{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:58:34Z","timestamp":1790315914806,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disasters increasingly challenge healthcare systems, highlighting the need to strengthen preparedness among future healthcare professionals. Although disaster risk awareness is important, it does not consistently translate into preparedness behaviours, reflecting the awareness\u2013action gap. Immersive virtual reality (VR) may enhance experiential disaster learning, but how it influences preparedness processes remains insufficiently understood, particularly in healthcare and critical care education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore how immersive VR\u2010based disaster simulations influence disaster risk perception and preparedness among nursing students, with particular attention to the awareness\u2013action gap and implications for future healthcare and critical care practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A qualitative descriptive study using immersive VR\u2010based disaster simulations followed by semi\u2010structured interviews. Twelve undergraduate and graduate nursing students in Japan experienced immersive VR simulations depicting floods and landslides. Individual semi\u2010structured interviews explored emotional responses, disaster risk perception, preparedness awareness and anticipated behavioural responses. Data were analysed using Krippendorff's content analysis with researcher triangulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five categories were identified: (1) heightened vulnerability and psychological burden through immersion; (2) persistence of the awareness\u2013action gap despite increased risk perception; (3) enhanced risk recognition and preparedness intentions; (4) recognition of the need for social and structural support systems; and (5) emerging responsibility accompanied by perceived limitations. VR transformed abstract disaster risk into emotionally salient experiences, strengthening threat appraisal and preparedness awareness; however, awareness did not consistently translate into preparedness behaviours, reflecting insufficient coping appraisal and self\u2010efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immersive VR may strengthen disaster risk perception and preparedness awareness, but immersive experiences alone may be insufficient to bridge the awareness\u2013action gap. Combining VR with reflective learning, skills\u2010based training and collaborative simulation may strengthen coping appraisal and preparedness action.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Immersive VR combined with reflective and skills\u2010based learning may support psychological readiness, situational awareness and disaster preparedness competencies among future nurses, including those preparing for critical care practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70681","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:21Z","timestamp":1790312421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging the Awareness\u2013Action Gap in Disaster Preparedness: A Qualitative Study of Immersive Virtual Reality Learning Among Nursing Students"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7600-6554","authenticated-orcid":false,"given":"Keiko","family":"Mori","sequence":"first","affiliation":[{"name":"Graduate School of Health Sciences Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miina","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Kobe University Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Haruna","sequence":"additional","affiliation":[{"name":"Snowlion. Inc.  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_16_2_1","unstructured":"United Nations Office for Disaster Risk Reduction (UNDRR) \u201cSendai Framework for Disaster Risk Reduction 2015\u20132030. United Nations Geneva \u201d2015."},{"key":"e_1_2_16_3_1","volume-title":"State of the World's Nursing 2020: Investing in Education, Jobs and Leadership","author":"World Health Organization","year":"2020"},{"issue":"2","key":"e_1_2_16_4_1","first-page":"53","article-title":"Nursing Support Provided by Nursing Students for Evacuees in Shelters: Issues and Challenges","volume":"28","author":"Hashimoto M.","year":"2023","journal-title":"Journal of the Japanese Society for Disaster Medicine"},{"key":"e_1_2_16_5_1","first-page":"45","article-title":"Learning Experiences of Nursing Students in Disaster Training With Hospitals","volume":"20","author":"Nakao Y.","year":"2022","journal-title":"Journal of Nagasaki Prefectural University Nursing and Nutrition"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010025\u201004275\u20103"},{"issue":"1","key":"e_1_2_16_7_1","first-page":"1","article-title":"Disaster Awareness and Preparedness Among Nursing Students: A Literature Review","volume":"23","author":"Hamamoto R.","year":"2017","journal-title":"Osaka University Journal of Nursing Science"},{"issue":"1","key":"e_1_2_16_8_1","first-page":"55","article-title":"Disaster Awareness and Preparedness Behaviors Among Nursing Students Based on Disaster Nursing Education","volume":"5","author":"Nakamura Y.","year":"2013","journal-title":"Journal of Human Sciences Research"},{"key":"e_1_2_16_9_1","first-page":"64","article-title":"Disaster Risk Perception and Preparedness Behavior Among Nursing Students","volume":"16","author":"Ando T.","year":"2023","journal-title":"Bulletin of Chiba Institute of Science"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1539\u20106924.2012.01942.x"},{"key":"e_1_2_16_11_1","first-page":"39","article-title":"Differences in Disaster Awareness and Behavior Among Nursing Students in Regions With Different Disaster Risks","volume":"21","author":"Matsukiyo Y.","year":"2012","journal-title":"Journal of Medical and Nursing Education"},{"issue":"2","key":"e_1_2_16_12_1","first-page":"28","article-title":"Disaster Awareness and Preparedness Among Nursing Students in Low\u2010Disaster Regions","volume":"25","author":"Onai M.","year":"2023","journal-title":"Japanese Journal of Disaster Nursing"},{"key":"e_1_2_16_13_1","first-page":"166","article-title":"A Literature Review on Disaster Education Methods for Nursing Students","volume":"34","author":"Nagayasu Y.","year":"2022","journal-title":"St. Catherine University Bulletin"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44217\u2010025\u201000771\u20105"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0329563"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs13070616"},{"issue":"1","key":"e_1_2_16_17_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/00223980.1975.9915803","article-title":"A Protection Motivation Theory of Fear Appeals and Attitude Change","volume":"91","author":"Rogers R. W.","year":"1975","journal-title":"Journal of Psychology"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098\u2010240X(200008)23:4<334::AID\u2010NUR9>3.0.CO;2\u2010G"},{"key":"e_1_2_16_19_1","volume-title":"Content Analysis: An Introduction to Its Methodology","author":"Krippendorff K.","year":"2018"},{"key":"e_1_2_16_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic Inquiry","author":"Lincoln Y. 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