Effectiveness of Virtual Reality Simulations in Reducing Anxiety among Newly Graduated Registered Nurses: A Mixed-Methods Pilot Study

This study explores the effectiveness of virtual reality (VR) simulations compared to traditional face-to-face methods in alleviating anxiety and enhancing clinical skills among newly graduated registered nurses (NGRNs) at a large medical center.

Purpose: The transition from education to clinical practice often induces high anxiety for NGRNs, impacting patient care and retention. Currently, 100% of NGRNs utilize simulation in some form during their training, highlighting simulations’ critical role in development. Although VR has shown promise in nursing education, limited research addresses its potential to reduce anxiety in clinical practice. The research aims to evaluate whether VR simulations, through immersive, controlled learning experiences, provide a better method for reducing anxiety and fostering competency in clinical settings than traditional face-to-face simulations. The study will determine how VR training might improve skill acquisition and workflow integration during the early stages of professional practice.

Methods: A comparative mixed methods design will be used. The sample includes 13 NGRNs enrolled in the post-baccalaureate registered nurse residency and transition-to-practice programs. Quantitative data will be collected using pre- and post-intervention anxiety assessments (e.g., self-confidence with clinical decision-making scale (NASC-CDM) and competency evaluations (e.g., Creighton competency evaluation instrument). Qualitative feedback from focus groups and interviews will provide additional context regarding VR’s impact on participants’ anxiety levels and skills integration. This dual approach allows for both statistical analysis and in-depth insight into participant experiences.

Implications: This pilot study addresses the practice gap in anxiety management for NGRNs transitioning to clinical practice at a large medical center. Results could support the integration of VR simulations into their transition-to-practice programs by determining (feasibility) and (preliminary effectiveness) of this innovative approach. By examining both quantitative anxiety measures and qualitative experiences, the study will provide comprehensive data on whether VR offers advantages over traditional simulation methods for supporting NGRNs.

As NGRNs face increasing workplace demands and mental health challenges (exacerbated by COVID-19), evidence-based strategies for anxiety management and skill development are critical. By implementing and evaluating VR simulations through this pilot study, the medical center can begin to establish (best practices) for supporting NGRNs' psychological wellbeing and clinical competence during their critical transition period. Findings will directly inform decisions about (scaling up) VR integration across departments, with potential improvements in NGRN confidence, patient outcomes, error rates, and retention within the institution.