Mixed reality in undergraduate nursing education: a systematic review and meta-analysis of benefits and challenges

Background: Nursing Schools are incorporating Mixed Reality (MR) into student training to enable them to confront challenging or infrequently encountered scenarios in their practice and ensure their preparedness. This systematic review evaluates the benefits and challenges of implementing MR in nurs...

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Detalhes bibliográficos
Autores: Guillén Aguinaga, Laura, Rayón Valpuesta, Esperanza, Guillén Aguinaga, Sara, Rodríguez-Díaz, Blanca, Montejo, Rocío, Alas Brun, Rosa María, Aguinaga Ontoso, Enrique, Onambele, Luc, Guillén-Aguinaga, Miriam, Guillén Grima, Francisco, Aguinaga Ontoso, Inés
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/54564
Acesso em linha:https://hdl.handle.net/2454/54564
Access Level:acceso abierto
Palavra-chave:Mixed reality
Augmented reality
Virtual reality
Nursing education
Nursing education research
Systematic review
Meta-analysis
Descrição
Resumo:Background: Nursing Schools are incorporating Mixed Reality (MR) into student training to enable them to confront challenging or infrequently encountered scenarios in their practice and ensure their preparedness. This systematic review evaluates the benefits and challenges of implementing MR in nursing curricula. Materials and Methods: A search was conducted in PubMed, WOS, Scopus, Embase, and CINAHL for studies published between 2011 and 2023. The search strategy used was (nurses OR nurse OR nursing) AND mixed reality AND simulation. Inclusion criteria required that studies focus on undergraduate nursing students and be written in English or Spanish. Exclusion criteria included reviews, bibliometric studies, and articles that did not separately report undergraduate nursing student results. Quality was evaluated with the JBI Critical Appraisal Checklist for Qualitative Research and the Newcastle-Ottawa Scale. A meta-analysis was conducted on studies with control groups to compare MR's effectiveness against traditional teaching methods. Results: Thirty-three studies met the inclusion criteria. MR was widely used to improve clinical judgment, patient safety, technical skill acquisition, and student confidence. The meta-analysis found that MR reduced anxiety (Cohen's d = -0.73, p < 0.001). However, its impact on knowledge acquisition and skill development was inconsistent. There was no improvement over traditional methods (p = 0.466 and p = 0.840). Despite positive qualitative findings, methodological variability, small sample sizes, and publication bias contributed to mixed quantitative results. The main challenges were cybersickness, usability, high costs, and limited institutional access to MR technology. Conclusions: Although MR can help nursing education by decreasing students' anxiety, its efficacy remains inconclusive. Future research should use larger, randomized controlled trials to validate MR's role in nursing education.