The Effects of Two-Tier Test-Based Virtual Reality Education on Anxiety, Knowledge, Self-Care Ability, and Cognitive Load in Patients Undergoing Urolithiasis Surgery

Preoperative anxiety is a common concern among patients undergoing urolithiasis surgery and may adversely affect perioperative experiences, treatment adherence, and postoperative recovery. Conventional preoperative education is often limited by time constraints, variability in information delivery, and insufficient patient engagement.

Virtual reality (VR)-based education has emerged as an innovative educational approach that provides immersive and interactive learning experiences. Previous studies have suggested that VR may improve patient understanding of surgical procedures and reduce anxiety by familiarizing patients with the perioperative environment. However, most existing VR education programs provide information passively and may not adequately identify or correct patient misconceptions.

The present study introduces a two-tier virtual reality educational approach that integrates immersive VR scenarios with structured knowledge assessment and feedback mechanisms. By encouraging participants to actively process information and receive immediate clarification of misunderstandings, the intervention is expected to enhance learning effectiveness and support patient self-management.

This randomized controlled trial aims to examine whether a two-tier VR educational strategy can provide additional benefits beyond standard VR education and routine preoperative instruction for patients undergoing urolithiasis surgery. Findings from this study may contribute to the development of more effective patient-centered educational interventions and provide evidence for the integration of advanced VR technologies into perioperative nursing practice.