The impact of virtual reality simulation on developing competence and confidence in non-technical skills in nursing. A scoping review.
BACKGROUND Medical errors are a global concern and can compromise patient safety, with up to 80% of these errors directly linked to non-technical skills (NTS) failures. Traditional simulation using mannikins is resource-intensive, and virtual reality simulation (VR) has the potential to offer comparable outcomes with enhanced consistency and lowered resource requirements, but the effectiveness of VR to teach and enhance NTS has been underexplored. AIM This scoping review explores the existing literature on VR simulation as a method for teaching NTS in nursing to evaluate whether VR simulation yields positive learning outcomes, particularly in comparison to traditional training methods such as mannikin-based simulation. METHOD The Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines were utilised. Included studies were written in English and published between 2005 and 2025, leveraging either mixed methods, qualitative or quantitative studies and retrieved from EMBASE, CINAHL, PUBMED, and MEDLINE OVID. The search terms, including nurs*, virtual reality and non-technical skills, were developed using the PCC mnemonic: Population, Concept and Context. RESULTS A total of 2787 articles were originally identified. The final selection of 11 articles met the inclusion criteria. The main NTS element measured was communication. No articles explored all elements of NTS, and limited studies measured confidence in performing NTS. Only two articles compared the acquisition of NTS learning within traditional simulation and VR, with neither affirming a preferred training modality. CONCLUSION From the 11 studies reviewed regarding simulation practice as a method for teaching NTS in nursing, there is a large focus on communication related outcomes. However, there remains a significant gap in the literature supporting the use and application of VR, specifically for training NTS. Whilst it is clear, further research is needed to determine the efficacy of VR in relation to NTS performance and related confidence, it is evident that there is a need to explore whether this simulation modality has great potential for NTS education delivery. What is known is VR is cost-effective, accessible and has good usability.