{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:43:20Z","timestamp":1790379800011,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.<\/jats:p>","DOI":"10.3390\/bs13070616","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T01:32:10Z","timestamp":1690248730000},"page":"616","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Virtual Reality and Augmented Reality Training in Disaster Medicine Courses for Students in Nursing: A Scoping Review of Adoptable Tools"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5599-2405","authenticated-orcid":false,"given":"Camilla Elena","family":"Magi","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0360-4470","authenticated-orcid":false,"given":"Stefano","family":"Bambi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Iovino","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-8296","authenticated-orcid":false,"given":"Khadija","family":"El Aoufy","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Balestri","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rasero","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-9349","authenticated-orcid":false,"given":"Yari","family":"Longobucco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.cnur.2022.06.008","article-title":"Disaster Preparedness: Keeping Nursing Staff and Students at the Ready","volume":"57","author":"Tussing","year":"2022","journal-title":"Nurs. Clin. North Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/inr.12369","article-title":"Disaster preparedness among nurses: A systematic review of literature","volume":"65","author":"Labrague","year":"2018","journal-title":"Int. Nurs. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Palmer, J., Ku, M., Wang, H., Crosse, K., Bennett, A., Lee, E., Simmons, A., Duffy, L., Montanaro, J., and Bazaid, K. (2022). Public health emergency and psychological distress among healthcare workers: A scoping review. BMC Public. Health, 22.","DOI":"10.1186\/s12889-022-13761-1"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mohtady Ali, H., Ranse, J., Roiko, A., and Desha, C. (2022). Healthcare Workers\u2019 Resilience Toolkit for Disaster Management and Climate Change Adaptation. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph191912440"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.1017\/dmp.2022.198","article-title":"Relationship Between Nursing Students\u2019 Awareness of Disaster, Preparedness for Disaster, Willingness to Participate in Disaster Response, and Disaster Nursing Competency","volume":"17","author":"Kang","year":"2022","journal-title":"Disaster Med. Public. Health Prep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1017\/S1049023X14000387","article-title":"When and Why Health Care Personnel Respond to a Disaster: The State of the Science","volume":"29","author":"Connor","year":"2014","journal-title":"Prehospital Disaster Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1146\/annurev.psych.52.1.1","article-title":"Social Cognitive Theory: An Agentic Perspective","volume":"52","author":"Bandura","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref_8","first-page":"161","article-title":"A Social Cognitive Approach to Disaster Preparedness","volume":"48","author":"Espina","year":"2015","journal-title":"Philipp. J. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e030547","DOI":"10.1136\/bmjopen-2019-030547","article-title":"Factors associated with healthcare workers willingness to participate in disasters: A cross-sectional study in Sana\u2019a, Yemen","volume":"9","author":"Hoe","year":"2019","journal-title":"BMJ Open."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"912751","DOI":"10.3389\/fmed.2022.912751","article-title":"Applications of social theories of learning in health professions education programs: A scoping review","volume":"9","author":"Mukhalalati","year":"2022","journal-title":"Front. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1017\/S1049023X1700019X","article-title":"Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review","volume":"32","author":"Gowing","year":"2017","journal-title":"Prehospital Disaster Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lee, H., and Han, J.-W. (2022). Development and evaluation of a virtual reality mechanical ventilation education program for nursing students. BMC Med. Educ., 22.","DOI":"10.1186\/s12909-022-03834-5"},{"key":"ref_13","unstructured":"Englewood Cliffs, N.J. (1984). Experiential Learning: Experience as the Source of Learning and Development, Prentice-Hall."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/jcal.12375","article-title":"Motivational and cognitive benefits of training in immersive virtual reality based on multiple assessments","volume":"35","author":"Makransky","year":"2019","journal-title":"J. Comput. Assist. Learn."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/CIN.0000000000000916","article-title":"Assessing the Financial Sustainability of High-Fidelity and Virtual Reality Simulation for Nursing Education: A Retrospective Case Analysis","volume":"40","author":"Bumbach","year":"2022","journal-title":"Comput. Inform. Nurs."},{"key":"ref_16","unstructured":"Stanislaw, P.S., and Michael, S.F. (2020). Contemporary Topics in Patient Safety, IntechOpen."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Xie, B., Liu, H., Alghofaili, R., Zhang, Y., Jiang, Y., Lobo, F.D., Li, C., Li, W., Huang, H., and Akdere, M. (2021). A Review on Virtual Reality Skill Training Applications. Front. Virtual Real., 2.","DOI":"10.3389\/frvir.2021.645153"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/CIN.0000000000000910","article-title":"Augmented Reality in Supporting Healthcare and Nursing Independent Learning: Narrative Review","volume":"41","author":"Quqandi","year":"2023","journal-title":"Comput. Inform. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.compedu.2019.02.002","article-title":"Investigating the process of learning with desktop virtual reality: A structural equation modeling approach","volume":"134","author":"Makransky","year":"2019","journal-title":"Comput. Educ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1007\/s11596-019-2093-4","article-title":"Application of Virtual Reality Technology in Disaster Medicine","volume":"39","author":"Duan","year":"2019","journal-title":"Curr. Med. