Virtual Reality-Based Nursing Education: Effects on Clinical Competence, Skill Retention, and Patient Safety

Abstract

Virtual reality (VR) simulation is increasingly used in nursing education to provide immersive, repeatable, and risk-free clinical learning experiences. It may help address limited clinical placement capacity, variation in student exposure, and the need to prepare learners for safe practice. This review synthesizes evidence on the effects of VR-based nursing education on clinical competence, skill retention, and patient safety, and identifies implications for nursing education and future research. A narrative review of peer-reviewed systematic reviews, meta-analyses, and primary studies published predominantly between 2020 and 2026 was conducted. Databases included CINAHL, PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar. VR-based education generally improves nursing students’ knowledge, self-efficacy, engagement, and clinical competence, particularly when scenarios are interactive, clinically relevant, and followed by structured debriefing. Evidence for psychomotor skill performance is mixed: several meta-analyses report moderate-to-large improvements in clinical skills, whereas others find no statistically significant advantage over conventional simulation or traditional instruction. Evidence on skill retention is limited because most studies assess outcomes immediately after intervention. VR appears to support patient safety indirectly by enabling safe rehearsal of high-risk procedures, error recognition, clinical reasoning, communication, and teamwork; direct evidence linking VR education to reduced clinical adverse events remains scarce. VR is a promising complement—not a replacement—for high-quality clinical education. Nursing programs should integrate VR with deliberate practice, feedback, debriefing, and supervised clinical application. Future studies should use standardized outcome measures, longer follow-up, multi-site designs, and patient-safety outcomes.