Abstract
Background: Immersive virtual reality (IVR) is shifting from an educational novelty to an essential strategy for preparing practice ready nurses. While programs increasingly adopt IVR to provide consistent clinical learning, there is limited guidance on how IVR impacts knowledge and clinical competence when scaled across multiple sites. By giving every student standardized complex scenarios, IVR supports competency based assessment while expanding simulation access for programs with limited infrastructure.
Purpose: Describe outcomes from implementing a competency based IVR sequence across six prelicensure nursing programs and a nurse residency, with emphasis on what supported successful replication.
Methods: Six nursing programs in large public universities integrated five IVR scenarios into senior clinical courses. Scenarios progressively increased from one to five patients and targeted time management, prioritization, delegation, communication, and safety. Performance was assessed using the modified Creighton Competency Evaluation Instrument for Clinical (CCEI-C) aligned with the Clinical Judgment Measurement Model (CJMM), the Multi-patient Knowledge Assessment Scale (MKAS),and IVR-generated data logs. After initial implementation at three programs, a standardized toolkit was developed for remote replication at three additional programs and a health system nurse residency.
Results: Across six programs, 1,266 prelicensure students completed the IVR sequence, along with four nurse residency cohorts. Replication at additional sites was supported through remote onboarding and shared materials. CCEI-C subscale scores showed strong clinical judgment and safety behaviors, with gains as patient load increased; performance peaked at scenario 3. Communication scores were lower across scenarios, highlighting a shared opportunity to strengthen handoff, escalation, and communication skills. MKAS scores showed significant pre to post gains on scenarios 3, 4, and 5, while scenarios 1 and 2 were unchanged. Learners reported increased confidence in managing competing priorities.
Conclusion: A structured, competency based IVR sequence can be scaled across diverse nursing education and practice settings using a common toolkit, remote onboarding, and guided debriefing. Multisite outcomes demonstrate that IVR can function as a portable framework for building practice readiness, generating competency data, and supporting collaborative curriculum improvement across programs.
Notes
References:
Aebersold, M., & Gonzalez, L. (2024). Can virtual reality simulations improve macrocognition?. BMJ Quality & Safety, 33(7), 411-412.
Bradley, C. S., Thomas, J., Yip, W., & Aebersold, M. (2024). In Pursuit of the Practice Ready Nurse: Insights From a National Survey. JONA: The Journal of Nursing Administration, 10-1097.
Bradley, C. S., Aebersold, M., DiClimente, L., Flaten, C., Muehlbauer, M. K., & Loomis, A. (2024). Breaking boundaries: How immersive virtual reality is reshaping nursing education. Journal of Nursing Regulation, 15(2), 28-37.
Bradley, C. S., Loomis, A., DiClemente, L., Flaten, C., Rahman, S., Muehlbauer, M. K., ... & Aebersold, M. (2025). Enhancing nursing competence and knowledge: Evaluating the impact of immersive virtual reality in nursing education. Journal of Nursing Regulation, 16(1), 2-9.
Foronda, C. L., Gonzalez, L., Meese, M. M., Slamon, N., Baluyot, M., Lee, J., & Aebersold, M. (2024). A comparison of virtual reality to traditional simulation in health professions education: a systematic review. Simulation in Healthcare, 19(1S), S90-S97.
Sigma Membership
Zeta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quasi-Experimental Study, Other
Research Approach
Quantitative Research
Keywords:
Competence, Simulation, Faculty Development, Virtual Reality, Immersive Design, Nursing Students, Clinical Competence, Simulation Methods & Models
Recommended Citation
Bradley, Cynthia and Flaten, Carol, "Scaling Nursing Immersive Virtual Reality Simulation: Multisite Outcomes and Lessons Learned" (2026). International Nursing Research Congress (INRC). 291.
https://www.sigmarepository.org/inrc/2026/presentations_2026/291
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-23
Scaling Nursing Immersive Virtual Reality Simulation: Multisite Outcomes and Lessons Learned
Toronto, Ontario, Canada
Background: Immersive virtual reality (IVR) is shifting from an educational novelty to an essential strategy for preparing practice ready nurses. While programs increasingly adopt IVR to provide consistent clinical learning, there is limited guidance on how IVR impacts knowledge and clinical competence when scaled across multiple sites. By giving every student standardized complex scenarios, IVR supports competency based assessment while expanding simulation access for programs with limited infrastructure.
Purpose: Describe outcomes from implementing a competency based IVR sequence across six prelicensure nursing programs and a nurse residency, with emphasis on what supported successful replication.
Methods: Six nursing programs in large public universities integrated five IVR scenarios into senior clinical courses. Scenarios progressively increased from one to five patients and targeted time management, prioritization, delegation, communication, and safety. Performance was assessed using the modified Creighton Competency Evaluation Instrument for Clinical (CCEI-C) aligned with the Clinical Judgment Measurement Model (CJMM), the Multi-patient Knowledge Assessment Scale (MKAS),and IVR-generated data logs. After initial implementation at three programs, a standardized toolkit was developed for remote replication at three additional programs and a health system nurse residency.
Results: Across six programs, 1,266 prelicensure students completed the IVR sequence, along with four nurse residency cohorts. Replication at additional sites was supported through remote onboarding and shared materials. CCEI-C subscale scores showed strong clinical judgment and safety behaviors, with gains as patient load increased; performance peaked at scenario 3. Communication scores were lower across scenarios, highlighting a shared opportunity to strengthen handoff, escalation, and communication skills. MKAS scores showed significant pre to post gains on scenarios 3, 4, and 5, while scenarios 1 and 2 were unchanged. Learners reported increased confidence in managing competing priorities.
Conclusion: A structured, competency based IVR sequence can be scaled across diverse nursing education and practice settings using a common toolkit, remote onboarding, and guided debriefing. Multisite outcomes demonstrate that IVR can function as a portable framework for building practice readiness, generating competency data, and supporting collaborative curriculum improvement across programs.
Description
Immersive virtual reality (IVR) is emerging as an essential strategy for preparing practice ready nurses, yet few studies describe how to scale IVR across diverse programs. This presentation reports outcomes and lessons learned from integrating a shared, competency based IVR sequence across six prelicensure nursing programs and a health system nurse residency. We will highlight implementation strategies that supported successful replication to advance competency based nursing education.