A randomized controlled trial of virtual reality-based relaxation to reduce pre-exam stress among nursing students.

Background: Test-related stress and anxiety are common among nursing students and may negatively affect academic performance and well-being. Virtual reality (VR)-based relaxation interventions have emerged as a potential strategy to reduce stress; however, evidence regarding their feasibility and acceptability in pre-examination settings remains limited. This study aimed to examine the effects of a brief VR relaxation intervention on perceived stress and test anxiety among nursing students, and to evaluate the intervention's acceptability and feasibility. Methods: This randomized controlled trial (RCT) evaluated the impact of a 10-minute, self-selected immersive VR relaxation session on nursing students' perceived stress and test anxiety prior to a final practical exam. Participants (N = 52) were randomized into a VR intervention group or a control group. The intervention group chose from various naturalistic VR environments (e.g., beach, forest). Results: The sample (n = 52) was 55.8% female and 44.2% male, with the majority aged 20-21 years (63.5%). Most participants were in their third academic year (57.7%). The mean cumulative GPA was 3.60 ± 0.66. There were no statistically significant differences between the intervention and control groups in any baseline characteristics (all Conclusion: A brief, 10-minute immersive VR session shows promise as a supportive intervention for managing pre-exam stress and anxiety in nursing students. The findings suggest that integrating VR technology into nursing curricula offers a scalable solution to improve student well-being and cognitive readiness during high-pressure academic periods. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT07574203, identifier NCT07574203.