Aug 2026· International Review of Research in Open and Distance Learning· Vol 27, pp. 325-339· 0 citations
TL;DR
It was suggested that integrating advanced clinical learning technologies into nurse practitioner programs should be prioritized, and five primary themes emerged, including student uptake, change management, accessibility, and confidence.
Abstract
The use of technology in healthcare education is rapidly expanding. Undergraduate nursing programs have integrated advanced technologies such as high-fidelity simulation, immersive virtual reality, augmented reality, and holographic simulations to support learning and improve retention in both in-person and distance learning. Meanwhile, little is known about the use of these clinical learning technologies in nurse practitioner education. This integrative review involved a systematic search of five databases: CINAHL, ERIC (ProQuest), MedLine (OVID), Google Scholar, and PubMed. Eleven studies met the inclusion and exclusion criteria and were analyzed for major themes. Five primary themes emerged, including (a) student uptake, (b) student learning, (c) change management, (d) accessibility, and (e) confidence. Findings suggested that integrating advanced clinical learning technologies into nurse practitioner programs should be prioritized. Going forward, focus should turn to establishing nurse practitioner program best practices for integrating clinical learning technologies, budgetary considerations, ongoing evaluation of learning outcomes, and theory development. Work in these areas may support the enhanced use of clinical learning technologies while providing educational institutions, nurse practitioner programs and public funders with the necessary data to inform future planning and further implementation of new technologies.
Technology-enhanced learning (TEL), including artificial intelligence (AI), virtual reality (VR), high-fidelity simulation (HFS), and gamification, is increasingly used in nursing education to address limitations in clinical training and support the development of students’ clinical reasoning skills. This review aimed to synthesize current evidence on the educational outcomes associated with AI, VR, HFS, and gamification in nursing education, and to identify the factors that facilitate or hinder their successful implementation.
A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251048860). Five electronic databases were searched for English-language studies published between 2015 and 2025. Studies were eligible if they involved undergraduate or postgraduate nursing students and evaluated AI, VR, HFS, or gamification in educational settings. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT 2018).
Forty studies met the inclusion criteria. HFS and VR were most frequently associated with improvements in knowledge, clinical judgment, and procedural skills. Gamification was associated with greater engagement, motivation, and knowledge retention. Evidence on AI was limited and preliminary, with a small number of studies suggesting possible benefits for critical thinking and problem-solving. Common barriers included technical problems, resource constraints, and inadequate faculty preparedness.
TEL methods appear to improve student learning and provide safe environments for practice. Successful integration of TEL into nursing education requires institutional support, evidence-based teaching strategies, and continuous faculty development. TEL should complement rather than replace traditional educational practices. Future research should examine the long-term impact of TEL on learning outcomes, its cost-effectiveness, and its implementation in resource-constrained settings.
Maha Besbes, Anaam Soloh, Mohammed Mustafa et al.· BMC Medical Education· 0 citations
BACKGROUND
Immersive virtual reality (IVR) is increasingly used in nursing education to enhance experiential learning and address limitations in clinical training. However, evidence regarding its effectiveness on higher-order cognitive skills remains fragmented.
OBJECTIVES
To synthesise and critically appraise existing evidence on the effectiveness of immersive virtual technologies, including Cave Automatic Virtual Environment (CAVE) systems, in improving critical thinking, decision-making, and problem-solving among undergraduate nursing students.
METHODS
An umbrella review was conducted following Joanna Briggs Institute methodology and reported according to PRIOR guidelines. Systematic reviews published between 2016 and 2025 were identified through searches of PubMed, Scopus, CINAHL, Cochrane Library, Web of Science, and PsycINFO. Eligible reviews included undergraduate nursing students exposed to immersive technologies (virtual, augmented, mixed, or extended reality). Methodological quality was assessed using AMSTAR 2. Data were synthesised narratively due to heterogeneity.
RESULTS
Five reviews (four systematic reviews and one systematic review with meta-analysis) were included. Evidence was heterogeneous. Improvements in decision-making and problem-solving were consistently reported, particularly in interactive, scenario-based IVR interventions. Effects on critical thinking were mixed, with meta-analytic findings showing no significant advantage over traditional methods. Generally favourable findings were reported for clinical skills and knowledge acquisition. Positive effects were also observed for satisfaction, motivation, and self-efficacy. However, variability in intervention design, outcome measures, and study quality limited comparability.
CONCLUSIONS
The available evidence suggests that IVR may represent a valuable adjunct to traditional nursing education, particularly for supporting decision-making, problem-solving, and clinical skills. Its impact on critical thinking remains inconclusive. Outcomes appear to be influenced by pedagogical design, including structured debriefing and curriculum integration.
Lara Delbene, Talita Sallai, Sara Mezini et al.· Nurse Education Today· 0 citations
The evidence showed that, virtual reality simulations with varying immersive abilities were the most popular innovative educational technology used in undergraduate mental health nursing education and both immersive and non‐immersive VRS were equally effective in improving student learning experiences compared to traditional learning modalities.
