Research Brief: The UbiSim VR Platform for Nursing Simulation [Spring 2025]

Introduction: What This Brief Explores

This research brief explores the research verification of the UbiSim immersive virtual reality (VR) platform for simulation in nursing education. We provide a comprehensive review of UbiSim’s efficacy, beginning with a roundup of experimental and descriptive peer-reviewed research and including findings from a survey conducted by UbiSim. Read below for highlights demonstrating how UbiSim supports nurses in developing the clinical judgment, therapeutic communication, and other competencies required to deliver high-quality patient care.

I. UbiSim Intervention Reduces Mental Health Stigma by 32% 

In a 2025 article published in CIN: Computers, Informatics, Nursing, researchers Sheri Howard, PhD, RN, CHSE, and Meghan Meadows-Taylor, MPH, PhD, investigated the use of virtual reality to improve nursing students' attitudes toward patients with mental health conditions. Their paper, "Using Virtual Reality in Mental Health Nursing to Improve Behavioral Health Equity," addressed a critical challenge in nursing education: the anxiety, stress, and fear nursing students often experience during mental health clinical rotations.

The study employed a mixed-method comparative analysis with 86 first-year BSN students across rural and urban campuses in the southern United States. The intervention group participated in a VR simulation using the UbiSim platform, which transported students to a virtual outpatient mental health clinic where they conducted assessments and practiced therapeutic communication with a virtual patient experiencing anxiety.

Results

• UbiSim VR users demonstrated 32.2% less stigma on the STIG-9 questionnaire compared to the control group. 
• UbiSim improved social restrictiveness attitudes by 22.2%, indicating they viewed patients with mental illness as less threatening after the VR experience. 
• Qualitative findings strongly supported these results, with students reporting more confidence, less fear, better therapeutic communication skills, and reduced stereotyping of patients with mental health conditions.

Implications

The researchers concluded that VR simulation provides nursing students with a greater understanding of equitable behavioral health while allowing them to analyze personal biases in a controlled environment. This research contributes to the growing body of evidence supporting UbiSim as an effective pedagogical tool for preparing nursing students to provide equitable behavioral healthcare and potentially addressing the shortage of nurses choosing to specialize in mental health.

II. UbiSim Use Increases Psychological Safety and Clinical Judgment

The journal Clinical Simulation in Nursing published an article titled “Prebriefing techniques that promote psychological safety and clinical judgment in nursing students,” describing a research study led by Dr. Holldrid Odreman (PhD, MScN-Ed, RN, CCNE, CCSNE), Professor at the School of Nursing at Niagara College, that aimed to enhance psychological safety in nursing students to improve their performance and clinical decision-making skills. Their focus was on identifying which simulation pre-briefing method most effectively boosts student confidence and performance while also fostering a supportive learning environment. 

Dr. Odreman and his team compared three pre-briefing strategies: traditional, concept-mapping, and virtual reality (VR). The research followed a randomized controlled trial (RCT) experimental design with multiple post-tests. A quantitative approach was employed to measure both psychological safety and clinical judgment across three separate prebriefing technique groups. The research involved the random assignment of 38 practical nursing students to one of three pre-briefing conditions: traditional verbal report, guided concept mapping, or a guided VR scenario using UbiSim. Prebriefing was followed by a standardized simulation skills scenario.

Results

• Psychological Safety improved by 72% with pre-briefing in UbiSim VR as compared to traditional methods
• Clinical Judgment scores were 57% higher with pre-briefing in UbiSim VR as compared to traditional methods
• Psychological Safety and Clinical Judgment had a statistically significant positive correlation with UbiSim VR

Implications:

The findings support UbiSim as an evidence-based solution that enhances both psychological safety and clinical judgment, two critical factors in preparing nursing students for clinical practice. Adopting UbiSim's Immersive VR platform could significantly enhance the pre-briefing process, leading to improved psychological safety, better clinical judgment as demonstrated by its high scores on the Lasater Clinical Judgment rubric, and more effective preparation of nursing students.  

III. Learnings After Implementing UbiSim in a Prelicensure Program 

The article “Virtual Reality Simulation Integration in a Prelicensure Nursing Program: Lessons Learned” describes lessons learned for nurse educators considering adopting UbiSim immersive VR simulation technology to reduce the costs of live role-play with standardized patients and relieve the screen fatigue that can accompany 2D computer-based virtual simulation. 

