Virtual reality in midwifery education: a mixed methods study to assess learning and understanding
Abstract
Background Virtual reality learning environments (VRLEs) are a potentially valuable learning tool that have recently increased in popularity due to widespread availability and decreased cost. VRLEs can provide an immersive learning environment that increases the understanding of three-dimensional relationships between anatomical structures. However, there is a paucity of evidence in the literature supporting its use within Midwifery education.Objectives To explore the effectiveness of a VRLE as an educational tool in midwifery education.Setting A large University in Ireland, with institutional ethical approval.Participants Undergraduate and graduate degree midwifery students.Design A descriptive qualitative and quantitative study was carried out. Data collection was carried out between September 2020 and March 2021.Methods Participants underwent a VRLE lesson based on the topic of fetal lie, position, and presentation in pregnancy. A multiple-choice questionnaire was used to quantitatively evaluate knowledge before and immediately after the intervention, and knowledge retention after one week. Qualitative data was collected using open-ended questions in the questionnaire. The primary outcome was a difference in pre- and post-intervention knowledge scores. Data was analysed using repeated measures one-way ANOVA. Qualitative data was analysed using thematic analysis and simple content analysis. All students participated in the quantitative and qualitative components of the study. Secondary outcomes included participant satisfaction and self-confidence in learning which were analysed using thematic analysis. The side effect profile of the virtual reality device was also explored using open-ended questions in the questionnaire.Results Forty-one midwifery students participated in the study, with a 100 % participation and response rate. Repeated measures one-way ANOVA revealed no statistically significant differences in knowledge scores pre- and post-intervention. Participants rated high satisfaction and self-confidence scores with regard to the VRLE as a learning modality. Side effects most commonly experienced by participants included dizziness (49 %), disorientation (30 %) and symptoms similar to motion sickness (32 %). The following themes were identified: "Learning in 3D", "The Power of Visual Learning", "The value of Educational Technology", "Learning can be fun and enjoyable".Conclusions This study showed that the VRLE had no impact on knowledge gain, though high levels of satisfaction and self-confidence indicate a positive response to the VRLE. VRLEs are a potentially valuable learning tool to help enhance the student learning experience, promoting increased engagement, satisfaction, and self-confidence with the learning material.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Jeffries, P. R. (2005) · PubMed · Cited by 1,207 · see citing works
Virtual reality and the transformation of medical education
Pottle, J. (2019) · Future Healthcare Journal · doi:10.7861/fhj.2019-0036 · Cited by 995 · see citing works
Review on cybersickness in applications and visual displays
Rebenitsch, L., & Owen, C. (2016) · Virtual Reality · doi:10.1007/s10055-016-0285-9 · Cited by 971 · see citing works
