Participating experience of virtual reality teaching among nursing Students：a meta synthesis of qualitative studies

Participating experience of virtual reality teaching among nursing Students：a meta synthesis of qualitative studies | 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 Participating experience of virtual reality teaching among nursing Students：a meta synthesis of qualitative studies Xing Gao, Yanxue Zheng, XiaoQin Li, WenFeng Fu, Fang Han This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4023157/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To systematically evaluate research on nursing students' experience of participating in teaching virtual reality technology. Methods A computerized search of PubMed, Web of science, Wiley Online Library, China Knowledge Network, Wanfang Database, and China Biomedical Literature Service System was conducted to search for qualitative studies on nursing students' experiences of participating in teaching with virtual reality technology, with a time frame from 2013 to 2023. The quality of the literature was evaluated using the quality evaluation criteria of Australian JBI evidence-based health care centers，and the results were summarized and integrated using the aggregative integration method. Results A total of 9 studies were included, ultimately distilling 37 findings from the original studies, which were summarized to form 7 new categories, yielding 3 integrated findings: strengths and needs of virtual reality teaching and learning experiences; weaknesses and challenges of virtual reality teaching and learning experiences; and future applications and possibilities of virtual reality teaching and learning. Conclusion By combining the advantages of virtual reality technology with the occurrence of nursing teaching, nursing students can experience immersive experiential learning at any time and any place without time and space constraints, and the overall cognitive pleasure of nursing students to this virtual teaching system is good. However, it is necessary to further enrich the details of teaching content design and optimize the technical experience of virtual reality. Nursing education Nursing students Virtual reality Experience Meta-integration Figures Figure 1 Figure 2 1 Introduction Virtual Reality (VR) technology, refers to the use of computer technology, constitutes a virtual, realistic world, the user can through certain input and output devices, participate in the virtual world, the formation of interactions, the expression of their real actions, behaviors, etc. for the virtual world of the control of behavior and other behaviors [1] . Experiencers through the user terminal such as VR helmet, all-in-one machine, etc. to watch the image of the virtual world generated by the computer simulation, listen to the sound, feel the action, etc., in the visual auditory, tactile and other multi-sensory immersive experience, and interact with the virtual reality system, and in the mutual reaction and feedback to achieve the feeling of immersive [2] . VR technology can visualize abstract knowledge and deepen the understanding of training objects [3] . The perceptual, interactive and conceptual features of virtual reality technology help students to understand and master knowledge at a deeper level and faster, make up for the problem of insufficient traditional medical teaching resources, and enhance the teaching effect [4] . At present, virtual reality technology is mainly applied to anatomy, surgical skills and surgery in medical education at home and abroad [5] . Tan Huan et al. applied virtual simulation technology in the classroom of medical imaging examination technology, which enhanced the enthusiasm of students to participate in experimental teaching and improved the effect of experimental teaching [6] . Lv Yunli et al. used virtual teaching technology in the operation technology training of gastrointestinal surgical nursing, which effectively enhanced the enthusiasm of nursing students to learn, and improved the theoretical knowledge and teaching satisfaction [7] .Marie et al. [8] developed a virtual simulator that can train device nurses to prepare preoperative devices for more than 100 surgeries, and it is verified that the system can be widely used in the training of primary or vocational device nurses, and the virtual system allows instrumentation nurses to acquire relevant skills in a safe environment. Nursing is a specialty that serves patients and requires a lot of operational skills in clinical work. Traditional plane teaching materials lack of interactive and three-dimensional characteristics, it is difficult to give the training object substantive and efficient guidance, and VR technology can make the skills training process with better authenticity and feedback, increase the effect of skills training, but also can effectively reduce the risk of clinical real operation to the patient.VR learning brings the experience of the traditional anatomical atlas is more focused, enjoyable, and effective than traditional, and improves the experience of the person's learning motivation ask [9,10] . Virtual reality technology has been initially explored in several clinical nursing fields, and for nursing students, virtual reality technology is currently used for nursing operation skills learning and nursing competence development in complex scenarios [11] . The technology is now more widely used in nursing education in developed countries [12] . However, at present, domestic and international studies mostly use quantitative methods to assess students' learning outcomes, and there are fewer studies on students' subjective perceptual experience in the process of using VR for learning, which can not yet comprehensively reflect the quality of virtual reality technology teaching [13] . In recent years, relevant researchers have gradually begun to pay attention to students' real experiences, and have conducted relevant qualitative studies to explore students' experiential feedback [14-15] . There is no relevant integrated study on the authentic experience and evaluation of nursing students' use of virtual reality technology in the teaching and learning process. Therefore, this study organizes the authentic experience and evaluation of nursing students' use of virtual reality technology in the teaching and learning process through the method of Meta integration to provide a reference for promoting the application of virtual reality technology in nursing teaching and improving nursing teaching. 2 Information and methods 2.1 Search strategy Computerized systematic search PubMed, Web of science, Wiley Online Library, China Knowledge Network, Wanfang Database, China Biomedical Literature Service System . To search for qualitative studies on virtual reality experiences of nursing students with a search timeframe of 2013 to 2023. The search strategy of subject and free word was used. The Chinese search terms were "students/nurses/nursing" "virtual/virtual reality/virtual simulation/virtual environment/ vr virtual reality/virtual reality technology" "qualitative research/qualitative research/rooted theory/phenomenology/ethnography/narrative". Ethnography/Narrative " etc. English search terms are virtual realit*/patient simulat*/virtual patient/virtual simulation/educational virtual/instructional virtual, qualitative research/ experience*/attitude*/feel*/response*/interview/phenomenology, nurs*/education of nursing/nursing students. The specific search strategy is based on PubMed as an example, see Figure 1. Fig. 1 Literature search strategy diagram 2.2 Literature inclusion and exclusion criteria Inclusion criteria: ① research object P (Population) for nursing students; ② phenomena of interest I (Interest of phenomena) for undergraduate nursing students' cognition, attitudes and experience of virtual reality teaching and learning, etc.; ③ scenarios Co (Context) for participation in virtual reality technology teaching on or off campus; ④ research type S ( Study design) is qualitative research, including phenomenology, rooted theory, descriptive research, case study, action research. Exclusion criteria: ① Non-Chinese and English literature; ② Literature that cannot be accessed in full text; ③ Repeatedly published literature; ④ Non-qualitative research literature. 2.3 Literature Screening and Data Extraction Literature was independently searched and screened by 2 researchers trained in evidence-based nursing methodology and qualitative research, and information was extracted and cross-checked, with disagreement encountered through discussion or consultation with a third researcher to assist in judgment. The researchers all had experience in the use of virtual simulation platforms and research on virtual reality related topics. Extracts included author, country, publication date, research methodology, object of study, phenomenon of interest, and main findings. 