1. VR is Affordable, Subscription Must Be Sustainable: At the authors’ institution, UbiSim VR simulation was found to allow greater student-to-faculty ratios, less need for medical equipment, and less use of paid standardized participants than live simulations, making the cost of UbiSim roughly half the cost of live simulation. They cautioned that educators should carefully consider how to sustain subscription access (eg, beyond any grant funding) before integrating VR simulation into their curriculum, as well as how ongoing VR equipment, faculty training, and support needs will be funded.

2. Plan for Cleaning and Maintenance: The authors cited the need for nursing programs to plan for the cleaning of VR headsets and controllers between users, with care taken to avoid damaging components. They recommended the purchase of ultraviolet cabinets, a significant up-front cost, or a less costly process of using antimicrobial wipes, air drying the components, and then wiping with fragrance-free baby wipes. However, they noted that this process is not eco-friendly and creates a list of supplies that must be maintained over time.

3. Consider Hands-On Learning: Following the VR simulation, some nurse learners provided feedback that they also felt the need to get their hands on the physical objects used for client care. For this reason, the authors introduced a “kinesthetic cart,” which contained the physical objects used during the VR scenarios. For example, if a client was given an intravenous medication in the simulation, students were presented with an actual simulation syringe of that medication to capture kinesthetic knowledge that may otherwise be lost in the VR environment. Subsequent learner surveys indicated comparable satisfaction between VR simulation and standardized patients. 

Implications:

UbiSim has created larger student-to-faculty ratios, a decreased need for medical equipment, paid standardized participants, and a significant reduction at approximately half the cost of live simulation. However, implementing VR simulation requires careful planning for nurse learners’ desire for kinesthetic learning and ongoing costs, including equipment maintenance, cleaning procedures, and faculty training. 

IV. Feasibility of UbiSim for Nurse Training in Rural Settings

The 2024 article “Exploring the Acceptability and Feasibility of an Immersive Virtual Reality Intervention for Newly Graduated Nurses Working in a Rural Area,” investigated the use of UbiSim immersive virtual reality (IVR) to develop the skills of new graduate nurses (NGNs) working in a rural hospital in Quebec. 11 NGNs participated in an IVR training intervention and completed questionnaires with six also participating in semi-structured interviews. Cybersickness was minimal, with only slight eye strain reported. 

The results showed high acceptability. According to the NGNs, simulation using IVR was rated as ’extremely effective’ (Md = 4), ’extremely appropriate’ (Md = 4) and ’extremely convenient’ (Md = 4). NGNs reported being ’extremely willing’ to receive this intervention (Md = 4).  

The qualitative findings revealed four major themes: 

1. IVR is relevant everywhere and for everyone, making immersive simulation accessible even in remote settings
2. IVR allows the development of various skills, including knowledge, clinical judgment, and prioritization
3. Challenges like cognitive overload and cybersickness can be overcome with strategies like familiarization time and case complexity gradation
4. The realism of IVR provides a sense of safety for skill practice. NGNs recommended IVR be used regularly for training.

Implications: 

The study provided promising evidence that UbiSim immersive virtual reality is an acceptable, feasible, and effective modality for providing simulation-based training to NGNs in rural and remote hospital settings. The accessibility of UbiSim makes it well-suited to deliver much-needed continuing education to nurses in areas far from educational centers. While some limitations were noted, such as reduced realism for technical and communication skills compared to in-person simulation, the overall findings support its use to help NGNs develop critical competencies. 

V. VR Implementation in a Nursing Professional Development Program 

The journal article “Welcome to the Metaverse: Virtual Reality in Nursing Professional Development” (Coughlin et al., 2024)  explores the implementation of UbiSim virtual reality (VR) technology as part of a nursing professional development education program at an academic health system. The program used VR simulation as an alternative form of experiential education aimed at preparing clinicians for real-world situations. VR was incorporated into nursing orientation and residency programs across four campuses. 

The project involved 63 participants, primarily staff nurses with less than a year of experience.

