Virtual simulation in nursing education: a scoping review

Virtual simulation has become an increasingly used pedagogical approach in nursing education, particularly since the COVID-19 pandemic. Despite rapid uptake across diverse modalities, a comprehensive map of the evidence covering the post-pandemic surge is lacking. This scoping review systematically maps evidence on virtual simulation in nursing education, identifying technology types, educational applications, research designs, outcome measures, and knowledge gaps to inform future practice and research.

A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported using the PRISMA-ScR checklist; the protocol was retrospectively registered on the Open Science Framework. PubMed, CINAHL (via EBSCOhost), Web of Science Core Collection, and Scopus were searched on 15 January 2026 for English-language peer-reviewed primary research published between January 2019 and December 2025. Two reviewers independently screened records and extracted data, with a third reviewer adjudicating disagreements. Findings were synthesised using descriptive statistics and descriptive categorisation of the extracted data.

Of 5,990 records retrieved, 198 studies were included. Publications rose sharply, increasing from two studies in 2019 to 82 in 2025, with almost two-thirds appearing in 2024-2025 (64.6%). Studies originated predominantly from South Korea (21.2%), the USA (18.7%), and China, Taiwan (11.1%). Interactive immersive virtual reality and 360-degree/180-degree video virtual reality together accounted for 63.1% of studies, followed by screen-based virtual simulation (23.7%); augmented reality accounted for a smaller share (4.0%). Quasi-experimental designs (27.8%) and randomised controlled trials (22.7%) predominated. Self-confidence/self-efficacy (44.4%), knowledge acquisition (42.4%) and satisfaction (39.4%) were the most frequently measured outcomes. Favourable findings were commonly reported for these outcomes among the included studies; however, this review did not chart the direction or magnitude of effects, and no methodological quality appraisal was undertaken.

Virtual simulation has been implemented across a broad range of nursing education contexts, and the mapped studies predominantly reported positive learning outcomes; however, limited longitudinal follow-up, geographic concentration in East Asia, small samples, and inconsistent outcome measures constrain the evidence base and warrant standardised, multi-site research.

Not applicable.