2.4 Evaluation of the methodological quality of the literature Quality evaluation was conducted independently by 2 investigators using the JBI Evidence-Based Health Care Center Quality Evaluation Criteria for Qualitative Research [16] , and a third researcher was invited to co-discuss the decision of inclusion for literature where there was disagreement. The evaluation consisted of 10 entries, each of which was "yes," "no," and "unclear." All of them were graded as A, some of them were graded as B, and all of them were graded as C. Literature of grade A and B quality was included in this study. 2.5 Meta integration methodology Pooled Meta-integration methods were used to integrate the results, and after fully grasping the research methodology of qualitative research, the results of similar studies were recapitulated through repeated readings and analyses, and new categories were formed, The new categories are later summarized as a result of the integration to form a new interpretation. 3 Results 3.1 Literature search results and basic characteristics of the included literature Initial inspection of the literature 2197, after the deletion of duplicates to obtain 1517 pieces of literature; through the reading of the title and the abstract of 25 pieces of literature screening; through the reading of the full text of the final screening of 9 pieces of literature to meet the requirements of the [17-25] , the literature search flow chart is shown in Figure 2, included in the basic characteristics of the literature in Table 1. Table 1 Basic characteristics of the included literature (n=9) Inclusion of literature nations Year of publication sample size Research methodology Phenomena of interest Research Topics Henna Mäkinen Finland 2021 41 Qualitative descriptive study describe nursing students' user experiences' (UX) regarding highly immersive virtual reality (VR) simulation with head mounted display used for learning Three themes: nursing care in the immersive VR simulation, technology in the immersive VR simulation, and learning nursing in the immersive VR simulation. Mohamad M. Saab Ireland 2021 26 Qualitative descriptive study using thematic analysis. Nursing students' perspectives of incorporating virtual reality in nurse education. Three themes: captivating, innovative, and empowering nature of virtual reality; contextual transfer; and challenges and threats to actualization. Mohamad M. Saab Ireland 2021 26 Qualitative descriptive study Nursing students' views of using virtual reality in healthcare Four themes : (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality Ann-Kathrin Lange Germany 2020 12 qualitative cohort study The degree of acceptance of VR applications by nursing students in Germany. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration. Seven themes: Performance expectancy, Effort expectancy, Social influence, Facilitating conditions, Hedonic motivation, Moderation factors, Further application possibilities Jaehee Jeon Korea 2020 14 qualitative study the essential components and improvements needed in an adult nursing VR-based simulation training program for nursing students through focus group interviews (FGIs) Four themes: Limitations of clinical practice, Benefits of simulation training, Need to improve simulation training, Need for VR-based simulation training training, Need to improve simulation training, Need for VR-based simulation training Zhi Hanli China 2022 14 qualitative study To understand the real feelings of undergraduate midwifery students on the application of virtual reality technology in practice teaching, to observe the effect of the application of virtual reality technology in teaching and to provide a basis for the reform of midwifery practice teaching mode. 4 themes: professional awareness, professional skills, professional confidence, and professional advice Muhammad Hibatullah Romli Malaysia 2022 21 qualitative study to explore pertaining issues on full online learning among nursing students and ofer a contingency solution. Three themes: (i) Full online learning has ramifcations on life (it is about life; blurred division on education life and personal life; non-conducive (i) Full online learning has ramifcations on life (it is about life; blurred division on education life and personal life; non-conducive environment for learning; health and well-being; human is an adaptable being while the transition takes time), (ii) Full online learning is a medium of (ii) full online learning is a medium of teaching and learning delivery but with several concerns (the boon and bane of fully online learning; challenges associated with full online learning; coping strategy in handling full online learning; and the need to develop a comprehensive and effective (ii) full online learning is a medium of teaching and learning delivery but with several concerns (the boon and bane of fully online learning; challenges associated with full online learning; challenges associated with full online learning; coping strategy in handling full online learning), and (iii) Foundation in teaching and learning is the key (role of the educator; teaching and learning (iii) Foundation in teaching and learning is the key (role of the educator; teaching and learning approaches; motivation and regulation) Eva Mari Andreasen Norway 2022 9 qualitative study to investigate how second-year undergraduate nursing students evaluated the usability of the Preoperative ISBAR Desktop VR Application. Two themes: (1) more motivational than standard learning activities and (2) technical and comprehension issues. Hyeon-Young Kim Korea 2021 21 phenomenological method. examined the significance, nature, and structure of the virtual experience of perioperative patients as undergone by nursing students during their practical training through VR and blended learning. Seven themes: "placed in a passive position," "facing the limits of communication," "thinking of developing and improving competency as a nurse," "recognizing the importance of interacting" "thinking of developing and improving competency as a nurse," "recognizing the importance of interacting with their patients", "learning vividly through experience", "engaging in a new type of experience". with their patients", "learning vividly through experience", "engaging in a new type of participatory learning," and "designing nursing knowledge." 3.2 Results of the evaluation of the methodological quality of the included literature The methodological quality of the nine included literature was evaluated as grade B in eight cases and grade A in one case. The specific quality evaluation of the included literature is shown in Table 2. Table 2. evaluation of the quality of the included literature (n=9) Inclusion of studies ① ② (iii) ④ ⑤ (vi) (vii) ⑧ ⑨ ⑩ Quality level (grade) Henna Mäkinen Y Y Y Y Y N UN Y Y Y B Mohamad M. Saab Y Y Y Y Y UN N Y Y Y B Mohamad M. Saab Y Y Y Y Y UN N Y Y Y B Ann-Kathrin Lange. Y Y Y Y Y N Y Y Y Y B Jaehee Jeon Y Y Y Y Y Y Y Y Y Y A Zhi Hanli Y Y Y Y Y N UN Y Y Y B Muhammad Hibatullah Romli Y Y Y Y Y N N Y Y Y B Eva Mari Andreasen Y Y Y Y Y N N Y Y Y B Hyeon-Young Kim Y Y Y Y Y UN Y Y Y Y B 3.1 Literature Search Results and Basic Characteristics of the Included Literature Initially, 2197 pieces of literature were identified, which were then reduced to 1517 after removing duplicates. A screening process based on titles and abstracts led to the selection of 25 pieces of literature. Subsequently, 9 final pieces of literature were chosen after a full-text review, meeting the specified criteria [17-25] . The literature search flow chart is depicted in Figure 2, and the basic characteristics of the literature are outlined in Table 1. 3.2 Evaluation Results of the Methodological Quality of the Included Literature The methodological quality of the nine included pieces of literature was assessed as grade B in eight cases and grade A in one case. Detailed evaluations of the quality of the included literature are presented in Table 2. 3.3 Meta-Integration Results Through a thorough review and analysis of the nine selected pieces of literature, the researcher distilled 37 findings from the original studies. These findings were then categorized into seven new categories and further synthesized to derive three integrated findings. The integration process is illustrated in Figure 1. 3.3.1 Integration Finding One: Strengths and Needs of Virtual Reality Teaching Experiences 3.3.1.1 Category 1: Student Immersion Experience The immersion experience for nursing students encompassed a sense of presence in nursing care, including natural nursing care and the visual environment of the VR setting. Factors such as the ability to move within the environment and access to necessary nursing equipment influenced the feeling of natural nursing care. Nursing students expressed positive experiences related to immersive virtual reality simulations of care, technology, and learning [17] . They found virtual reality to be engaging, innovative, and empowering, fostering active participation and knowledge retention [18] . Additionally, students shared positive experiences and knowledge gained from virtual reality simulations, highlighting the effectiveness and novelty of the approach [19] . 