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Spherical Video-Based Virtual Reality Training for Nurses' Delirium Care Competence: A Randomized Controlled Trial
Yin-Ling Hung1,2, Yi-Chao Zhou3,4,5, Hsin-Pei Feng6
1Graduate Institute of Medical Sciences, College of Medicine, National Defense Medical University, Taipei, Taiwan, medcol.mw.
Background:
Delirium is an acute cognitive disturbance commonly encountered in acute care settings, and nurses play a crucial role in its early detection and management. Innovative training strategies are needed to strengthen nurses' delirium care competence and preparedness.
Aim:
To determine whether a spherical video-based virtual reality (SVVR) training program improves nurses' knowledge, attitudes, and confidence in delirium care.
Methods:
A two-group, parallel randomized controlled trial with qualitative evaluation was conducted. Registered nurses from a medical center in northern Taiwan were randomly allocated to an SVVR training group (n = 54) or a noninteractive video group with identical content (n = 54). Outcomes were assessed at baseline (T0), immediately postintervention (T1), and at 1-month follow-up (T2) using generalized estimating equations. Semistructured interviews with SVVR participants explored their learning experiences.
Results:
Both groups improved in delirium knowledge; however, the SVVR group demonstrated greater gains at T1 (p = 0.001) and T2 (p = 0.022). Confidence increased in both groups, with a larger immediate postintervention increase in the SVVR group (p = 0.001). Sensitivity analysis further indicated that the participants who encountered delirium cases during follow-up reported higher confidence (p = 0.040). Qualitative findings showed that immersive learning enhanced engagement, concentration, perceived realism, patient assessment, clinical decision-making, and interdisciplinary collaboration.
Conclusion:
SVVR training was associated with greater and sustained gains in delirium care knowledge and greater immediate gains in confidence compared with noninteractive video education. Confidence appeared to be further reinforced by subsequent clinical exposure.
Implication For Nursing Management:
SVVR may offer nurse managers a standardized and repeatable approach to continuing education and workforce development, particularly for preparing newly graduated nurses for delirium care. Implementation requires consideration of equipment, costs, technical support, and staff readiness.
Trial Registration:
ClinicalTrials.gov identifier: NCT06880263.
