The Virtual Frontier: A Systematic Review of the New Nursing Role in Integrating, Dispensing, and Ethical Stewardship of Virtual Reality for Therapeutic Use with Patients and Clinical Education
Abstract
Background: Virtual Reality (VR) has become a valuable therapeutic and educational tool in healthcare, leveraging its capacity to create immersion and controlled environments for pain management, rehabilitation, mental therapy, and clinical training. In spite of this promise, the specific contribution of the nursing profession to the application and management of VR has been underemphasized in the literature.
Aim: The aim of this review is to synthesize literature from 2015 to 2024 to explore the nursing function within the VR environment in all its dimensions, with a particular focus on therapeutic applications, practical responsibilities in VR organization, and nursing application of VR in learning.
Methods: A systematic review of the primary academic databases (PubMed, CINAHL, PsycINFO) for English-language literature published between 2015 and 2024 was employed to undertake a narrative review. Search keywords were virtual reality, nursing role, patient therapy, and nursing education.
Results: The review supports the efficacy of VR in several clinical disciplines and presents the emerging role of the nurse as clinical advocate, VR administrator, safety officer, and outcomes evaluator. The review also identifies VR as a groundbreaking tool in nursing education and observes such prevailing challenges as practical hindrances, patient safety concerns like cybersickness, and ethical issues related to data confidentiality and fair access.
Conclusion: Nurses are central to the safe, effective, and ethical application of VR in healthcare. Reaching its full potential relies on defining the nursing role with targeted education, development of clear clinical procedures, and policy that facilitates its sustained and equitable integration into routine practice.
Full text article
References
Adams, D., Bah, A., Barwulor, C., Musaby, N., Pitkin, K., & Redmiles, E. M. (2018). Ethics emerging: the story of privacy and security perceptions in virtual reality. In Fourteenth symposium on usable privacy and security (SOUPS 2018) (pp. 427-442). https://www.usenix.org/conference/soups2018/presentation/adams
Ang, S., & Quarles, J. (2023). Reduction of cybersickness in head mounted displays use: A systematic review and taxonomy of current strategies. Frontiers in Virtual reality, 4, 1027552. https://doi.org/10.3389/frvir.2023.1027552
Bargeri, S., Scalea, S., Agosta, F., Banfi, G., Corbetta, D., Filippi, M., ... & Gianola, S. (2023). Effectiveness and safety of virtual reality rehabilitation after stroke: an overview of systematic reviews. EClinicalMedicine, 64. https://doi.org/10.1016/j.eclinm.2023.102220
Bauce, K., Kaylor, M. B., Staysniak, G., & Etcher, L. (2023). Use of theory to guide integration of virtual reality technology in nursing education: A scoping study. Journal of Professional Nursing, 44, 1-7. https://doi.org/10.1016/j.profnurs.2022.10.003
Cant, R., Ryan, C., & Kelly, M. A. (2023). Use and effectiveness of virtual simulations in nursing student education: An umbrella review. CIN: Computers, Informatics, Nursing, 41(1), 31-38. DOI: 10.1097/CIN.0000000000000932
Chae, D., Yoo, J. Y., Kim, J., & Ryu, J. (2021). Effectiveness of virtual simulation to enhance cultural competence in pre-licensure and licensed health professionals: A systematic review. Clinical Simulation in Nursing, 56, 137-154. https://doi.org/10.1016/j.ecns.2021.04.013
Chang, Z. Y., Kang, G. C. Y., Koh, E. Y. L., Fong, R. J. K., Tang, J., Goh, C. K., & Tan, N. C. (2022). Immersive virtual reality in alleviating pain and anxiety in children during immunization in primary care: a pilot randomized controlled trial. Frontiers in pediatrics, 10, 847257. https://doi.org/10.3389/fped.2022.847257
Connor, K. I., Siebens, H. C., Mittman, B. S., Ganz, D. A., Barry, F., Ernst, E. J., ... & Vickrey, B. G. (2020). Quality and extent of implementation of a nurse-led care management intervention: care coordination for health promotion and activities in Parkinson’s disease (CHAPS). BMC health services research, 20(1), 732. https://doi.org/10.1186/s12913-020-05594-8
