Beyond the pilot: Nursing students’ experiences with curricular integration of virtual reality simulation

Aim/Objective As immersive virtual reality (IVR) becomes more common in nursing education, curricular integration beyond pilot initiatives is essential for sustained impact. This study explores undergraduate nursing students' perceptions and experiences of IVR when it was longitudinally integrated into a required clinical course, rather than to measure effectiveness or outcomes. Background IVR simulations provide standardized, controlled environments where students can practice clinical reasoning and decision making without risk to patients. While single-session IVR benefits have been reported, limited evidence addresses its impact when aligned with curriculum-wide simulation strategy and best practice standards. Design This qualitative study used an interpretive descriptive design. Methods Data were collected through semi-structured interviews and a focus group with 11 prelicensure students enrolled in a third-year clinical course. Thematic analysis followed Braun and Clarke's six-step framework. Results Thematic analysis revealed that repeated exposure to IVR enhanced students' comfort with the technology, supported cognitive and emotional engagement, and fostered perceived improvements in clinical reasoning and confidence. Simulation design elements such as structured orientation, role variation, and standards-based prebriefing and debriefing were essential. Conclusions These findings suggest that IVR can support deeper learning, clinical reasoning, and learner motivation when implemented as part of a broader simulation curriculum guided by simulation best practices. One-off IVR experiences may limit educational value, whereas longitudinal integration offers a scalable, equitable strategy to prepare students for clinical complexity.