Abstract

Virtual reality (VR) has gained increasing prominence in nursing education; however, quantitative evidence comparing its effectiveness across learning outcomes remains limited. This meta-analysis synthesized findings from six experimental and quasi-experimental studies to evaluate the impact of VR-based instruction on motivation, knowledge, and skill performance among nursing students. The review followed the PRISMA 2020 guidelines for study identification, screening, eligibility assessment, and inclusion. Risk of bias for each study was evaluated using the Revised Cochrane Risk-of-Bias tool (RoB 2.0). Standardized mean differences (Hedges’ g) were calculated under a random-effects model, and all statistical analyses were performed using Stata 18. The overall pooled effect demonstrated a statistically significant advantage of VR-based learning compared with traditional instruction (Hedges’ g = -16.58, 95% CI [-28.66, -4.49], p = .01). Subgroup analyses revealed that VR produced the strongest effect on motivation (g = -35.43, p = .02), whereas knowledge (g = -7.33, p = .13) and skill performance (g = -9.88, p = .26) showed positive but non-significant effects. Substantial heterogeneity (I² > 98%) reflected variation in VR fidelity, intervention duration, clinical contexts, and assessment instruments. Funnel plot inspection indicated minimal evidence of publication bias. Overall, these results highlight VR’s strong potential to enhance affective learning outcomes, particularly motivation and engagement. While cognitive and psychomotor gains were less pronounced, the consistently positive direction suggests that multi-session VR integration, structured debriefing, and competency-based frameworks may improve outcomes. Future research should adopt rigorous randomized designs, standardized reporting, and longitudinal assessments to clarify VR’s sustained educational benefits.

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