{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:15:11Z","timestamp":1788160511235,"version":"build-2803163510"},"reference-count":47,"publisher":"Korean Society of Nursing Science","issue":"3","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["jkan.or.kr"],"crossmark-restriction":true},"short-container-title":["J Korean Acad Nurs"],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:p>Purpose: This study evaluated the effects of a hybrid simulation program using the metaverse and standardized patients to enhance delirium nursing competency among intensive care unit (ICU) nurses. Outcomes included delirium nursing knowledge, attitudes, and performance confidence.Methods: A quasi-experimental study with cluster allocation was conducted among 52 ICU nurses, including 28 in the experimental group and 24 in the control group. Data were collected from July 8 to August 28, 2024. The experimental group participated in a hybrid delirium nursing competency simulation program comprising two metaverse-based sessions (lectures, quizzes, discussions, and practice) followed by a face-to-face standardized patient simulation session. The control group received a conventional face-to-face lecture on delirium nursing. Data were analyzed using the chi-square test, the Fisher exact test, the independent t-test, and the paired t-test with IBM SPSS Statistics ver. 27.0.Results: After the intervention, the experimental group demonstrated significantly greater improvement in delirium nursing attitude (t=2.05, p=.046) and performance confidence (t=3.35, p=.002) compared with the control group. However, the change in delirium nursing knowledge did not differ significantly between groups (t=0.71, p=.483).Conclusion: The hybrid delirium nursing competency program using the metaverse and standardized patients was associated with greater positive changes in ICU nurses\u2019 delirium nursing attitudes and performance confidence than conventional lecture-based education. This immersive and interactive hybrid simulation approach may be a sustainable continuing education strategy for strengthening delirium nursing competency among ICU nurses.<\/jats:p>","DOI":"10.4040\/jkan.26013","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:37:08Z","timestamp":1785116228000},"page":"331-343","update-policy":"https:\/\/doi.org\/10.4040\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of a hybrid delirium nursing competency enhancement program using the metaverse and standardized patients for intensive care unit nurses: a quasi-experimental study"],"prefix":"10.4040","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0511-2740","authenticated-orcid":true,"given":"Juwon","family":"Yun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5058-9912","authenticated-orcid":true,"given":"Mi 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