3.3.1.2 Category 2: Motivation and Inspiration for Nursing Students Nursing students perceived the use of VR in nursing education as beneficial, enhancing their learning experience and understanding of the content [20] . They found VR applications manageable and engaging, attributing their positive attitudes towards these applications to social influences and the playful nature of VR learning [20] . The use of immersive virtual reality technology in nursing education was seen as a novel and accessible method of skill acquisition, improving students' professional competence and confidence [22] . Communication through virtual phone calls was noted to enhance students' awareness of clear and effective communication [24] . Nursing students' experiences of being in the patient's position were found to provide valuable insights into patient care and empathy, emphasizing the importance of holistic care and effective communication [25] . 3.3.1.3 Category 3: Contribution to Professional Learning Participants reported that virtual reality simulations helped bridge the gap between theoretical knowledge and real-world clinical practice, enhancing their understanding and integration of nursing principles [21] . Virtual reality technology was seen as a valuable tool for simulating uncommon clinical scenarios, providing a safe and effective learning environment for students to refine their skills [22] . Participants emphasized the need for realistic and up-to-date educational resources, such as procedure videos, to enhance their learning experience and align with standard practices [23] . The integration of new teaching methods, including VR and blended learning, was found to enhance academic achievements and promote participatory learning experiences [25] . 3.3.2 Integration Outcome 2: Disadvantages and Challenges of Virtual Reality Teaching Experience 3.3.2.1 Category 1: Difficulties Encountered Despite the advantages of VR technology, participants highlighted challenges such as age limitations, technical difficulties, and side effects like dizziness during VR experiences [23] . Some students found their initial clinical practice challenging, feeling awkward and unprepared in patient interactions [20] . They also expressed dissatisfaction with limited training opportunities and experiences [21] . 3.3.2.2 Category 2: Limitations in Student Learning and Experience Full online learning was noted to have implications on students' personal lives, creating challenges in communication and socialization, especially for new students [23] . Students placed in passive roles as patients felt subjugated and lacked authority in clinical scenarios [25] . Dissatisfaction with outdated teaching materials and the need for more diverse and engaging learning opportunities were also highlighted [22] . 3.3.3 Integration Outcome 3: Future Applications and Possibilities for Virtual Reality Teaching and Learning 3.3.3.1 Category 1: Facilitating Conditions for the Realization of Virtual Reality Participants believed that VR was more suitable for outpatient settings and recommended its use in various educational and community settings [19] . They emphasized the importance of integrating VR into educational curricula to maximize its benefits and ease of use for both students and teachers [20] . Participants expressed the desire for more realistic and diverse simulation training opportunities to enhance their learning experiences [21] . 3.3.3.2 Category 2: Future Possibilities Participants recommended the future use of VR in health promotion, disease prevention, patient education, and empathy training for healthcare professionals [19] . They highlighted the potential of VR in enhancing empathy towards patients and improving understanding of diverse healthcare scenarios [20] . 4 Discussion 4.1 Characterization of the Included Literature One of the nine papers included in this study was from China and was published between 2013 and 2023. All the included literature was of high quality (grade B) and demonstrated good reliability. The studies utilized descriptive qualitative and phenomenological approaches to explore nursing students' experiences with virtual reality technology, enhancing the teaching and learning of nursing practices. 4.2 Advantages of Virtual Reality Teaching Virtual reality offers a range of stimuli that enhance motivation, theoretical knowledge mastery, critical thinking, operational skills, and practical responsiveness among nursing students [ 19 ] . The technology has been shown to improve hands-on skills, learning abilities, and confidence in clinical practice, bridging the gap between theory and practice [22] . 4.3 Disadvantages of Teaching with Virtual Reality While virtual reality technology has transformed medical education, challenges such as simulation limitations, varying effectiveness based on instructors, and potential side effects like VR sickness have been noted [ 21 ] . The cost and development time associated with VR applications, as well as the need for continuous collaboration with nursing faculty and clinical experts, pose additional challenges [22] . 4.4 Needs for Improvement and Future Possibilities The integration of virtual reality technology in nursing education holds significant promise, but further development and optimization are required. Future research should focus on enhancing the realism and diversity of virtual learning experiences, improving interface design, and integrating technology seamlessly into nursing curricula. Collaboration between government, universities, and industry is essential for the advancement of virtual reality in nursing education, ultimately cultivating high-quality nursing professionals. 5 Limitations The present study has several limitations. First, according to the inclusion criteria for literature, only qualitative and mixed-method studies published in indexed journals, written in English or Chinese, were selected. Therefore, gray literature and some papers or dissertations were not searched, which may lead to information bias. Therefore, gray literature and some papers or dissertations were not searched, which may lead to information bias. In addition, due to cultural and policy differences, the attitudes, opinions, and feelings of nursing students are greatly influenced by different regional cultures, which may lead to different outcomes. 6 Conclusion In this study, through the Meta integration of 9 qualitative studies, By combining the advantages of virtual reality technology with the occurrence of nursing teaching, nursing students can experience immersive experiential learning anytime and anywhere without being restricted by time and space, and the overall cognitive pleasure of nursing students towards this virtual teaching system is good. However, it is necessary to further enrich the details of teaching content design and optimize the technical experience of virtual reality. Declarations Ethics approval and consent to participate: Ethical approval was not required for this meta synthesis. Consent for publication: Not applicable Data availability ： No/Not applicable (this manuscript does not report data generation or analysis). Conflict of Interests: None declared. Funding: There is no funding for the study. The corresponding author has full access to all data in the study and is ultimately responsible for the decision to submit for publication. Authors' contributions : All authors conceived and designed the study. ZYX and GX organized and conducted the search and participated in the selection of the relevant articles and performed the quality assessment of the studies. HF ,LXQ and FWF supervised the project and made the changes and corrections suggested by the reviewers. Acknowledgements: Not applicable. Authors' information: Authors and Affiliations First Auther : Xing Gao Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected] co-first author: Yanxue Zheng,Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected] . XiaoQin Li:Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected] . WenFeng Fu:Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected] . Corresponding author:Fang Han,Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected] . References TIAN Jihong,JIANG Dai. Future changes in medical education from the development of virtual reality (VR)[J]. 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Simulator sickness during driving simulation studies. Accident Analysis & Prevention, 42(3), 788-796. https://doi.org/10.1016/j.aap.2009.04.013 Patrão, B., Pedro, S., & Menezes, P. (2020). How to deal with motion sickness in virtual reality. Portuguese Meeting on Computer Graphics and Interaction 2015. https://doi.org/10.2312/pt.20151201 Fernandes, A. S., & Feiner, S. K. (2016). Combating VR sickness through subtle dynamic field-of-view modification. in 2016 IEEE symposium on 3D user interfaces (3DUI) (pp. 201- 210). IEEE. https://doi.org/10.1109/3DUI.2016.7460053 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted 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. 