The impact of a 360-degree immersive VR video observation environment on deltoid IM injection skill acquisition and 2-month competency maintenance: a single-group pretest–posttest study

Abstract

Digital technologies are crucial for nursing competency, especially in maintaining educational continuity during global and regional crises. However, evidence on 360-degree immersive VR for specific high-stakes procedures like deltoid intramuscular (IM) injections remains limited. To evaluate the impact of a 360-degree immersive VR video environment on nursing students' deltoid IM injection skill performance and safety compliance. A pre-experimental, single-group pretest and 2-month delayed post-test design was conducted with 89 nursing students. Participants viewed a standardized 360-degree VR video of the IM procedure. Skills were assessed at baseline and after two months using a 20-item Intramuscular Injection Skills Checklist (0–2 scale) by a trained, calibrated single evaluator. Data were analyzed via Wilcoxon signed-rank tests. Students (mean age 22.67; 85.4% female) reported 97.8% satisfaction. Total skill scores improved significantly from 1.16 ± 0.24 (pre-test) to 1.72 ± 0.19 (2-Month Retention Test) ( p  < 0.001). Notably, high baseline compliance in specific safety steps, such as glove-wearing and needle withdrawal, was successfully sustained at the retention test, providing vital pedagogical insights into clinical risk prevention within the limitations of a single-rater evaluation framework. 360-degree immersive VR provides an effective, standardized platform for the continuity of safe clinical skill acquisition. These findings offer a scalable solution for both nursing curricula and disaster-resilient professional development. Future research should pursue multi-center randomized controlled trials and hybrid VR-haptic simulations to optimize long-term clinical competencies across the nursing workforce.