Immersive Extended Reality and Affective-Behavioral Outcomes in Nursing Students: A Systematic Review and...

Area of Science:

• Nursing Education
• Educational Technology
• Human-Computer Interaction

Background:

• Extended reality (XR) technologies are emerging tools in nursing education.
• XR aims to improve experiential learning and emotional engagement.
• The effectiveness of XR across different learning domains is not fully understood.

Purpose of the Study:

• To systematically review and meta-analyze the impact of XR on nursing students' learning outcomes.
• To evaluate XR's effects on cognitive, psychomotor, and affective domains.
• To synthesize evidence from randomized controlled studies.

Main Methods:

• A systematic review and meta-analysis of 32 randomized studies (n=1,578) published between 2012-2024.
• Searched five databases; assessed study quality using Joanna Briggs Institute checklist.
• Analyzed data using Review Manager 5.4 and R 4.3.3; rated evidence certainty with GRADE.

Main Results:

• XR significantly improved learner satisfaction (SMD=0.50, p=0.02) and psychomotor performance (SMD=0.46, p=0.01).
• Effects on confidence and cognitive outcomes were smaller and inconsistent (p>0.05).
• XR showed advantages over mannequins for psychomotor skills and over videos for satisfaction.

Conclusions:

• XR shows potential for enhancing nursing skill acquisition and emotional engagement.
• Evidence for significant cognitive gains and attitudinal changes is currently limited.
• Future research should focus on long-term outcomes, mixed reality, and adaptive XR systems.