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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-4023157","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":285593118,"identity":"94a5a5f5-bf76-43b9-a226-d24fb4a58011","order_by":0,"name":"Xing Gao","email":"","orcid":"","institution":"Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xing","middleName":"","lastName":"Gao","suffix":""},{"id":285593120,"identity":"eaf22db1-5557-44da-b656-befeca61d6be","order_by":1,"name":"Yanxue Zheng","email":"","orcid":"","institution":"Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yanxue","middleName":"","lastName":"Zheng","suffix":""},{"id":285593121,"identity":"4c5fa345-5654-4652-8781-fb292c9d89e1","order_by":2,"name":"XiaoQin Li","email":"","orcid":"","institution":"Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University","correspondingAuthor":false,"prefix":"","firstName":"XiaoQin","middleName":"","lastName":"Li","suffix":""},{"id":285593124,"identity":"a58b37ad-3f8e-4ce0-86ae-acc8bd66b310","order_by":3,"name":"WenFeng Fu","email":"","orcid":"","institution":"Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University","correspondingAuthor":false,"prefix":"","firstName":"WenFeng","middleName":"","lastName":"Fu","suffix":""},{"id":285593126,"identity":"f5ddb6cd-a8ed-44ad-a402-0a2f9f034595","order_by":4,"name":"Fang Han","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACxmbGBuM/Ff94+NkbiNTC3N7cUMBz5oCMZM8BIrWw9xxv+MDbcsDG4EYCkVp4ZyQ2bpBsuMMjOfPxxhsMNTbRBLVIzkhsNjDc8YyHXzqt2ILhWFpuAyEthjMS2wwSzzDzSM7OMZNgbDhMWIv9jcT2HwfbmHkMbp4hUgtjz8EGw8a2wzwGN3iI1dLe2GDMcCaNR7IH6JcEYvzC2Mz+wJihwsaen/3wxhsfamwIa0EGBhIJpCiHaCFVxygYBaNgFIwMAACopERk2w3gTAAAAABJRU5ErkJggg==","orcid":"","institution":"Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University","correspondingAuthor":true,"prefix":"","firstName":"Fang","middleName":"","lastName":"Han","suffix":""}],"badges":[],"createdAt":"2024-03-07 06:30:40","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4023157/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4023157/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53845163,"identity":"421ea16b-51db-4b0e-a1e9-29d0c2b60d17","added_by":"auto","created_at":"2024-04-01 08:23:51","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":197688,"visible":true,"origin":"","legend":"\u003cp\u003eLiterature search strategy diagram\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4023157/v1/e21f41486aab4e4390a81fa6.png"},{"id":53845162,"identity":"2e4d904c-11dd-41e9-bae7-14a2ef6756f1","added_by":"auto","created_at":"2024-04-01 08:23:51","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":46923,"visible":true,"origin":"","legend":"\u003cp\u003eliterature screening process and result\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4023157/v1/3b9b620e50d6d5bc43ba7745.png"},{"id":69619002,"identity":"0a1b3f47-a2e1-4a37-b9c6-9f990958165d","added_by":"auto","created_at":"2024-11-22 09:47:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":915620,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4023157/v1/24a77a69-e00a-48c3-a8cb-789decf57f31.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Participating experience of virtual reality teaching among nursing Students：a meta synthesis of qualitative studies","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eVirtual Reality (VR) technology, refers to the use of computer technology, constitutes a virtual, realistic world, the user can through certain input and output devices, participate in the virtual world, the formation of interactions, the expression of their real actions, behaviors, etc. for the virtual world of the control of behavior and other behaviors\u003csup\u003e[1]\u003c/sup\u003e. Experiencers through the user terminal such as VR helmet, all-in-one machine, etc. to watch the image of the virtual world generated by the computer simulation, listen to the sound, feel the action, etc., in the visual auditory, tactile and other multi-sensory immersive experience, and interact with the virtual reality system, and in the mutual reaction and feedback to achieve the feeling of immersive\u003csup\u003e[2]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eVR technology can visualize abstract knowledge and deepen the understanding of training objects\u003csup\u003e[3]\u003c/sup\u003e. The perceptual, interactive and conceptual features of virtual reality technology help students to understand and master knowledge at a deeper level and faster, make up for the problem of insufficient traditional medical teaching resources, and enhance the teaching effect\u003csup\u003e[4]\u003c/sup\u003e. At present, virtual reality technology is mainly applied to anatomy, surgical skills and surgery in medical education at home and abroad \u003csup\u003e[5]\u003c/sup\u003e.\u0026nbsp;Tan Huan et al. applied virtual simulation technology in the classroom of medical imaging examination technology, which enhanced the enthusiasm of students to participate in experimental teaching and improved the effect of experimental teaching\u003csup\u003e[6]\u003c/sup\u003e . Lv Yunli et al. used virtual teaching technology in the operation technology training of gastrointestinal surgical nursing, which effectively enhanced the enthusiasm of nursing students to learn, and improved the theoretical knowledge and teaching satisfaction\u003csup\u003e[7]\u003c/sup\u003e .Marie et al.\u003csup\u003e[8]\u003c/sup\u003e developed a virtual simulator that can train device nurses to prepare preoperative devices for more than 100 surgeries, and it is verified that the system can be widely used in the training of primary or vocational device nurses, and the virtual system allows instrumentation nurses to acquire relevant skills in a safe environment.\u003c/p\u003e\n\u003cp\u003eNursing is a specialty that serves patients and requires a lot of operational skills in clinical work. Traditional plane teaching materials lack of interactive and three-dimensional characteristics, it is difficult to give the training object substantive and efficient guidance, and VR technology can make the skills training process with better authenticity and feedback, increase the effect of skills training, but also can effectively reduce the risk of clinical real operation to the patient.VR learning brings the experience of the traditional anatomical atlas is more focused, enjoyable, and effective than traditional, and improves the experience of the person's learning motivation ask \u003csup\u003e[9,10]\u003c/sup\u003e. Virtual reality technology has been initially explored in several clinical nursing fields, and for nursing students, virtual reality technology is currently used for nursing operation skills learning and nursing competence development in complex scenarios\u003csup\u003e[11]\u003c/sup\u003e. The technology is now more widely used in nursing education in developed countries\u003csup\u003e[12]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eHowever, at present, domestic and international studies mostly use quantitative methods to assess students' learning outcomes, and there are fewer studies on students' subjective perceptual experience in the process of using VR for learning, which can not yet comprehensively reflect the quality of virtual reality technology teaching\u003csup\u003e[13]\u003c/sup\u003e. In recent years, relevant researchers have gradually begun to pay attention to students' real experiences, and have conducted relevant qualitative studies to explore students' experiential feedback\u003csup\u003e[14-15]\u003c/sup\u003e. There is no relevant integrated study on the authentic experience and evaluation of nursing students' use of virtual reality technology in the teaching and learning process. Therefore, this study organizes the authentic experience and evaluation of nursing students' use of virtual reality technology in the teaching and learning process through the method of Meta integration to provide a reference for promoting the application of virtual reality technology in nursing teaching and improving nursing teaching.\u003c/p\u003e"},{"header":"2 Information and methods","content":"\u003cp\u003e\u003cstrong\u003e2.1 Search strategy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComputerized systematic search PubMed, Web of science, Wiley Online Library, China Knowledge Network, Wanfang Database, China Biomedical Literature Service System . To search for qualitative studies on virtual reality experiences of nursing students with a search timeframe of 2013 to 2023. The search strategy of subject and free word was used. The Chinese search terms were \u0026quot;students/nurses/nursing\u0026quot; \u0026quot;virtual/virtual reality/virtual simulation/virtual environment/ vr virtual reality/virtual reality technology\u0026quot; \u0026quot;qualitative research/qualitative research/rooted theory/phenomenology/ethnography/narrative\u0026quot;. Ethnography/Narrative \u0026quot; etc. English search terms are virtual realit*/patient simulat*/virtual patient/virtual simulation/educational virtual/instructional virtual, qualitative research/ experience*/attitude*/feel*/response*/interview/phenomenology, nurs*/education of nursing/nursing students. The specific search strategy is based on PubMed as an example, see Figure 1.