Huang, H., Rauch, U., & Liaw, S.-S. (2010) · Computers & Education · doi:10.1016/j.compedu.2010.05.014 · Cited by 951 · see citing works
Kyaw, B. M., Saxena, N., Posadzki, P., Vseteckova, J., Nikolaou, C. K., George, P. P., Divakar, U., Masiello, I., Kononowicz, A. A., Zary, N., et al. (2019) · Journal of Medical Internet Research · doi:10.2196/12959 · Cited by 859 · see citing works
Simulation in Nursing Education: From Conceptualization to Evaluation
Jeffries, P. R. (2007) · Cited by 784 · see citing works
Zhao, J., Xu, X., Jiang, H., & Ding, Y. (2020) · BMC Medical Education · doi:10.1186/s12909-020-1994-z · Cited by 620 · see citing works
Clinical virtual simulation in nursing education: randomized controlled trial
Padilha, J. M., Machado, P. P., Ribeiro, A., Ramos, J., & Costa, P. (2019) · Journal of Medical Internet Research · doi:10.2196/11529 · Cited by 550 · see citing works
Effectiveness of virtual reality in nursing education: meta-analysis
Chen, F.-Q., Leng, Y.-F., Ge, J.-F., Wang, D.-W., Li, C., Chen, B., & Sun, Z.-L. (2020) · Journal of Medical Internet Research · doi:10.2196/18290 · Cited by 535 · see citing works
Nicholson, D., Chalk, C., Funnell, W. R. J., & Daniel, S. J. (2006) · Medical Education · doi:10.1111/j.1365-2929.2006.02611.x · Cited by 474 · see citing works
Medicine Meets Virtual Reality 14
(2005) · Computers & Graphics · doi:10.1016/j.cag.2005.09.016 · Cited by 460 · see citing works
Immersive virtual reality as a teaching tool for neuroanatomy
Stepan, K. O., Zeiger, J., Hanchuk, S., Signore, A. D., Shrivastava, R. K., Govindaraj, S., & Iloreta, A. M. (2017) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21986 · Cited by 407 · see citing works
Developing serious games for cultural heritage: a state-of-the-art review
Anderson, E. F., McLoughlin, L., Liarokapis, F., Peters, C., Petridis, P., & de Freitas, S. (2010) · Virtual Reality · doi:10.1007/s10055-010-0177-3 · Cited by 357 · see citing works
Yammine, K., & Violato, C. (2014) · Anatomical Sciences Education · doi:10.1002/ase.1510 · Cited by 351 · see citing works
A Model for Understanding How Virtual Reality Aids Complex Conceptual Learning
Salzman, M., Dede, C., Loftin, R. B., & Chen, J. (1999) · PRESENCE Virtual and Augmented Reality · doi:10.1162/105474699566242 · Cited by 332 · see citing works
Baniasadi, T., Ayyoubzadeh, S. M., & Mohammadzadeh, N. (2020) · Oman Medical Journal · doi:10.5001/omj.2020.43 · Cited by 329 · see citing works
Maresky, H. S., Oikonomou, A., Ali, I. T., Ditkofsky, N. G., Pakkal, M., & Ballyk, B. A. (2018) · Clinical Anatomy · doi:10.1002/ca.23292 · Cited by 302 · see citing works
Learning in a Virtual World: Experience With Using Second Life for Medical Education
Wiecha, J., Heyden, R. J., Sternthal, E., & Merialdi, M. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1337 · Cited by 288 · see citing works
Health and safety implications of virtual reality: a review of empirical evidence
Sharples, S., & Patel, H. (2002) · Applied Ergonomics · doi:10.1016/s0003-6870(02)00020-0 · Cited by 268 · see citing works
Huang, H., Liaw, S.-S., & Lai, C.-M. (2013) · Interactive Learning Environments · doi:10.1080/10494820.2013.817436 · Cited by 261 · see citing works
Ryan, G. V., Callaghan, S., Rafferty, A., Higgins, M. F., Mangina, E., & McAuliffe, F. (2022) · Journal of Medical Internet Research · doi:10.2196/30082 · Cited by 242 · see citing works
Self-citationThe Transformational Effects of COVID-19 on Medical Education
