Effects of virtual reality training on clinical skill performance in nursing students: A systematic review, meta-analysis and meta-regression

Aims: This review examined the impact of virtual reality (VR) training on nursing students' clinical skill performance and identified essential features of VR training. Background: VR provides immersive content, simulating real-life scenarios and preventing errors in clinical settings. Design: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Data sourcesStudies were obtained from Ovid-EMBASE, MEDLINE, CINAHL and PubMed. Review methods: Studies related to VR training published from 1 January 2000 to 8 May 2024 were included. Comprehensive Meta-Analysis 4.0 software was used for meta-analysis and random effects meta-regression. The overall effect was assessed with Hedges' g and Z-statistics (p < 0.05). Heterogeneity was measured using I-squared (I2) statistics. Results: Among the 31 476 studies, 11 randomized controlled trial studies were included. Meta-analysis demonstrated a significant improvement in clinical skill performance, with a medium to large effect (g = 0.61) in the VR group (Z = 3.80, p < 0.001). Subgroup analyses highlighted higher nursing skills in the VR training topic. Meta-regression revealed that the VR training topic (beta = 1.23, p < 0.001) and method of VR training (beta = -0.53, p = 0.05) were significant covariates influencing clinical skill performance. Conclusion: VR training improves nursing students' clinical skill performance, addressing shortcomings in the clinical practicum.