\u003c/p\u003e\n\u003cp\u003eFig. 1 Literature search strategy diagram\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Literature inclusion and exclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion criteria: ① research object P (Population) for nursing students; ② phenomena of interest I (Interest of phenomena) for undergraduate nursing students\u0026apos; cognition, attitudes and experience of virtual reality teaching and learning, etc.; ③ scenarios Co (Context) for participation in virtual reality technology teaching on or off campus; ④ research type S ( Study design) is qualitative research, including phenomenology, rooted theory, descriptive research, case study, action research. Exclusion criteria: ① Non-Chinese and English literature; ② Literature that cannot be accessed in full text; ③ Repeatedly published literature; ④ Non-qualitative research literature.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Literature Screening and Data Extraction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLiterature was independently searched and screened by 2 researchers trained in evidence-based nursing methodology and qualitative research, and information was extracted and cross-checked, with disagreement encountered through discussion or consultation with a third researcher to assist in judgment. The researchers all had experience in the use of virtual simulation platforms and research on virtual reality related topics. Extracts included author, country, publication date, research methodology, object of study, phenomenon of interest, and main findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Evaluation of the methodological quality of the literature\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQuality evaluation was conducted independently by 2 investigators using the JBI Evidence-Based Health Care Center Quality Evaluation Criteria for Qualitative Research\u003csup\u003e[16]\u003c/sup\u003e, and a third researcher was invited to co-discuss the decision of inclusion for literature where there was disagreement. The evaluation consisted of 10 entries, each of which was \u0026quot;yes,\u0026quot; \u0026quot;no,\u0026quot; and \u0026quot;unclear.\u0026quot; All of them were graded as A, some of them were graded as B, and all of them were graded as C. Literature of grade A and B quality was included in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Meta integration methodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePooled Meta-integration methods were used to integrate the results, and after fully grasping the research methodology of qualitative research, the results of similar studies were recapitulated through repeated readings and analyses, and new categories were formed, The new categories are later summarized as a result of the integration to form a new interpretation.\u003c/p\u003e"},{"header":"3 Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Literature search results and basic characteristics of the included literature\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInitial inspection of the literature 2197, after the deletion of duplicates to obtain 1517 pieces of literature; through the reading of the title and the abstract of 25 pieces of literature screening; through the reading of the full text of the final screening of 9 pieces of literature to meet the requirements of the \u003csup\u003e[17-25]\u003c/sup\u003e, the literature search flow chart is shown in Figure 2, included in the basic characteristics of the literature in Table 1.\u003c/p\u003e\n\u003cp\u003eTable 1 Basic characteristics of the included literature (n=9)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"922\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInclusion of literature\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003e\u003cstrong\u003enations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of publication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e\u003cstrong\u003esample size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResearch methodology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhenomena of interest\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResearch Topics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eHenna M\u0026auml;kinen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eFinland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003eQualitative descriptive study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003edescribe nursing students\u0026apos; user experiences\u0026apos; (UX) regarding highly immersive virtual reality (VR) simulation with head mounted display used for learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eThree themes: nursing care in the immersive VR simulation, technology in the immersive VR simulation, and learning nursing in the immersive VR simulation.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eMohamad M. Saab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eIreland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003eQualitative descriptive study using thematic analysis.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eNursing students\u0026apos; perspectives of incorporating virtual reality in nurse education.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eThree themes: captivating, innovative, and empowering nature of virtual reality; contextual transfer; and challenges and threats to actualization.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eMohamad M. Saab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eIreland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003eQualitative descriptive study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eNursing students\u0026apos; views of using virtual reality in healthcare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eFour themes : (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eAnn-Kathrin Lange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003equalitative cohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eThe degree of acceptance of VR applications by nursing students in Germany. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eSeven themes: Performance expectancy,\u0026nbsp;Effort expectancy,\u0026nbsp;Social influence, Facilitating conditions, Hedonic motivation,\u0026nbsp;Moderation factors,\u0026nbsp;Further application possibilities\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eJaehee Jeon\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eKorea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003equalitative study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003ethe essential components and improvements needed in an adult nursing VR-based simulation training program for nursing students through focus group interviews (FGIs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eFour themes:\u0026nbsp;Limitations of clinical practice,\u0026nbsp;Benefits of simulation training,\u0026nbsp;Need to improve simulation training,\u0026nbsp;Need for VR-based simulation training training, Need to improve simulation training, Need for VR-based simulation training\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eZhi Hanli\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003equalitative study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eTo understand the real feelings of undergraduate midwifery students on the application of virtual reality technology in practice teaching, to observe the effect of the application of virtual reality technology in teaching and to provide a basis for the reform of midwifery practice teaching mode.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003e4 themes: professional awareness, professional skills, professional confidence, and professional advice\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eMuhammad Hibatullah Romli\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eMalaysia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003equalitative study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eto explore pertaining issues on full online learning among nursing students and ofer a contingency solution.