Johnson, Joshua ORCID: https://orcid.org/0000-0002-0375-0224, Mills, Brenden ORCID: https://orcid.org/0000-0002-7409-7007, Hopper, Luke ORCID: https://orcid.org/0000-0002-5059-7760, Hansen, Sara, Mumford, Kelley ORCID: https://orcid.org/0009-0001-9557-6111, Joseph, Renju ORCID: https://orcid.org/0009-0002-6375-5606, Philip, Susan ORCID: https://orcid.org/0000-0002-2309-5458, Kruger, Gina ORCID: https://orcid.org/0000-0003-2291-7648 and Osman, Abdi D ORCID: https://orcid.org/0000-0002-8104-8019 (2026) The effectiveness of virtual reality aggression and violence de-escalation training for nursing and midwifery students: A quasi-experimental study. Teaching and Learning in Nursing. ISSN 1557-3087

Abstract

Background: Nursing students experience substantial exposure to aggression and violence while attending clinical placement. De-escalation training can effectively prepare students for aggressive encounters, yet is resource-intensive to deliver. Immersive virtual reality (VR) may improve training accessibility for nursing students. Aim: To evaluate the effectiveness of a VR de-escalation training program to improve nursing students’ confidence in managing patient aggression and its perceived usability. Methods: This study utilized a single-group quasi-experimental pre-/post-test design. Undergraduate Australian nursing students (n = 221) completed a VR de-escalation training program, providing pre-/postintervention self-reported confidence in coping with patient aggression, system usability, and motion sickness data. Results: Significant improvements in confidence scores were observed from pre- to postintervention (p < 0.001, d = 0.70). Participants found the program easy-to-use and reported minimal motion sickness. The majority agreed VR is a suitable medium for de-escalation training (93%) and desired further VR de-escalation training (89%). Conclusions: Results show a single 20-minute VR training exposure significantly improved participant confidence in managing aggressive patients. VR may provide an opportunity to increase the accessibility of aggression management training for nursing students.

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