Effect of a short virtual reality training on first-attempt hand-disinfection performance in an OSCE: a randomized...

Reliable hygienic hand-disinfection is essential for infection prevention and control. It remains unclear whether a short VR training module improves objectively assessed procedural performance compared with conventional instruction. This single-center, parallel-group randomized controlled trial examined first-opportunity hand-disinfection performance in an Objective Structured Clinical Examination (OSCE) after VR training versus a video control.

In 2025, first-year nursing students at a single Austrian University of Applied Sciences were randomized (1:1) to a 20-minute VR training module with contamination visualization feedback or a time- and headset-matched instructional video control without interactivity. Randomization used block allocation (blocks of six); instructions were standardized via audio playback. Three days later, students completed a routine five-station OSCE. Hygienic hand-disinfection was required at the beginning of each of five OSCE stations and was documented within routine station checklists. Hand-disinfection ratings from the five stations were extracted from routine OSCE checklists and coded (0 = incorrect, 1 = partially correct, 2 = correct). The preregistered primary endpoint was station 1 performance. The primary hypothesis was tested with adjusted proportional-odds regression, adjusting for age, gender, and prior hygiene-course grade as a baseline indicator of hygiene-related academic performance; all other analyses were exploratory.

Of 128 randomized students (VR n = 65; control n = 63), all had available station 1 hand-disinfection scores, which constituted the primary outcome. One value was missing for the prior hygiene-course grade covariate, yielding N = 127 for adjusted models. At station 1, fully correct performance occurred in 52/65 (80.0%) in VR versus 15/63 (23.8%) in control. VR training was associated with markedly better first-opportunity performance (adjusted OR = 11.16, 95% CI [4.95, 25.14], p = 5.9 × 10^{- 9}), supported by a binary pass/fail sensitivity analysis (adjusted OR = 6.06, 95% CI [1.84, 19.92]). Exploratory analyses suggested higher performance across stations, with group differences varying by station. No harms or adverse events were observed during the trial.

A short VR training module for hand-disinfection with contamination visualization was associated with better first-opportunity OSCE hand-disinfection performance compared with a headset-delivered instructional video control. This suggests that short, feedback-rich VR training may support immediate procedural readiness under standardized assessment conditions.

This study was preregistered within a larger longitudinal project and later registered as a stand-alone study in the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/3B6SC).

Not applicable.