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eThree themes: (i) Full online learning has ramifcations on life (it is about life; blurred division on education life and personal life; non-conducive (i) Full online learning has ramifcations on life (it is about life; blurred division on education life and personal life; non-conducive environment for learning; health and well-being; human is an adaptable being while the transition takes time), (ii) Full online learning is a medium of (ii) full online learning is a medium of teaching and learning delivery but with several concerns (the boon and bane of fully online learning; challenges associated with full online learning; coping strategy in handling full online learning; and the need to develop a comprehensive and effective (ii) full online learning is a medium of teaching and learning delivery but with several concerns (the boon and bane of fully online learning; challenges associated with full online learning; challenges associated with full online learning; coping strategy in handling full online learning), and (iii) Foundation in teaching and learning is the key (role of the educator; teaching and learning (iii) Foundation in teaching and learning is the key (role of the educator; teaching and learning approaches; motivation and regulation)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eEva Mari Andreasen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eNorway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003equalitative study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eto investigate how second-year undergraduate nursing students evaluated the usability of the\u003c/p\u003e\n \u003cp\u003ePreoperative ISBAR Desktop VR Application.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eTwo themes: (1) more motivational than standard learning activities and (2) technical and comprehension issues.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.18418201516793%\"\u003e\n \u003cp\u003eHyeon-Young Kim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.583965330444204%\"\u003e\n \u003cp\u003eKorea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.3921993499458285%\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.608884073672806%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.276273022751896%\"\u003e\n \u003cp\u003e\u0026nbsp;phenomenological method.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37703141928494%\"\u003e\n \u003cp\u003eexamined the significance, nature, and structure of the virtual experience of perioperative patients as undergone by nursing students during their practical training through VR and blended learning.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.577464788732396%\"\u003e\n \u003cp\u003eSeven themes: \u0026quot;placed in a passive position,\u0026quot; \u0026quot;facing the limits of communication,\u0026quot; \u0026quot;thinking of developing and improving competency as a nurse,\u0026quot; \u0026quot;recognizing the importance of interacting\u0026quot; \u0026quot;thinking of developing and improving competency as a nurse,\u0026quot; \u0026quot;recognizing the importance of interacting with their patients\u0026quot;, \u0026quot;learning vividly through experience\u0026quot;, \u0026quot;engaging in a new type of experience\u0026quot;. with their patients\u0026quot;, \u0026quot;learning vividly through experience\u0026quot;, \u0026quot;engaging in a new type of participatory learning,\u0026quot; and \u0026quot;designing nursing knowledge.\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Results of the evaluation of the methodological quality of the included literature\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe methodological quality of the nine included literature was evaluated as grade B in eight cases and grade A in one case. The specific quality evaluation of the included literature is shown in Table 2.\u003c/p\u003e\n\u003cp\u003eTable 2. evaluation of the quality of the included literature (n=9)\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\" valign=\"top\"\u003e\n \u003cp\u003eInclusion of studies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003e①\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003e②\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003e(iii)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003e④\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003e⑤\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003e(vi)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003e(vii)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003e⑧\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003e⑨\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003e⑩\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eQuality level (grade)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eHenna M\u0026auml;kinen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eUN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eMohamad M. Saab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eUN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eMohamad M. Saab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eUN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eAnn-Kathrin Lange.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eJaehee Jeon\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eZhi Hanli\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eUN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eMuhammad Hibatullah Romli\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eEva Mari Andreasen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.819004524886878%\"\u003e\n \u003cp\u003eHyeon-Young Kim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.5610859728506785%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6923076923076925%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eUN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.352941176470588%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.126696832579186%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.787330316742081%\" valign=\"top\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.914027149321267%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e3.1 Literature Search Results and Basic Characteristics of the Included Literature\u003c/strong\u003e\u003cbr\u003eInitially, 2197 pieces of literature were identified, which were then reduced to 1517 after removing duplicates. A screening process based on titles and abstracts led to the selection of 25 pieces of literature. Subsequently, 9 final pieces of literature were chosen after a full-text review, meeting the specified criteria \u003csup\u003e[17-25]\u003c/sup\u003e. The literature search flow chart is depicted in Figure 2, and the basic characteristics of the literature are outlined in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Evaluation Results of the Methodological Quality of the Included Literature\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The methodological quality of the nine included pieces of literature was assessed as grade B in eight cases and grade A in one case. Detailed evaluations of the quality of the included literature are presented in Table 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Meta-Integration Results\u003cbr\u003e\u0026nbsp;\u003c/strong\u003eThrough a thorough review and analysis of the nine selected pieces of literature, the researcher distilled 37 findings from the original studies. These findings were then categorized into seven new categories and further synthesized to derive three integrated findings. The integration process is illustrated in Figure 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3.1 Integration Finding One: Strengths and Needs of Virtual Reality Teaching Experiences\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e3.3.1.1 Category 1: Student Immersion Experience\u003cbr\u003eThe immersion experience for nursing students encompassed a sense of presence in nursing care, including natural nursing care and the visual environment of the VR setting. Factors such as the ability to move within the environment and access to necessary nursing equipment influenced the feeling of natural nursing care. Nursing students expressed positive experiences related to immersive virtual reality simulations of care, technology, and learning \u003csup\u003e[17]\u003c/sup\u003e. They found virtual reality to be engaging, innovative, and empowering, fostering active participation and knowledge retention\u003csup\u003e\u0026nbsp;[18]\u003c/sup\u003e. Additionally, students shared positive experiences and knowledge gained from virtual reality simulations, highlighting the effectiveness and novelty of the approach \u003csup\u003e[19]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e3.3.1.2 Category 2: Motivation and Inspiration for Nursing Students\u003cbr\u003eNursing students perceived the use of VR in nursing education as beneficial, enhancing their learning experience and understanding of the content \u003csup\u003e[20]\u003c/sup\u003e. They found VR applications manageable and engaging, attributing their positive attitudes towards these applications to social influences and the playful nature of VR learning \u003csup\u003e[20]\u003c/sup\u003e. The use of immersive virtual reality technology in nursing education was seen as a novel and accessible method of skill acquisition, improving students\u0026apos; professional competence and confidence\u003csup\u003e[22]\u003c/sup\u003e. Communication