Lucey, C. R., & Johnston, S. C. (2020) · JAMA · doi:10.1001/jama.2020.14136 · Cited by 240 · see citing works
Heydari, M. R., Taghva, F., Amini, M., & Delavari, S. (2019) · BMC Research Notes · doi:10.1186/s13104-019-4421-y · Cited by 175 · see citing works
Howarth, P. A., & Costello, P. J. (1997) · Displays · doi:10.1016/s0141-9382(97)00011-5 · Cited by 171 · see citing works
3D visualization of tomographic volume data using the generalized voxel model
Höhne, Κ. H., Bomans, M., Pommert, A., et al. (1990) · The Visual Computer · doi:10.1007/bf01902627 · Cited by 169 · see citing works
Ünver, V., Başak, T., Watts, P. I., Gaioso, V. P., Moss, J. A., Taştan, S., İyigün, E., & Tosun, N. (2017) · Contemporary Nurse · doi:10.1080/10376178.2017.1282319 · Cited by 164 · see citing works
Peterson, D. C., & Mlynarczyk, G. S. A. (2016) · Anatomical Sciences Education · doi:10.1002/ase.1612 · Cited by 162 · see citing works
Effectiveness of Immersive Virtual Reality in Nursing Education
Choi, J., Thompson, C. E., Choi, J., Waddill, C. B., & Choi, S. (2021) · Nurse Educator · doi:10.1097/nne.0000000000001117 · Cited by 159 · see citing works
Liaw, S. Y., Chan, S. W., Chen, F.-G., Hooi, S. C., & Siau, C. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3322 · Cited by 147 · see citing works
2016 Future Technologies Conference (FTC)
(2016) · doi:10.1109/ftc38997.2016 · Cited by 137 · see citing works
A Discussion of Virtual Reality As a New Tool for Training Healthcare Professionals
Fertleman, C. R., Aubugeau-Williams, P., Sher, C., Lim, A.-N., Lumley, S., Delacroix, S., & Pan, X. (2018) · Frontiers in Public Health · doi:10.3389/fpubh.2018.00044 · Cited by 132 · see citing works
Liesefeld, H., Fu, X.-L., & Zimmer, H. (2015) · Journal of Experimental Psychology. Learning, Memory and Cognition · doi:10.1037/xlm0000081 · Cited by 112 · see citing works
The effect of a virtual reality learning environment on learners’ spatial ability
Sun, R., Wu, Y. J., & Cai, Q. (2018) · Virtual Reality · doi:10.1007/s10055-018-0355-2 · Cited by 111 · see citing works
The nursing and medical students motivation to attain knowledge
Bengtsson, M., & Ohlsson, B. (2009) · Nurse Education Today · doi:10.1016/j.nedt.2009.07.005 · Cited by 106 · see citing works
The impact of Web3D technologies on medical education and training
John, N. W. (2005) · Computers & Education · doi:10.1016/j.compedu.2005.06.003 · Cited by 106 · see citing works
Kong, X., Nie, L., Zhang, H., et al. (2016) · Journal of surgical education · doi:10.1016/j.jsurg.2015.10.002 · Cited by 104 · see citing works
Virtual reality and live simulation
Ingrassia, P. L., Ragazzoni, L., Carenzo, L., Colombo, D., Gallardo, A. R., & Corte, F. D. (2014) · European Journal of Emergency Medicine · doi:10.1097/mej.0000000000000132 · Cited by 98 · see citing works
Virtual reality applications in mental health: Challenges and perspectives
Srivastava, K., Das, R., & Chaudhury, S. (2014) · Industrial Psychiatry Journal · doi:10.4103/0972-6748.151666 · Cited by 95 · see citing works
An Experimental Study On Usefulness Of Virtual Reality 360° In Undergraduate Medical Education
Sultan, L., Abuznadah, W., Al-Jifree, H., Khan, M. A., Alsaywid, B. S., & Ashour, F. (2019) · Advances in Medical Education and Practice · doi:10.2147/amep.s219344 · Cited by 94 · see citing works
Evaluation of neuroanatomical training using a 3D visual reality model.