Sini Jacob, Sebastian Samuel, Greety Antony et al.· International Journal of Men...· 0 citations
Background: Computer-assisted instruction (CAI) encompasses a broad spectrum of digital technologies designed to facilitate structured, interactive learning across educational and healthcare settings. Its adoption in nursing has accelerated considerably in response to mounting demands for flexible, evidence-based, and competency-driven education.
Purpose: This narrative review examines the conceptual foundations, major typologies, and multidimensional applications of CAI in nursing education, clinical practice, research, community health, and professional advocacy.
Main Findings: CAI modalities including drill and practice, tutorial, simulation, discovery, and problem-solving approaches each confer distinct pedagogical advantages. In nursing education, CAI supports individualised, self-paced, and multimedia-enhanced learning. In clinical environments, it improves documentation accuracy, patient education, continuing professional development, and nurse-led telehealth delivery. In research, it enables systematic literature retrieval, data management, and statistical analysis. In community settings, CAI extends the reach of health promotion and strengthens public health data infrastructure. It also strengthens nursing advocacy by enabling digital reporting and informed clinical decision-making. Limitations including information overload, digital infrastructure deficits, and the inability of CAI to replicate the emotional dimensions of care are identified.
Conclusion: CAI holds substantial transformative potential for nursing across all professional domains. Strategic investment in digital infrastructure, faculty capacity, and context-sensitive instructional design is essential to maximize its benefits.
Dr. Annie Chandra S, Dr. Arul Jothi V· Young Nurses Journal of Rese...· 0 citations
Background: Nursing education faces unprecedented challenges in preparing competent, future-ready practitioners capable of addressing complex healthcare demands. Innovative pedagogical strategies have emerged as critical tools for enhancing clinical competence, critical thinking, and professional readiness.
Objective: To systematically review and synthesize evidence on innovative teaching strategies in nursing education, examining their effectiveness on critical thinking, clinical competence, decision making, and student satisfaction compared to traditional methods.
Methods: A systematic review was conducted following PRISMA 2020 guidelines. Comprehensive searches were performed across PubMed, and Google Scholar databases for studies published between 2019 and 2026. Studies examining simulation-based learning, virtual reality (VR), augmented reality (AR), artificial intelligence (AI), flipped classroom, problem-based learning (PBL), case-based learning (CBL), gamification, e-learning, interprofessional education (IPE), mobile learning, and competency-based education (CBE) were included. Data ex-traction focused on study design, sample characteristics, teaching strategies, outcomes, and student satisfaction. Thematic synthesis was performed to identify patterns and effectiveness across pedagogical approaches.
Results: Thirty studies met inclusion criteria, representing diverse geographical contexts including global and Indian nursing education settings. Simulation-based learning and VR/AR technologies demonstrated significant improvements in clinical competence, self-confidence, and knowledge retention. AI-enhanced pedagogies showed promise in personalized learning and competency scaffolding. Flipped classroom and PBL approaches enhanced critical thinking and student engagement. Student satisfaction was consistently higher with technology-enhanced and active learning strategies compared to traditional lecture-based methods. Indian nursing education reforms, including the National Nursing and Midwifery Commission (NNMC) Act, are driving curriculum modernization and competency-based frameworks.
Conclusion: Innovative teaching strategies significantly enhance nursing education outcomes across multiple domains. Technology-enhanced learning, active pedagogies, and competency-based approaches prepare nurses for contemporary healthcare challenges. Successful implementation requires faculty development, infrastructure investment, and pedagogical integration that balances technological innovation with humanistic care principles.
Dr. Kavichelvi K, D. Jaspher M· Young Nurses Journal of Rese...· 1 citation
: Clinical reasoning is a core competence in nursing education. It helps nursing students collect patient cues, interpret clinical information, make safe decisions, and reflect on nursing actions. In recent years, technology-enhanced learning has been widely used in nursing education, including simulation, virtual simulation, virtual patients, online learning, virtual reality, and artificial intelligence-supported learning. These methods may provide safe, repeatable, and interactive learning contexts for students to practise clinical reasoning before entering real clinical settings. This systematic review aims to summarize current evidence on clinical reasoning in technology-enhanced nursing education. The review focuses on three questions: what technologies have been used, how these technologies support clinical reasoning, and what problems still exist in current research. The reviewed literature shows that simulation-based learning and virtual simulation are the most common approaches. These methods can improve students’ clinical reasoning, knowledge retention, self-efficacy, confidence, and satisfaction. Structured debriefing and reflection are important mechanisms that link technology use with reasoning development. However, current studies still have limitations, such as small samples, short intervention periods, inconsistent outcome measures, and limited long-term follow-up. Future research should use stronger designs, clearer theoretical models, and more direct measures of clinical reasoning.
Nanxiang Zhang· Curriculum and Teaching Meth...· 0 citations