The Effectiveness and Characteristics of Metaverse-Based Nursing Education for Students: A Systematic Review

Metaverse-based education is emerging in nursing; this review maps its characteristics and effects. The aim was to systematically review metaverse-based nursing education programs to identify their effectiveness, current status, and characteristics.

A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature was searched in eight electronic databases (four Korean: Research Information Sharing Service, Korean Studies Information Service System, Database Periodical Information Academic, Korean Medical Database; four international: PubMed, CINAHL, EMBASE, MEDLINE). Of the 41 retrieved records, only four quasi-experimental studies met the inclusion criteria, highlighting evidence sparsity. The Risk of Bias Assessment Tool for Nonrandomized Studies was used to evaluate methodological rigor and quality of evidence.

The four studies (sample size range: 57-72; all conducted in Korea) applied metaverse programs to nursing skills, major courses, or simulation-based clinical practice. Reported outcomes included improvements in self-efficacy, knowledge, confidence, and critical thinking ability. However, considerable heterogeneity was noted across interventions and outcome measures, limiting the comparability of the findings.

The evidence suggests that metaverse-based education has the potential to supplement or replace traditional nursing practice education in situations with limited access, such as pandemics. All included studies were Korean quasi-experiments with small sample sizes; thus, the certainty of the evidence is very low. Future research should employ multisite randomized controlled trials, optimize the frequency and intensity of interventions, and assess long-term outcomes to inform future strategies.