Effect of brief virtual reality training on first-attempt hand-disinfection performance in an OSCE: A randomized controlled trial

Effect of brief virtual reality training on first-attempt hand-disinfection performance in an OSCE: A randomized controlled trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of brief virtual reality training on first-attempt hand-disinfection performance in an OSCE: A randomized controlled trial Benjamin Roszipal, Martin Ernst, Alexander Hoffelner, Matthias Kalmring, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9083764/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 10 You are reading this latest preprint version Abstract Background Reliable hygienic hand-disinfection is essential for infection prevention and control. It remains unclear whether a brief immersive VR training module improves objectively assessed procedural performance compared with conventional instruction. This single-center, parallel-group randomized controlled trial examined first-opportunity hand-disinfection performance in an Objective Structured Clinical Examination (OSCE) after VR training versus a video control. Methods In 2025, first-year nursing students at a single Austrian University [University name withheld for anonymity] were randomized (1:1) to a 20-minute immersive VR module (contamination visualization feedback) or a time- and headset-matched instructional video control (no interactivity). Randomization used block allocation (blocks of six); instructions were standardized via audio playback. Three days later, students completed a routine five-station OSCE. Hygienic hand-disinfection was required at the beginning of each of five OSCE stations and was documented within routine station checklists. Hand-disinfection ratings from the five stations were extracted from routine OSCE checklists and coded (0 = incorrect, 1 = partially correct, 2 = correct). The preregistered primary endpoint was station 1 performance. The primary hypothesis was tested with adjusted proportional-odds regression (age, gender, hygiene course grade), all other analyses were exploratory. Results Of 128 randomized students (VR n = 65; control n = 63), primary outcome data were complete; one covariate value was missing, yielding N = 127 for adjusted models. At station 1, fully correct performance occurred in 52/65 (80.0%) in VR versus 15/63 (23.8%) in control. VR training was associated with markedly better first-opportunity performance (adjusted OR = 11.16, 95% CI [4.95, 25.14], p = 5.9×10⁻⁹), supported by sensitivity analyses (pass/fail adjusted OR = 6.06, 95% CI [1.84, 19.92]; linear b = 0.77). Exploratory analyses suggested higher performance across stations, with group differences varying by station. No harms or adverse events were observed during the trial. Conclusion A brief immersive hand-disinfection training module with contamination visualization improved first-opportunity OSCE hand-disinfection performance compared with a headset-delivered video control. This suggests that brief, feedback-rich immersive training may support immediate procedural readiness under standardized assessment conditions. Trial registration This study was preregistered within a larger longitudinal project and later registered as a stand-alone study in the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/3B6SC). Full Text Additional Declarations No competing interests reported. Supplementary Files AdditionalFile1script.r Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 11 May, 2026 Reviews received at journal 07 May, 2026 Reviews received at journal 18 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers agreed at journal 09 Apr, 2026 Reviewers invited by journal 02 Apr, 2026 Editor assigned by journal 02 Apr, 2026 Editor invited by journal 24 Mar, 2026 Submission checks completed at journal 20 Mar, 2026 First submitted to journal 20 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9083764","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":619184930,"identity":"3183b2bc-a656-476c-ac3d-c8f74c1dff96","order_by":0,"name":"Benjamin 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It remains unclear whether a brief immersive VR training module improves objectively assessed procedural performance compared with conventional instruction. This single-center, parallel-group randomized controlled trial examined first-opportunity hand-disinfection performance in an Objective Structured Clinical Examination (OSCE) after VR training versus a video control.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn 2025, first-year nursing students at a single Austrian University [University name withheld for anonymity] were randomized (1:1) to a 20-minute immersive VR module (contamination visualization feedback) or a time- and headset-matched instructional video control (no interactivity). Randomization used block allocation (blocks of six); instructions were standardized via audio playback. Three days later, students completed a routine five-station OSCE. 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