{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:05:45Z","timestamp":1791471945058,"version":"4.3.4"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":134,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004884","name":"Education Department of Sichuan Province","doi-asserted-by":"publisher","award":["JG2024-0082"],"award-info":[{"award-number":["JG2024-0082"]}],"id":[{"id":"10.13039\/501100004884","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional nursing education faces significant challenges in bridging theoretical knowledge and clinical practice, with clinical placements increasingly constrained by limited availability and patient safety concerns. Immersive virtual reality (IVR) simulation offers unprecedented sensory immersion and spatial presence as a potential solution. However, existing evidence regarding IVR\u2019s effectiveness in nursing education remains fragmented and inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of IVR simulation on nursing students\u2019 learning outcomes using Bloom\u2019s taxonomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis followed PRISMA guidelines and included randomized controlled trials comparing IVR simulation with conventional education in nursing students. MEDLINE, Embase, CINAHL, and CENTRAL were searched from inception to March 25, 2025. Outcomes were classified into cognitive, psychomotor, and affective domains according to Bloom\u2019s taxonomy. Random\u2010effects models were applied, with subgroup and sensitivity analyses conducted to explore sources of heterogeneity and identify potential effect modifiers. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty RCTs involving 2063 nursing students were included. In the cognitive domain, IVR simulation significantly improved knowledge acquisition (SMD\u2009=\u20090.33, 95% CI: 0.04\u20130.61); numerical trends suggested stronger effects when debriefing was incorporated, and benefits diminished at follow\u2010up. In the psychomotor domain, IVR simulation did not significantly enhance skill performance (SMD\u2009=\u20090.49, 95% CI: \u22120.24\u20131.22), despite a numerical trend favoring the intervention. In the affective domain, IVR simulation significantly improved self\u2010efficacy (SMD\u2009=\u20090.38, 95% CI: 0.04\u20130.72) but showed no significant effects on satisfaction or confidence. Adverse effects were generally mild and consisted primarily of visual and vestibular symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IVR simulation may enhance knowledge acquisition and self\u2010efficacy among nursing students. The importance of debriefing and the need for reinforcement strategies to sustain knowledge gains were highlighted. IVR\u2019s effects on skills and other affective outcomes remain inconclusive. Further high\u2010quality RCTs with standardized protocols are required to clarify IVR\u2019s role in nursing education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/4686851","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:41:03Z","timestamp":1778910063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Immersive Virtual Reality Simulation on Nursing Students\u2019 Learning Outcomes: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3134-0149","authenticated-orcid":false,"given":"Xia","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8512-7138","authenticated-orcid":false,"given":"Yanling","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanmei","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7496-6076","authenticated-orcid":false,"given":"Chunsong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biru","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-7398","authenticated-orcid":false,"given":"Xingli","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-0307","authenticated-orcid":false,"given":"Yuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_12_1_2","volume-title":"State of the World\u2019s Nursing 2025: Investing in Education, Jobs, Leadership and Service Delivery","author":"World Health Organization","year":"2025"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2834.2011.01335.x"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2018.06.007"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2011.10.022"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2025.106625"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.2147\/jmdh.S258112"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/nne.0000000000001224"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/0142159x.2013.818632"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2020.104662"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04202-x"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/sih.0000000000000411"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10055-020-00489-9"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2025.106725"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.03.018"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2023.105248"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2024.101648"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.teln.2024.10.020"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01384-9"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.3928\/01484834-20211213-05"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.12799\/rcphn.2024.00689"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.2196\/39989"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.3163\/1536-5050.103.3.010"},{"key":"e_1_2_12_23_2","article-title":"A Taxonomy for Learning","author":"Anderson L. 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