Feasibility and Safety of Virtual Reality-Based Online Group Discussions Among Nursing Students: A Cross-Sectional Study.

Objective Virtual reality (VR) has emerged as a potential tool for enhancing learning experiences in various fields, including nursing education. However, its feasibility, safety, and impact on online group discussions remain underexplored. This study aimed to assess the feasibility and safety of VR conferencing in basic education courses for nursing students. Methods This cross-sectional study was conducted with third-year nursing students at Mie University, Tsu, Japan. Participants were assigned non-randomly to either a VR discussion group using MetaQuest 3 and Horizon Workrooms or a video discussion group using Zoom meetings. The groups discussed challenges in the daily lives of patients with chronic shoulder pain and completed tasks, such as listing and ranking challenges. After the discussions, data on discussion drop rates, levels of understanding, teamwork, psychological safety, cybersickness, cognitive load, and impressions of VR and avatar usage were collected. All variables are summarized by the group as means and standard deviations, medians and interquartile ranges, or frequencies and percentages, as appropriate. Results A total of 36 nursing students participated in this study (VR group: n=17; video group: n=19). All participants completed the discussions without dropping out or experiencing cybersickness. The average discussion time was comparable between the groups (approximately 10 minutes). Both groups demonstrated an equivalent understanding of the topic. Both discussion methods had positive effects on teamwork and psychological safety. Cognitive load differences were mixed, with VR reducing some elements of task-related stress (e.g., understanding the overall discussion) but showing higher demands in others (e.g., the design for learning tasks). Participants in the VR group reported a high intention to continue using VR and noted that avatar customization (e.g., clothing and hairstyles) influenced the discussions. Conclusions Both VR and video groups engaged in discussions of similar quality and completed the discussion. As none of the participants had cybersickness or dropped out of the discussions, it was thought that the VR discussions were feasible. Carefully selecting discussion themes, evaluation items, and avatar conditions, as well as verifying the effectiveness of online discussion methods, are necessary.