Embracing opportunities and addressing barriers in learning empathy through VR simulation games: a qualitative descriptive study of nursing students’ experiences

Background: Empathy is crucial in nursing, and recent studies show that virtual reality (VR) can effectively foster empathic concern in educational settings. However, individuals with lower technological orientation often view VR critically, which can hinder their learning experiences. It is essential to understand how to engage all nursing students with virtual reality, and how they experience empathy learning through virtual simulation games as well as to identify the barriers they may encounter in the process. To address this research gap, the aim of this study was to describe nursing students’ experiences of learning empathy in the virtual reality simulation game. Methods: A descriptive qualitative design was employed. A convenience sample of twenty final-year undergraduate nursing students from three universities of applied sciences on the southern, western, and southwestern coasts of Finland was recruited to participate the study. The nursing students participated in virtual reality gaming prior to the interviews. Data were collected through interviews from May 2021 to January 2022. Inductive content analysis was used. Results: Nursing students had opportunities to experience empathy in the virtual reality simulation game through student’s self-reflection and by sensing the virtual patient’s emotions by listening and observing and reasoning. In addition, realism of the virtual patient’s situation was an opportunity to experience empathy. Students also experienced barriers to experience empathy, including focus on technique, limited dialogue with the virtual patient and awareness of the virtual patient’s artificial nature. Conclusion: There are opportunities to experience empathy through virtual simulation games which can enhance empathy learning for nursing students. However, it is crucial to address the barriers that may hinder this process. Focused technique practice is essential before the simulation to facilitate empathetic interactions. Allowing for mutual discussions with the virtual patient should be prioritized in the design of VR simulations to deepen emotional connections. Ensuring that the simulation is perceived as meaningful and realistic can significantly enhance the learning experience. By addressing these elements, educators can create a more impactful learning experience that bridges the gap between technical skills and empathetic patient care.