Demeco, A., Zola, L., Frizziero, A., Martini, C., Palumbo, A., Foresti, R., ... & Costantino, C. (2023). Immersive virtual reality in post-stroke rehabilitation: a systematic review. Sensors, 23(3), 1712. https://doi.org/10.3390/s23031712
Deng, Z., Xiang, N., & Pan, J. (2023). State of the art in immersive interactive technologies for surgery simulation: a review and prospective. Bioengineering, 10(12), 1346. https://doi.org/10.3390/bioengineering10121346
Dolan, H., Amidon, B. J., & Gephart, S. M. (2021). Evidentiary and theoretical foundations for virtual simulation in nursing education. Journal of Professional Nursing, 37(5), 810-815. https://doi.org/10.1016/j.profnurs.2021.06.001
Efendi, D., Apriliyasari, R. W., Prihartami Massie, J. G. E., Wong, C. L., Natalia, R., Utomo, B., ... & Chen, K. H. (2023). The effect of virtual reality on cognitive, affective, and psychomotor outcomes in nursing staffs: systematic review and meta-analysis. BMC nursing, 22(1), 170. https://doi.org/10.1186/s12912-023-01312-x
Esposito, C., Autorino, G., Iervolino, A., Vozzella, E. A., Cerulo, M., Esposito, G., ... & Escolino, M. (2022). Efficacy of a virtual reality program in pediatric surgery to reduce anxiety and distress symptoms in the preoperative phase: a prospective randomized clinical trial. Journal of Laparoendoscopic & Advanced Surgical Techniques, 32(2), 197-203. https://doi.org/10.1089/lap.2021.0566
Felemban, O. M., Alshamrani, R. M., Aljeddawi, D. H., & Bagher, S. M. (2021). Effect of virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric patients: a randomized clinical trial. BMC Oral Health, 21(1), 321. https://doi.org/10.1186/s12903-021-01678-x
Ferguson, C., Davidson, P. M., Scott, P. J., Jackson, D., & Hickman, L. D. (2015). Augmented reality, virtual reality and gaming: an integral part of nursing. Contemporary nurse, 51(1), 1-4. https://doi.org/10.1080/10376178.2015.1130360
Foronda, C. L., Fernandez-Burgos, M., Nadeau, C., Kelley, C. N., & Henry, M. N. (2020). Virtual simulation in nursing education: a systematic review spanning 1996 to 2018. Simulation in Healthcare, 15(1), 46-54. DOI: 10.1097/SIH.0000000000000411
Gutiérrez-Puertas, V., Gutiérrez-Puertas, L., Aguilera-Manrique, G., Rodríguez-García, M. C., & Márquez-Hernández, V. V. (2021). Nursing students’ perceptions of smartphone use in the clinical care and safety of hospitalised patients. International Journal of Environmental Research and Public Health, 18(3), 1307. https://doi.org/10.3390/ijerph18031307
Hackenberger, A. (2023). Intensive care unit diaries: a nurse-led program. Critical care nurse, 43(1), 20-30. https://doi.org/10.4037/ccn2023573
Indovina, P., Barone, D., Gallo, L., Chirico, A., De Pietro, G., & Giordano, A. (2018). Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: a comprehensive literature review. The Clinical journal of pain, 34(9), 858-877. DOI: 10.1097/AJP.0000000000000599
Kim, Y., Kim, H., & Kim, Y. O. (2017). Virtual reality and augmented reality in plastic surgery: a review. Archives of plastic surgery, 44(03), 179-187. https://doi.org/10.5999/aps.2017.44.3.179
Lan, X., Tan, Z., Zhou, T., Huang, Z., Huang, Z., Wang, C., ... & Huang, Y. (2023). Use of virtual reality in burn rehabilitation: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 104(3), 502-513. https://doi.org/10.1016/j.apmr.2022.08.005
Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2018). Virtual reality for stroke rehabilitation. Stroke, 49(4), e160-e161. https://doi.org/10.1161/STROKEAHA.117.020275
Lee, S., Kim, Y., & Lee, B. H. (2016). Effect of virtual reality‐based bilateral upper extremity training on upper extremity function after stroke: a randomized controlled clinical trial. Occupational therapy international, 23(4), 357-368. https://doi.org/10.1002/oti.1437
Li, X., Luh, D. B., Xu, R. H., & An, Y. (2023). Considering the consequences of cybersickness in immersive virtual reality rehabilitation: a systematic review and meta-analysis. Applied Sciences, 13(8), 5159. https://doi.org/10.3390/app13085159
Litwin, S. P., Nguyen, C., Hundert, A., Stuart, S., Liu, D., Maguire, B., ... & Stinson, J. (2021). Virtual reality to reduce procedural pain during IV insertion in the pediatric emergency department: a pilot randomized controlled trial. The Clinical journal of pain, 37(2), 94-101. DOI: 10.1097/AJP.0000000000000894
