Extended Reality (XR) technologies in nursing education: A systematic review

Abstract

Background: Extended reality (XR), as a learning and teaching method in higher nursing education, has been gradually applied over the years. Despite the increasing adoption of XR technologies in nursing education, there remains limited comprehensive evidence synthesizing their effectiveness across learning outcomes. Purpose: This review aims to examine the effectiveness of utilizing XR technology in nursing education pedagogy Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Five databases: Cochrane, ProQuest, PubMed, Scopus, and Web of Science were searched using predefined keywords. The PICOS framework guided study selection. Included studies were assessed for quality using the Joanna Briggs Institute (JBI) Critical Appraisal Tools and the Mixed Methods Appraisal Tool (MMAT). Results: A total of 17 studies were included, involving 2,403 nursing students. XR interventions, particularly Virtual Reality (VR), were the most commonly used type across studies. These interventions improved students’ knowledge, skills, and confidence, including their understanding of the social determinants of health, and were highly satisfying due to their immersive features. However, physical discomfort, such as motion sickness, headaches, and eye strain, was reported. The methodological quality of the included studies ranged from fair to good. Conclusions: Extended reality, particularly VR-based, has significant positive effects on nursing students. Adverse impacts were also found in the application of this technology in the learning system.  Addressing these issues is critical to optimizing the application of XR in nursing education. By integrating XR into nursing curricula, educators potentially foster critical thinking, decision-making, and procedural accuracy-key competencies.