The Effectiveness of Virtual Reality Simulation in Psychiatric Nursing Students and Its Impact on Their Confidence and Anxiety Levels in Clinical Decision-Making: A Randomized Controlled Study

This randomized controlled trial aims to investigate the impact of a schizophrenia-focused virtual reality simulation (VRS) on clinical decision-making skills. This randomized controlled trial aims to investigate the impact of a schizophrenia-focused virtual reality simulation (VRS) on clinical decision-making skills, self-confidence, and anxiety levels of undergraduate psychiatric nursing students. The study will be conducted with second- or third-year nursing students enrolled in a psychiatric nursing course at a university in Türkiye.

Participants will be randomly assigned to either the intervention or control group. The intervention group will participate in VRS, which includes an interactive, gamified simulation scenario based on a patient diagnosed with schizophrenia. This simulation will be conducted twice: once at the beginning of the academic term, prior to clinical placement, and again at mid-term. Each simulation session will be followed by structured debriefing sessions held in small groups (4-5 students), led by a trained facilitator to enhance reflective learning and reinforce clinical reasoning.

The control group will receive standard psychiatric nursing education, consisting of theoretical lectures and routine clinical practice, without exposure to VRS.

Data will be collected using the Clinical Decision-Making Scale, Self-Confidence Scale, Anxiety Scale, Personal Information Form, and the Modified Simulation Effectiveness Tool (SET-M). Measurements will be taken at three time points: (1) before the first VRS session or clinical practice, (2) at mid-term, and (3) at the end of the academic term.

This study is expected to contribute significantly to the understanding of how technology-enhanced, culturally tailored simulation tools affect learning outcomes in psychiatric nursing education. Specifically, it aims to demonstrate that VRS can enhance students' self-confidence in clinical decision-making and reduce their anxiety before and during psychiatric clinical placements. The findings are anticipated to guide the future integration of digital simulation technologies into psychiatric nursing curricula in Türkiye and globally.