Brewer‐Deluce, D., Wilson, T. D., Eagleson, R. A., & de Ribaupierre, S. (2012) · PubMed · Cited by 75 · see citing works
Hardie, P. R., Darley, A., Carroll, L., Redmond, C., Campbell, A. G., & Jarvis, S. (2020) · BMC Nursing · doi:10.1186/s12912-020-00471-5 · Cited by 74 · see citing works
Self-citationBerg, H., & Steinsbekk, A. (2020) · BMC Medical Education · doi:10.1186/s12909-020-02030-7 · Cited by 72 · see citing works
Marsh, K., Giffin, B. F., & Lowrie, D. J. (2008) · Anatomical Sciences Education · doi:10.1002/ase.56 · Cited by 64 · see citing works
VR4Health: Personalized teaching and learning anatomy using VR
Fairén, M., Moyés, J., & Calderón, E. I. (2020) · Journal of Medical Systems · doi:10.1007/s10916-020-01550-5 · Cited by 58 · see citing works
The future of patient safety: Surgical trainees accept virtual reality as a new training tool
Rosenthal, R., Gantert, W. A., Hamel, C. T., et al. (2008) · Patient Safety in Surgery · doi:10.1186/1754-9493-2-16 · Cited by 35 · see citing works
Virtual Fracture Carving Improves Understanding of a Complex Fracture
Pahuta, M. A., Schemitsch, E. H., Backstein, D. J., Papp, S., & Gofton, W. T. (2012) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.k.00996 · Cited by 35 · see citing works
A Randomised Control Trial and Comparative Analysis of Multi-Dimensional Learning Tools in Anatomy
Wang, C., Daniel, B. K., Asıl, M., Khwaounjoo, P., & Çakmak, Y. Ö. (2020) · Scientific Reports · doi:10.1038/s41598-020-62855-6 · Cited by 34 · see citing works
Second Life®: A New Strategy in Educating Nursing Students
Aebersold, M., Tschannen, D. J., Stephens, M. R., et al. (2011) · Clinical Simulation in Nursing · doi:10.1016/j.ecns.2011.05.002 · Cited by 33 · see citing works
Vallance, A. K., Hemani, A., Fernandez, V., Livingstone, D., McCusker, K., & Toro-Troconis, M. (2014) · Psychiatric Bulletin · doi:10.1192/pb.bp.113.044396 · Cited by 28 · see citing works
Advincula, W. D., Choco, J. A. G., Magpantay, K. A. G., et al. (2019) · AIP conference proceedings · doi:10.1063/1.5096690 · Cited by 11 · see citing works
On the Development of Virtual Reality Scenarios for Computer-Assisted Biomedical Applications
Govea-Valladares, E. H., Medellín-Castillo, H. I., Ballesteros, J. L., & Rodríguez-Florido, M. A. (2018) · Journal of Healthcare Engineering · doi:10.1155/2018/1930357 · Cited by 8 · see citing works
Innovating medical education—Bringing the clinical environment online
Hicks, E. B., Kirwan, J., O'Brien, C. T., et al. (2021) · Medical Education · doi:10.1111/medu.14652 · Cited by 4 · see citing works
Werner, H., Castro, P. T., Matos, A. P., et al. (2019) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.20483 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
AI-Powered Simulation for Nursing Education: Mixed Methods Systematic Review
Jiang, H., Wang, Z., Shen, W., Meng, M., Yang, D., Li, X., & Hao, Y. (2026) · Journal of Medical Internet Research · doi:10.2196/95167 · Cited by 4 · see citing works
“Recent years have witnessed a growing integration of AI technologies into nursing education simulations, including AI-powered virtual patients, intelligent tutoring systems, conversational agents, augmented reality applications, and predictive learning analytics platforms [19,20].”
- Authors
- Ryan, G., Callaghan, S., Rafferty, A., Murphy, J., Higgins, M., Barry, T., Mangina, E., Carroll, L., & McAuliffe, F.
- Affiliations
- University College Dublin (IE)
- National Maternity Hospital (IE)
- Corresponding author
- McAuliffe, Fionnuala
- ORCID
- Venue
- Nurse Education Today
- Publisher
- Elsevier BV
- Published
- 2022-12
- Volume
- 119
- Pages
- 105573
- ISSN
- 0260-6917 (ISSN-L)
- OpenAlex
- W4296677322
- Cited by
- 37
- References
- 54
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 11 · 2023: 4
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nurse Education Today (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
- Keywords
- reality, midwifery education, 3D anatomical visualization, knowledge retention, student satisfaction, self-confidence, immersive learning, educational technology, student engagement, midwifery students, student perceptions
- MeSH terms
- Virtual Reality, Clinical Competence, Education, Nursing, Baccalaureate, Female, Humans, Learning, Midwifery, Pregnancy, Students, Nursing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review