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With an ever-increasing need of skilled healthcare workers, efficient learning methods like Virtual Reality (VR) are becoming increasingly important. We developed and tested a VR simulation for endotracheal suctioning. The aim of this pilot study was to examine the VR simulation’s acceptance and increase of knowledge among participants. Furthermore, the effects of presence on acceptance and increase of knowledge were investigated. A total of 51 students participated in the pilot study, using a quasi-experimental pre-post-test design. A modified Unified Theory of Acceptance and Use of Technology (UTAUT) and the Igroup Presence Questionnaire (IPQ) were used. Correlation and regression analyses were performed. Pre- and post-tests showed a significant increase of knowledge (p < 0.001). The correlation between presence and behavioural intention was highly positive (r = 0.52, p < 0.001). Performance and effort expectancy are dominant effects on behavioural intention of using the VR simulation as an educational tool. The results indicate that a simulation which conveys a higher sense of presence is more likely to be accepted by learners. Regarding outcomes of presence on increase of knowledge, we found no significant correlation. Based on our study, we propose a design for a future mixed reality simulation with haptic elements and a plan on how to assess skills improvement.

Background Clinical skills training is an essential component of nursing education. However, sometimes education does not sufficiently prepare nurses for the real world. Virtual reality (VR) is an innovative method to complement existing learning strategies, yet few studies investigate its effectiveness. This study compared educational outcomes achieved by three groups learning with either of two different VR simulation variants, with varying technological features, or a video training on the endotracheal suctioning skill. Methods The investigated outcomes were knowledge and skill acquisition, learner satisfaction, and technology acceptance. 131 undergraduate nursing students were randomised into three groups, based on the interventions they received. Knowledge was assessed through a pre-post-test design, skill through a post-intervention objective structured clinical examination on a manikin, learning satisfaction and technology acceptance through standardised questionnaires, and qualitative feedback through focus groups. Results All interventions led to a significant knowledge acquisition, with no significant difference between the groups. The video intervention group performed significantly better than the VR groups in skill demonstration. One of the two VR intervention groups had a significantly higher learner satisfaction than the video group. Technology acceptance was high for both VR groups, with the simpler VR simulation resulting in higher technology acceptance than the one with more experimental features. Students described the VR experience as realistic, interactive, and immersive, and saw the opportunity to practise skills in a safe environment, learn from mistakes, and increase knowledge and confidence. Conclusions For the development of VR trainings, we recommend keeping them simple and targeting a specific educational outcome since trying to optimise for multiple outcomes is resource intensive and hard to achieve. Psychomotor skills were easier for participants to learn by watching a video on the procedure rather than practically learning it with the VR hardware, which is a more abstract representation of reality. We therefore recommend using VR as a complementing resource to skills labs, rather than replacing existing learning strategies. Perhaps VR is not ideal for practising practical psychomotor skills at the moment, but it can increase knowledge, satisfaction, motivation, confidence and prepare for further practical training. Trial registration Not applicable.

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