Moyer, J. E. (2023). Virtual reality simulation applications in pre-licensure psychiatric nursing curricula: An integrative review. Issues in Mental Health Nursing, 44(10), 984-1001. https://doi.org/10.1080/01612840.2023.2243330
Nault, K. A., & Thau, S. (2022). Professions, honesty, and income. Current Opinion in Psychology, 47, 101403. https://doi.org/10.1016/j.copsyc.2022.101403
Navarro-Haro, M. V., López-del-Hoyo, Y., Campos, D., Linehan, M. M., Hoffman, H. G., García-Palacios, A., ... & García-Campayo, J. (2017). Meditation experts try Virtual Reality Mindfulness: A pilot study evaluation of the feasibility and acceptability of Virtual Reality to facilitate mindfulness practice in people attending a Mindfulness conference. PloS one, 12(11), e0187777. https://doi.org/10.1371/journal.pone.0187777
Riches, S., Pisani, S., Bird, L., Rus-Calafell, M., Garety, P., & Valmaggia, L. (2021). Virtual reality-based assessment and treatment of social functioning impairments in psychosis: a systematic review. International Review of Psychiatry, 33(3), 337-362. https://doi.org/10.1080/09540261.2021.1918648
Saab, M. M., Landers, M., Murphy, D., O’Mahony, B., Cooke, E., O’Driscoll, M., & Hegarty, J. (2022). Nursing students’ views of using virtual reality in healthcare: A qualitative study. Journal of Clinical Nursing, 31(9-10), 1228-1242. https://doi.org/10.1111/jocn.15978
Saposnik, G. (2016). Virtual reality in stroke rehabilitation. In Ischemic stroke therapeutics: A comprehensive guide (pp. 225-233). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-17750-2_22
Schroeder, A. H., Bogie, B. J., Rahman, T. T., Therond, A., Matheson, H., & Guimond, S. (2022). Feasibility and efficacy of virtual reality interventions to improve psychosocial functioning in psychosis: systematic review. JMIR Mental Health, 9(2), e28502. https://doi.org/10.2196/28502
Shevchuk, O. M. (2023). Administrative and legal means of protecting citizens of Ukraine in public administration. Publishing House “Baltija Publishing”. https://doi.org/10.20956/halrev.v9i2.4396
Shevchuk, O., Bululukov, O., Lysodyed, O., Mamonova, V., & Matat, Y. (2021). Нuman right to virtual reality in the healthcare: legal issues and enforcement problems. Juridical Tribune/Tribuna Juridica, 11.
Shin, J. H., Kim, M. Y., Lee, J. Y., Jeon, Y. J., Kim, S., Lee, S., ... & Choi, Y. (2016). Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: a single-blinded, randomized controlled trial. Journal of neuroengineering and rehabilitation, 13(1), 17. https://doi.org/10.1186/s12984-016-0125-x
Shorey, S., & Ng, E. D. (2021). The use of virtual reality simulation among nursing students and registered nurses: A systematic review. Nurse education today, 98, 104662. https://doi.org/10.1016/j.nedt.2020.104662
Sigmon, C. A. N., Park, S. Y., Bam, D., Rimel, S. E., & Boeldt, D. L. (2023). Feasibility and acceptability of virtual reality mindfulness in residents, fellows, and students at a university medical campus. Mayo Clinic Proceedings: Digital Health, 1(4), 467-475. https://doi.org/10.1016/j.mcpdig.2023.07.006
Smith, K. L., Wang, Y., & Colloca, L. (2022). Impact of virtual reality technology on pain and anxiety in pediatric burn patients: a systematic review and meta-analysis. Frontiers in virtual reality, 2, 751735. https://doi.org/10.3389/frvir.2021.751735
Son, H., Ross, A., Mendoza-Tirado, E., & Lee, L. J. (2022). Virtual reality in clinical practice and research: viewpoint on novel applications for nursing. JMIR nursing, 5(1), e34036. https://doi.org/10.2196/34036
Yamato, T. P., Pompeu, J. E., Pompeu, S. M., & Hassett, L. (2016). Virtual reality for stroke rehabilitation. Physical therapy, 96(10), 1508-1513. https://doi.org/10.2522/ptj.20150539
Authors
Copyright (c) 2024 Khalid Abdullah Mudaysh Bajawi, Abdullah Mussa Ahmad Sairafi, Abdulrahman Abdullah Najdi, Aqeel Mohammed Ahmed Majmi, Yahya Atiah Hassan Faqihi, Hawraa Abdulhadi Haashim Alsadah, Nouf Nasser Abdulaziz Almulhim, Zainab Abdullah Alburayh, Fatimah Yousef Abdullah Alobud, Sawsan Hussain Mohammed Alawad, Rawan Fahad Abdultif Alzuwayyid, Rawan Abdulrahman Al Marzooq, Asala Hamdan Alruwaili, Fatimah Yassen Abdullah Alalawi

This work is licensed under a Creative Commons Attribution 4.0 International License.
