Development and Assessment of a Multi-User Virtual Environment Nursing Simulation Program: A Mixed Methods Research Study

Background: Recent technological advancements have enabled multi-user virtual environments that can provide safe and interactive training opportunities for healthcare providers. This study aims to develop a multi-user virtual simulation program for metacognition and evaluate the students’ satisfaction, clinical judgment, and nursing competencies. Methods: Mixed methods was used. A virtual reality simulation program based on an existing curriculum model and experiential learning theory was developed. The five scenarios were evaluated for content validity and tested for pilot. A total of 57 senior nursing students participated. Clinical judgment and nursing competencies were scored, and interviews were conducted with focus groups. Results: Total scores for nursing competency before and after the simulation program were 243.6(29.82) and 264.0(34.53), respectively, with a significant increase of 20.4 (t = 4.690, p < .001) post-session. Total scores for clinical judgment ranged from 22.2 to 32.0 (out of 44 maximum possible points). Overall, most of the participants were able to achieve their learning outcomes through the program. Conclusions: The findings suggest that the use of virtual simulation is effective in enhancing nursing competence by enhancing metacognition.