through virtual phone calls was noted to enhance students\u0026apos; awareness of clear and effective communication \u003csup\u003e[24]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eNursing students\u0026apos; experiences of being in the patient\u0026apos;s position were found to provide valuable insights into patient care and empathy, emphasizing the importance of holistic care and effective communication\u003csup\u003e[25]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e3.3.1.3 Category 3: Contribution to Professional Learning\u003cbr\u003eParticipants reported that virtual reality simulations helped bridge the gap between theoretical knowledge and real-world clinical practice, enhancing their understanding and integration of nursing principles\u003csup\u003e[21]\u003c/sup\u003e. Virtual reality technology was seen as a valuable tool for simulating uncommon clinical scenarios, providing a safe and effective learning environment for students to refine their skills\u003csup\u003e[22]\u003c/sup\u003e. Participants emphasized the need for realistic and up-to-date educational resources, such as procedure videos, to enhance their learning experience and align with standard practices\u003csup\u003e[23]\u003c/sup\u003e. The integration of new teaching methods, including VR and blended learning, was found to enhance academic achievements and promote participatory learning experiences\u003csup\u003e[25]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3.2 Integration Outcome 2: Disadvantages and Challenges of Virtual Reality Teaching Experience\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e3.3.2.1 Category 1: Difficulties Encountered\u003cbr\u003eDespite the advantages of VR technology, participants highlighted challenges such as age limitations, technical difficulties, and side effects like dizziness during VR experiences\u003csup\u003e[23]\u003c/sup\u003e. Some students found their initial clinical practice challenging, feeling awkward and unprepared in patient interactions\u003csup\u003e[20]\u003c/sup\u003e. They also expressed dissatisfaction with limited training opportunities and experiences \u003csup\u003e[21]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e3.3.2.2 Category 2: Limitations in Student Learning and Experience\u003cbr\u003eFull online learning was noted to have implications on students\u0026apos; personal lives, creating challenges in communication and socialization, especially for new students \u003csup\u003e[23]\u003c/sup\u003e. Students placed in passive roles as patients felt subjugated and lacked authority in clinical scenarios\u003csup\u003e[25]\u003c/sup\u003e. Dissatisfaction with outdated teaching materials and the need for more diverse and engaging learning opportunities were also highlighted \u003csup\u003e[22]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3.3 Integration Outcome 3: Future Applications and Possibilities for Virtual Reality Teaching and Learning\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e3.3.3.1 Category 1: Facilitating Conditions for the Realization of Virtual Reality\u003cbr\u003eParticipants believed that VR was more suitable for outpatient settings and recommended its use in various educational and community settings\u003csup\u003e[19]\u003c/sup\u003e. They emphasized the importance of integrating VR into educational curricula to maximize its benefits and ease of use for both students and teachers \u003csup\u003e[20]\u003c/sup\u003e. Participants expressed the desire for more realistic and diverse simulation training opportunities to enhance their learning experiences \u003csup\u003e[21]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e3.3.3.2 Category 2: Future Possibilities\u003cbr\u003eParticipants recommended the future use of VR in health promotion, disease prevention, patient education, and empathy training for healthcare professionals\u003csup\u003e[19]\u003c/sup\u003e. They highlighted the potential of VR in enhancing empathy towards patients and improving understanding of diverse healthcare scenarios \u003csup\u003e[20]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Characterization of the Included Literature\u003c/h2\u003e \u003cp\u003eOne of the nine papers included in this study was from China and was published between 2013 and 2023. All the included literature was of high quality (grade B) and demonstrated good reliability. The studies utilized descriptive qualitative and phenomenological approaches to explore nursing students' experiences with virtual reality technology, enhancing the teaching and learning of nursing practices.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Advantages of Virtual Reality Teaching\u003c/h2\u003e \u003cp\u003eVirtual reality offers a range of stimuli that enhance motivation, theoretical knowledge mastery, critical thinking, operational skills, and practical responsiveness among nursing students\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. The technology has been shown to improve hands-on skills, learning abilities, and confidence in clinical practice, bridging the gap between theory and practice \u003csup\u003e[22]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Disadvantages of Teaching with Virtual Reality\u003c/h2\u003e \u003cp\u003eWhile virtual reality technology has transformed medical education, challenges such as simulation limitations, varying effectiveness based on instructors, and potential side effects like VR sickness have been noted\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. The cost and development time associated with VR applications, as well as the need for continuous collaboration with nursing faculty and clinical experts, pose additional challenges \u003csup\u003e[22]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Needs for Improvement and Future Possibilities\u003c/h2\u003e \u003cp\u003eThe integration of virtual reality technology in nursing education holds significant promise, but further development and optimization are required. Future research should focus on enhancing the realism and diversity of virtual learning experiences, improving interface design, and integrating technology seamlessly into nursing curricula. Collaboration between government, universities, and industry is essential for the advancement of virtual reality in nursing education, ultimately cultivating high-quality nursing professionals.\u003c/p\u003e \u003c/div\u003e"},{"header":"5 Limitations","content":"\u003cp\u003eThe present study has several limitations. First, according to the inclusion criteria for literature, only qualitative and mixed-method studies published in indexed journals, written in English or Chinese, were selected. Therefore, gray literature and some papers or dissertations were not searched, which may lead to information bias. Therefore, gray literature and some papers or dissertations were not searched, which may lead to information bias. In addition, due to cultural and policy differences, the attitudes, opinions, and feelings of nursing students are greatly influenced by different regional cultures, which may lead to different outcomes.\u003c/p\u003e"},{"header":"6 Conclusion","content":"\u003cp\u003eIn this study, through the Meta integration of 9 qualitative studies, By combining the advantages of virtual reality technology with the occurrence of nursing teaching, nursing students can experience immersive experiential learning anytime and anywhere without being restricted by time and space, and the overall cognitive pleasure of nursing students towards this virtual teaching system is good. However, it is necessary to further enrich the details of teaching content design and optimize the technical experience of virtual reality.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e Ethical approval was not required for this meta synthesis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eNo/Not applicable (this manuscript does not report data generation or analysis).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interests:\u003c/strong\u003eNone declared.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e There is no funding for the study. The corresponding author has full access to all data in the study and is ultimately responsible for the decision to submit for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e:\u0026nbsp;All authors conceived and designed the study.\u0026nbsp;ZYX\u0026nbsp;and GX organized and conducted the search and participated in the selection of the relevant articles and performed the quality assessment of the studies. HF ,LXQ and FWF supervised the project and made the changes and corrections suggested by the reviewers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003eNot\u0026nbsp;applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors and Affiliations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst Auther : Xing Gao \u0026nbsp;Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected]\u003c/p\u003e\n\u003cp\u003eco-first author: Yanxue Zheng,Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail:[email protected].