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e125","DOI":"10.5001\/omj.2020.43","article-title":"Challenges and Practical Considerations in Applying Virtual Reality in Medical Education and Treatment","volume":"35","author":"Baniasadi","year":"2020","journal-title":"Oman Med. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104662","DOI":"10.1016\/j.nedt.2020.104662","article-title":"The use of virtual reality simulation among nursing students and registered nurses: A systematic review","volume":"98","author":"Shorey","year":"2021","journal-title":"Nurse Educ. Today"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Munn, Z., Peters, M.D.J., Stern, C., Tufanaru, C., McArthur, A., and Aromataris, E. (2018). Systematic Review or Scoping Review? Guidance for Authors When Choosing between a Systematic or Scoping Review Approach. BMC Med. Res. Methodol., 18.","DOI":"10.1186\/s12874-018-0611-x"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping Studies: Towards a Methodological Framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int. J. Soc. Res. Methodol. Theory Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1136\/bmj.38636.593461.68","article-title":"Effectiveness and efficiency of search methods in systematic reviews of complex evidence: Audit of primary sources","volume":"331","author":"Greenhalgh","year":"2005","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13643-017-0454-2","article-title":"Convergent and sequential synthesis designs: Implications for conducting and reporting systematic reviews of qualitative and quantitative evidence","volume":"6","author":"Hong","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1146\/annurev-publhealth-032013-182440","article-title":"Combining the Power of Stories and the Power of Numbers: Mixed Methods Research and Mixed Studies Reviews","volume":"35","author":"Pluye","year":"2014","journal-title":"Annu. Rev. Public. Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Thomas, J., and Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med. Res. Methodol., 8.","DOI":"10.1186\/1471-2288-8-45"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.nedt.2018.09.006","article-title":"Comparative study of a simulated incident with multiple victims and immersive virtual reality","volume":"71","author":"Rios","year":"2018","journal-title":"Nurse Educ. Today"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1097\/01.NEP.0000000000000369","article-title":"Effectiveness of Two Varying Levels of Virtual Reality Simulation","volume":"39","author":"Smith","year":"2018","journal-title":"Nurs. Educ. Perspect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/01.NEP.0000000000000035","article-title":"Learning and Retention Using Virtual Reality in a Decontamination Simulation","volume":"37","author":"Smith","year":"2016","journal-title":"Nurs. Educ. Perspect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3928\/01484834-20211213-05","article-title":"The Use of Virtual Reality to Improve Disaster Preparedness Among Nursing Students: A Randomized Study","volume":"61","author":"Shujuan","year":"2022","journal-title":"J. Nurs. Educ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1097\/CIN.0000000000000856","article-title":"Teaching Disaster Evacuation Management Education to Nursing Students Using Virtual Reality Mobile Game-Based Learning","volume":"40","author":"Hu","year":"2022","journal-title":"Comput. Inform. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1080\/10903127.2019.1676345","article-title":"Virtual Reality Triage Training Can Provide Comparable Simulation Efficacy for Paramedicine Students Compared to Live Simulation-Based Scenarios","volume":"24","author":"Mills","year":"2020","journal-title":"Prehospital Emerg. Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"104809","DOI":"10.1016\/j.nedt.2021.104809","article-title":"Development of disaster nursing education and training programs in the past 20 years (2000\u20132019): A systematic review","volume":"99","author":"Loke","year":"2021","journal-title":"Nurse Educ. Today"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e29080","DOI":"10.2196\/29080","article-title":"Augmented, Mixed, and Virtual Reality-Based Head-Mounted Devices for Medical Education: Systematic Review","volume":"9","author":"Barteit","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/CIN.0000000000000540","article-title":"Comparative Cost of Virtual Reality Training and Live Exercises for Training Hospital Workers for Evacuation","volume":"37","author":"Farra","year":"2019","journal-title":"Comput. Inform. Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Uymaz, P., and Uymaz, A.O. (2022). Assessing acceptance of augmented reality in nursing education. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0263937"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Meyer, N., Niemand, T., Davila, A., and Kraus, S. (2022). Biting the bullet: When self-efficacy mediates the stressful effects of COVID-19 beliefs. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265330"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3928\/00220124-20130701-67","article-title":"Perception Versus Reality: A Comparative Study of the Clinical Judgment Skills of Nurses During a Simulated Activity","volume":"44","author":"Fenske","year":"2013","journal-title":"J. Contin. Educ. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ijintrel.2021.03.009","article-title":"An examination of the effectiveness of virtual reality technology for intercultural competence development","volume":"82","author":"Akdere","year":"2021","journal-title":"Int. J. Intercult. Relat."}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/13\/7\/616\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:18:11Z","timestamp":1760127491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/13\/7\/616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,24]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["bs13070616"],"URL":"https:\/\/doi.org\/10.3390\/bs13070616","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,24]]}}}