Woon Adele Pei Ning, Mok Wen Qi, Chieng Ying Jia Shermin, Zhang Hui Min, Ramos Patricia, Mustadi Haryani Binte, Lau Ying
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Nurse Educ Today. 2021 Mar;98:104655. doi: 10.1016/j.nedt.2020.104655. Epub 2020 Nov 28.
We aimed to (1) evaluate the effectiveness of virtual reality (VR) training in improving knowledge among nursing students and (2) identify the essential features of training.
This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.
Randomised controlled trials (RCTs) were obtained from PubMed, EMBASE, Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest and Scopus databases from inception up until 15 October 2019.
Meta-analysis and random-effects meta-regression was performed using the Comprehensive Meta-analysis 3.0 software. The overall effect was measured using Hedges' g and determined using Z-statistics at the significance level of p < 0.05. Heterogeneity was assessed using χ and I statistics. The risk of bias tool and the Grading of the Recommendation, Assessment, Development and Evaluation (GRADE) system were employed to assess individual and overall quality of evidence, respectively.
Among the 1993 records identified, 14 trials were included. Meta-analysis demonstrated a significant improvement in knowledge, with a small-to-medium effect (g = 0.47) in the VR group compared to the control group (Z = 2.66, p = 0.01). Subgroup analyses highlighted that VR training was more efficacious in delivering procedural knowledge to undergraduate nursing students when conducted in multiple, self-guided, short sessions within 30 min and by using low-moderate level of immersion. Meta-regression did not detect significant covariates that influenced knowledge scores.
Virtual reality may be a viable teaching strategy to improve knowledge acquisition, but it is presently suitable for supplementing conventional teaching methods. Nonetheless, VR could complement current pedagogy to address challenges associated with decreased clinical placement opportunities. Larger, well-designed RCTs are required to strengthen the evidence about the effectiveness of VR training.
我们旨在（1）评估虚拟现实（VR）培训在提高护生知识水平方面的有效性，以及（2）确定培训的基本特征。
本系统评价按照系统评价和Meta分析的首选报告项目指南进行。
随机对照试验（RCT）从创刊至2019年10月15日从PubMed、EMBASE、Cochrane图书馆、PsycINFO、护理及相关健康文献累积索引、ProQuest和Scopus数据库中获取。
使用Comprehensive Meta-analysis 3.0软件进行Meta分析和随机效应Meta回归。总体效应采用Hedges' g测量，并在p < 0.05的显著性水平下使用Z统计量确定。异质性采用χ和I统计量评估。采用偏倚风险工具和推荐分级、评估、制定与评价（GRADE）系统分别评估个体和总体证据质量。
在识别出的1993条记录中，纳入了14项试验。Meta分析表明，与对照组相比，VR组的知识水平有显著提高，效应量为小到中等（g = 0.47）（Z = 2.66，p = 0.01）。亚组分析强调，当在30分钟内以多次、自主、短时间的方式进行，并使用中低水平的沉浸感时，VR培训在向本科护生传授程序性知识方面更有效。Meta回归未检测到影响知识得分的显著协变量。
虚拟现实可能是一种可行的教学策略，可提高知识获取，但目前适合补充传统教学方法。尽管如此，VR可以补充当前的教学方法，以应对临床实习机会减少带来的挑战。需要更大规模、设计良好的RCT来加强关于VR培训有效性的证据。
