Effectiveness of virtual clinical learning in nursing education: a systematic review

With the development of technology in education, simulations, virtual and online technologies are being incorporated into nursing education, especially for clinical education. This was especially necessary when an event occurred that did not necessarily allow for face-to-face contact, such as Covid-19, disasters like typhoons and others. However, limited resources for clinical education of nurses can contribute to the challenges of incorporating and appropriately utilizing virtual clinical learning technologies. Nursing education has been driven by the use of virtual learning technologies such as virtual reality, augmented reality, immersive virtual reality simulation, mixed reality, among others, which are delivered using tablets, phones or computers to create a lived experience for an intended learning outcome. This review aims to examine their effectiveness in terms of core professional competencies, problem solving, nursing process and communication skills.

This systematic review was conducted in accordance with the guidelines of the Preferred Reporting Items for systematic reviews and Meta-Analysis. Experimental peer-reviewed articles (randomized controlled trials, and quasi-experimental studies with one to two or more groups (pre-/post-test) using e-simulation technology for nursing education and assessment were included. PubMed, Embase, PsycINFO and Web of Science were searched. The search duration was from inception to 30th April 2024.

Virtual simulation technologies could be used for the practical teaching of nursing students. These technologies have been shown to significantly improve problem-solving skills (effect size 0.2 to 0.9), communication skills (effect size 0.4-0.7), and core professional competencies (effect size 0.3 to 0.9) with a small to large effect size.

The results indicate that virtual simulation technologies have important benefits for students' learning when integrated into clinical nursing education and practice. Educators should consider the use of virtual learning technologies when revising nursing curricula. It is important that nursing education policy makers integrate the use of virtual simulation into nurse education, and adapting this pedagogical approach could help improve student readiness for effective healthcare delivery.