Virtual reality in nursing education: Integrating technology, pedagogy, and learning outcomes - A scoping review

To map and synthesize how VR has been applied in nursing education by integrating technologies, pedagogical strategies, learning outcomes and implementation challenges.

Virtual Reality (VR) has become an increasingly relevant educational tool in nursing education, particularly following the COVID-19 pandemic. However, evidence remains fragmented across technological, pedagogical and learning dimensions.

A scoping review was conducted according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Searches were performed in the Web of Science Core Collection for studies published between 2020 and 2024. Sixty-eight empirical studies met the inclusion criteria, including randomized controlled trials, quasi-experimental, observational, descriptive, mixed-methods and feasibility studies.

VR applications ranged from immersive head-mounted displays to interactive virtual platforms, supporting the development of technical and socio-emotional competencies. Common pedagogical approaches included simulation-based learning, problem- and scenario-based learning, self-directed learning, feedback and reflective debriefing. Self-confidence and self-efficacy were the most frequently assessed outcomes, followed by satisfaction and engagement, with predominantly positive findings. Improvements in practical performance and knowledge acquisition were also reported, although outcomes were often comparable to traditional educational approaches. Across studies, educational effectiveness was consistently associated with instructional design features, particularly feedback, repeated practice and structured reflection. Technical limitations, physical discomfort and institutional barriers were the main implementation challenges.

VR is a complementary pedagogical resource whose effectiveness depends on instructional design and purposeful curricular integration. Future research should prioritize long-term outcomes, transfer to clinical practice and cost-effectiveness analyses.