The effectiveness of extended reality methods (augmented reality, virtual reality, and mixed reality) in enhancing clinical competency in nursing education: A systematic review and meta-analysis.
Abstract
Aim
This systematic review aimed to evaluate the overall effectiveness of extended reality technologies as a unified educational approach in supporting the development of clinical competency in nursing education.
Design
A systematic review and meta-analysis.
Methods
This review focused exclusively on randomized controlled trials to ensure methodological consistency and a high level of evidence. Articles were retrieved from seven major databases: PubMed, Cochrane Library, OVID, Scopus, Web of Science, CINAHL, and ScienceDirect. Searches were conducted using keywords related to extended reality technologies and nursing education, and the review was reported in accordance with the PRISMA 2020 checklist.
Results
The systematic review included 22 studies; 12 were included in the meta-analysis. The meta-analysis showed that extended reality technologies significantly improved exam performance and learning satisfaction compared with traditional educational methods. However, no significant effects were observed for communication skills, knowledge acquisition, self-confidence, simulation performance, or stress. High heterogeneity was identified for several outcomes, reflecting variability in intervention designs and participant characteristics.
Conclusion
The findings suggest that extended reality technologies may support selected aspects of nursing education, particularly exam performance and learning satisfaction. However, the evidence does not consistently demonstrate significant effects across all domains of clinical competency, including communication skills, knowledge acquisition, self-confidence, simulation performance, and stress. Future studies using standardized protocols, validated measurement tools, and competency-driven outcome measures are needed to fully integrate extended reality technologies into evidence-based nursing education and practice.