Impact of an immersive virtual reality simulator education program on nursing students' intravenous injection administration: A mixed methods study

Background: Undergraduate nursing students often face limited opportunities to gain hands-on experience in performing invasive procedures and techniques. Immersive media tools may be helpful in training and enhancing skill development among nursing students. Objectives: The specific aims of this study were threefold: (1) to describe the development process of an intravenous injection virtual reality simulator (IIVRS) program, (2) to determine the effect of the IIVRS program on intravenous injection knowledge, and (3) to examine the acceptability, learning motivation, and experience of the IIVRS program among nursing students. Methods: This study is a mixed method design, encompassing a one-group pre- and post-test approach and the utilization of reflection logs among 128 second-year nursing students enrolled at a university in northern Taiwan. An innovative gamification IIVRS program was developed by our research team. Knowledge of intravenous injection was assessed using a point visual analog scale at pre-and post-testing. Acceptability and motivation were assessed using items on a 5-point Likert scale. The IIVRS program experience was evaluated using open-ended questions of reflection. A paired t-test was used for comparing knowledge at pre-and post-tests, independent t-tests were conducted to compare levels of acceptance and learning motivation among different students' characteristics, and content analysis was used for qualitative data. Results: Students' knowledge of intravenous injection was significantly improved (Pre-test Mean = 3.08 vs. Post-test Mean = 4.96, p < 0.001). Students reported high levels of acceptance (Mean = 4.65) and learning motivation (Mean = 4.69). Students reported three themes of their experience: (1) attracts my attention and stimulates my motivation to learn, (2) enhanced memorization of the skill and process, and (3) a sense of presence and realism/unrealism. Conclusion: The virtual reality program for intravenous injection administration can be an effective education tool, fostering students' motivation to learn and a heightened sense of accomplishment.