Undergraduate nursing students' perceptions of using holopatient in learning and clinical training: An...

Simulation-based education is central to nursing curricula, supporting clinical reasoning, confidence, and safe practice. Mixed reality (MR) applications such as HoloPatient provide immersive, life-sized patient encounters that may enhance student learning. Although international evidence highlights benefits in knowledge acquisition, critical thinking, and confidence, research in Saudi Arabia remains limited.

This study aimed to explore undergraduate nursing students' perceptions of HoloPatient, focusing on its educational value, challenges, and ethical considerations within the Saudi context.

An exploratory-descriptive qualitative design was employed. Semi-structured interviews were conducted with 32 nursing students (second to internship years) at the University of Tabuk, Saudi Arabia (mean age 21.8 years; 56.3% female). Participants were purposively sampled to capture diversity in year, gender, language, and HoloPatient use. Data collection occurred through 45-60 min interviews in Arabic or English, audio-recorded, transcribed, and translated. Reflexive thematic analysis was applied, guided by the Technology Acceptance Model, using NVivo software.

Students identified key benefits: enhanced clinical reasoning (81.3%), increased confidence and readiness (65.6%), and realism and engagement (59.4%). Challenges included technical constraints (56.3%), ergonomic discomfort (37.5%), and limited device availability (28.1%). Ethical concerns centered on over-reliance on technology (46.9%), academic integrity (40.6%), and privacy/professionalism (34.4%). Training needs included structured debriefing (75.0%) and device orientation (62.5%).

Findings highlight both opportunities and barriers to integrating MR in nursing education. While HoloPatient strengthened reasoning, confidence, and engagement, implementation challenges and ethical concerns require careful attention. Structured debriefing, comprehensive orientation, faculty development, and robust technical support are critical to maximise educational value. In Saudi Arabia, these insights provide timely guidance for aligning MR adoption with national strategies for digital transformation in education.