\u003c/p\u003e\n\u003cp\u003eXiaoQin Li:Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail:[email protected].\u003c/p\u003e\n\u003cp\u003eWenFeng Fu:Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail: [email protected].\u003c/p\u003e\n\u003cp\u003eCorresponding author:Fang Han,Gynecology Comprehensive Ward of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng district, Jining City 272000, Shandong Province, China. E-mail:[email protected].\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTIAN Jihong,JIANG Dai. Future changes in medical education from the development of virtual reality (VR)[J]. 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Construction of medical imaging examination technology course based on virtual simulation teaching platform[J]. Education and Teaching Forum,2020(18):294-295.\u003c/li\u003e\n \u003cli\u003eLv Yunli, Zeng Yonghong. Application of virtual teaching method in nursing teaching[J]. China Continuing Medical Education. 2019,11(05):26-28.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Bracq M-S, Michinov E, Arnaldi B, et al.Learning procedural skills with a virtual reality simulator: an acceptability study[J].Nurse Education Today, 2019,79:153160.\u003c/li\u003e\n \u003cli\u003eStepan K, Zeiger J, Hanchuk S, et a1. Immersive virtual reality as a teaching tool for neurol anatomy [J]. Int Forum Allergy Rhinol, 2017,7:1006- 1013.\u003c/li\u003e\n \u003cli\u003eGan Lingling,Sha Chuan,Wang Bo.Practice and thinking of VR technology in teaching medicine in China[J.Chinese Journal of Medical Education Exploration,2019,18(9):817-875.\u003c/li\u003e\n \u003cli\u003eShorey S, Ng E D. The use of virtual reality simulation among nursing students and registered nurses: a systematic review[J].Nurse Education Today, 2021 ,98:104662.\u003c/li\u003e\n \u003cli\u003eBadowski D,Wells-Beede E. State of prebriefing and debriefing in virtual simulation[J].Clinical Simulation in Nursing,2022,62:42-51.\u003c/li\u003e\n \u003cli\u003eM\u0026auml;kinen H, Haavisto E, Havola S, Koivisto JM. Graduating nursing students\u0026apos; user experiences of the immersive virtual reality simulation in learning - A qualitative descriptive study. Nurs Open. 2023 May;10(5):3210-3219. doi: 10.1002/nop2.1571. Epub 2023 Jan 4. PMID: 36598872; PMCID: PMC10077358.\u003c/li\u003e\n \u003cli\u003eSaab MM, Landers M, Murphy D, O\u0026apos;Mahony B, Cooke E, O\u0026apos;Driscoll M, Hegarty J. Nursing students\u0026apos; views of using virtual reality in healthcare: a qualitative study. J Clin Nurs. 2022 May;31(9-10):1228-1242. doi: 10.1111/jocn.15978. Epub 2021 Jul 22. PMID: 34296483.\u003c/li\u003e\n \u003cli\u003eSaab MM, Hegarty J, Murphy D, Landers M. Incorporating virtual reality in nurse education: a qualitative study of nursing students\u0026apos; perspectives. nurse Educ Today. 2021 Oct;105:105045. doi: 10.1016/j.nedt.2021.105045. Epub 2021 Jul 2. PMID: 34245956.\u003c/li\u003e\n \u003cli\u003eLange AK, Koch J, Beck A, Neugebauer T, Watzema F, Wrona KJ, Dockweiler C. Learning With Virtual Reality in Nursing Education: Qualitative Interview Study Among Nursing Students Using the Unified Theory of Acceptance and Use of Technology Model. JMIR Nurs. 2020 Sep 1;3(1):e20249. doi: 10.2196/20249. pmid: 34345791; pmcid: pmc8279447.\u003c/li\u003e\n \u003cli\u003eJeon J, Kim JH, Choi EH. Needs Assessment for a VR-Based Adult Nursing Simulation Training Program for Korean Nursing Students: a Qualitative Study Using Focus Group Interviews. Int J Environ Res Public Health. 2020 Nov 29;17(23):8880. doi: 10.3390/ijerph17238880. 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Assessment, and Recommendation) Desktop Virtual Reality Application: a Qualitative Observational Study. JMIR Hum Factors. 2022 Dec 29;9(4):e40400. doi: 10.2196/40400. PMID: 36580357; PMCID: PMC9837706.\u003c/li\u003e\n \u003cli\u003eKim HY, Lee JH, Lee EH. Virtual Experience of Perioperative Patients: Walking in the Patients\u0026apos; Shoes Using Virtual Reality and Blended Learning. Int J Environ Res Public Health. 2021 Jun 15;18(12):6457. doi: 10.3390/ijerph18126457. PMID: 34203661; PMCID: PMC8296282.\u003c/li\u003e\n \u003cli\u003eChen FQ, Leng YF, Ge JF, et al. Effectiveness of virtual reality in nursing education: meta-analysis\u0026nbsp;［J］. J Med Internet Res,2020,22(9):e18290.\u003c/li\u003e\n \u003cli\u003eChang YM, Lai CL. Exploring the experiences of nursing students in using immersive virtual reality to learn nursing skills [J]. Nurse Educ Today, 2021, 97:104670.\u003c/li\u003e\n \u003cli\u003eVerkuyl M, Hughes M, Tsui J, et al. Virtual gaming simulation in nursing education: a focus group study\u0026nbsp;［J］. J Nurs Educ, 2017, 56(5):274-280.\u003c/li\u003e\n \u003cli\u003eUlrich D, Farra S, Smith S, et al. The student experience using virtual reality simulation to teach decontamination [J]. Clin Simul Nurs, 2014, 10(11):546-553.\u003c/li\u003e\n \u003cli\u003eChang YM, Lai CL. Exploring the experiences of nursing students in using immersive virtual reality to learn nursing skills. Nurse Educ Today. 2021 Feb;97:104670.\u003c/li\u003e\n \u003cli\u003eSamadbeik M Yaaghobi D,Bastani P,Abhari S,Rezaee R, Garavand A. The Applications of Virtual Reality Technology in Medical Groups Teaching. j Adv Med Educ Prof. 2018 Jul;6(3):123-129.\u003c/li\u003e\n \u003cli\u003eBrooks, J. O., Goodenough, R. R., Crisler, M. C., Klein, N. D., Alley, R. L., Koon, B. L., Logan, W. C., Ogle, J. H., Tyrrell, R. A., \u0026amp; Wills, R. F. (2010). Simulator sickness during driving simulation studies. Accident Analysis \u0026amp; Prevention, 42(3), 788-796. \u0026nbsp;https://doi.org/10.1016/j.aap.2009.04.013\u003c/li\u003e\n \u003cli\u003ePatr\u0026atilde;o, B., Pedro, S., \u0026amp; Menezes, P. (2020). How to deal with motion sickness in virtual reality. Portuguese Meeting on Computer Graphics and Interaction 2015. \u0026nbsp;https://doi.org/10.2312/pt.20151201\u003c/li\u003e\n \u003cli\u003eFernandes, A. S., \u0026amp; Feiner, S. K. (2016). Combating VR sickness through subtle dynamic field-of-view modification. in 2016 IEEE symposium on 3D user interfaces (3DUI) (pp. 201- 210). IEEE. https://doi.org/10.1109/3DUI.2016.7460053\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nursing education, Nursing students, Virtual reality, Experience, Meta-integration","lastPublishedDoi":"10.21203/rs.3.rs-4023157/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4023157/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective \u003c/strong\u003eTo systematically evaluate research on nursing students' experience of participating in teaching virtual reality technology.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eA\u003cstrong\u003e \u003c/strong\u003ecomputerized search of PubMed, Web of science, Wiley Online Library, China Knowledge Network, Wanfang Database, and China Biomedical Literature Service System was conducted to search for qualitative studies on nursing students' experiences of participating in teaching with virtual reality technology, with a time frame from 2013 to 2023. The quality of the literature was evaluated using the quality evaluation criteria of Australian JBI evidence-based health care centers，and the results were summarized and integrated using the aggregative integration method.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eA total of 9 studies were included, ultimately distilling 37 findings from the original studies, which were summarized to form 7 new categories, yielding 3 integrated findings: strengths and needs of virtual reality teaching and learning experiences; weaknesses and challenges of virtual reality teaching and learning experiences; and future applications and possibilities of virtual reality teaching and learning.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003eBy combining the advantages of virtual reality technology with the occurrence of nursing teaching, nursing students can experience immersive experiential learning at any time and any place without time and space constraints,\u003c/p\u003e\n\u003cp\u003eand the overall cognitive pleasure of nursing students to this virtual teaching system is good. However, it is necessary to further enrich the details of teaching content design and optimize the technical experience of virtual reality.\u003c/p\u003e","manuscriptTitle":"Participating experience of virtual reality teaching among nursing Students：a meta synthesis of qualitative studies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-01 08:23:46","doi":"10.21203/rs.3.rs-4023157/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d8f9e0d4-578e-4a8a-adcd-a569e1c77a9e","owner":[],"postedDate":"April 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-22T09:38:56+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-01 08:23:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4023157","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4023157","identity":"rs-4023157","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}