Feasibility and acceptability of immersive virtual reality for end-of-life care education among nurses in high-context cultures

Aim: to explore the feasibility and acceptability of implementing an immersive virtual reality (IVR) end-of-life care training program among nursing staff in a high-context culture. Background: End-of-life nursing education is limited in high-context cultures where discussing death and dying is emotionally challenging. IVR offers an innovative possibility to enhance nurses’ knowledge and empathy and guide patients’ medical decision-making. However, the feasibility and acceptability of this approach in end-of-life care training for nursing staff remain underexplored. Design: A mixed-methods pre- and post-intervention design supplemented with free-text qualitative feedback. Methods: Nursing staff with at least 3 months of clinical experience participated in a IVR-based simulation. Pre- and post-intervention knowledge, learning experience, satisfaction and qualitative responses were collected. Data were analysed using descriptive statistics, paired t-tests and content analysis of open-ended responses. Results: Fifty nurses were recruited (mostly 21–29 years old females with a college degree). Post-intervention knowledge score improved significantly (pre: M 9.18 SD 0.66; post: M 9.58 SD 0.58, Z = -3.780, p < .001). Overall, participants reported high satisfaction (mean: 27.26/30) with positive feedback on the usefulness of VR (M = 87.50/100), the appropriateness of the content in the module (M = 28.32/30) and minimal physical discomfort (M = 2.44/8). IVR was rated more favourably than traditional training (M = 90.60/100), but was viewed as a complementary tool. Conclusion: IVR-based end-of-life care training is feasible and well-received by nursing staff in high-context cultures, enhancing knowledge and motivation. While promising, IVR should be integrated as a supplementary strategy alongside conventional training to preserve contextual depth in palliative care education.