02, p=.005) were significantly higher in the experiment group using within-team debriefing. CONCLUSION The results indicate that simulation using within-team debriefing was an effective educational method for nursing students.
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The Effects of Simulation Based Practical Education on Nursing Students' Self-efficacy, Performance Confidence, and Educational Satisfaction Inok Kim Physical Therapy Rehabilitation Science.2024; 13(1): 18. CrossRef
Development of a Patient Safety Simulation Program for New Nurses in the Intensive Care Unit Su Jin Jung, Jin-Hee Park Journal of Korean Academy of Fundamentals of Nursing.2024; 31(1): 100. CrossRef
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