Most participants (74.6%) were first-time VR users. A three-phase approach was used in which NPD practitioners received training on VR hardware and software (preparation phase); facilitators guided learners through VR scenarios (implementation phase); and participants reflected on the experience and its implications for practice in a self-reported survey (debrief phase).

Survey participants agreed that VR simulation:

• Enhanced clinical knowledge retention: 98.3%
• Met educational objectives: 77.7%
• Was an enjoyable learning environment: 69.8%
• Was effective for learning nursing clinical skills: 66.7%
• Was easy to use: 55.6%
• Improved their confidence: 52.4%
• Reduced their performance anxiety: 44.4%
• Was preferable to traditional teaching methods: 38.1%

Implications: The study findings suggest that integrating UbiSim into nursing professional development programs could enable health systems to enhance the quality and effectiveness of their nursing education, leading to improved knowledge retention and clinical skills. Improvements in confidence and reductions in performance anxiety indicate that UbiSim could add value as a way for nurses facing new or challenging clinical scenarios to practice and refine complex skills without risk to patients. Additionally, the finding that it was easy and enjoyable suggests that UbiSim could increase engagement in professional development activities.

VI. Dissertation Research: Key Findings About Accuracy, Clinical Judgment, and Soft Skills 

The study “Evaluating a Virtual Reality Simulation-Based Tool in Undergraduate Nursing Students for Impact on Accuracy, Clinical Judgment, Fear, and Self-Confidence when Donning, Doffing, and Disposing of Personal Protective Equipment” (Russell, 2023) aimed to determine the effectiveness and acceptability of head-mounted virtual reality simulation VR in teaching PPE procedures to nursing students. It focused on evaluating the impact of VR on accuracy, clinical judgment, fear, and self-confidence and sought to understand its acceptability among faculty and students for PPE training.

The study utilized a small group evaluation design with repeated measures among 38 undergraduate nursing students at West Virginia University. Various validated scales and checklists were used to measure outcomes like accuracy, clinical judgment, and self-confidence. Statistical analysis was conducted to evaluate differences and changes over time.

Results:

1. Enhanced Accuracy and Clinical Judgment: The study's results suggest that VR can improve accuracy in donning, doffing, and disposing of PPE, especially with repeated practice. Improvements in clinical judgment were observed, suggesting that VR can help students become more organized and aware of clinical situations over time.
2. Reduction in Fear: A significant decrease in fear was noted among students using VR, implying a reduction in anxiety and unease related to PPE procedures.
3. Increase in Self-Confidence: Students reported higher self-confidence levels after using the VR tool, indicating a preference for this modality over traditional methods.
4. Acceptance Among Faculty and Students: Despite some previous skepticism, the study found a growing acceptance of VR among faculty for teaching PPE procedures, contrary to some previous studies. Students expressed high acceptance and preference for VR, finding it supportive and life-like. This generation's familiarity with virtual environments for recreation likely contributes to this acceptance, suggesting that VRS is a fitting learning tool for contemporary students. The realistic scenarios provided by VR were particularly appreciated for their contribution to learning.

Implications:

By demonstrating improved accuracy, clinical judgment, fear reduction, and self-confidence among students, the study supports adopting innovative platforms like UbiSim for enhanced learning outcomes. This study provides substantial evidence supporting the use of immersive virtual reality, like UbiSim, as a pedagogically proven and preferred modality for nursing education, particularly for critical skills like PPE procedures. As the healthcare industry and students’ learning preferences continue to evolve, utilizing innovative educational tools like UbiSim will be vital for enhancing learning outcomes.

VII. UbiSim Survey Reveals Impact on Nursing Program Growth and Learner Experience 

The Spring 2024 Nursing Simulation Survey was conducted by UbiSim online from May 8-31, 2024. UbiSim surveyed 679 nurse learners, instructors, simulation directors, and program leaders on the impact of headset-based immersive VR technology in nurse training.

82%

Nursing Programs Leaders Say UbiSim Helps Them Recruit and Accept More Students

82% of nursing program directors surveyed agreed that headset-based immersive VR has helped their nursing program to attract more students, saying “it helps us with recruitment,” while 72% agreed it has helped their nursing program to accept more students. Significantly, three-quarters of nursing program directors who use UbiSim say their nursing program has grown by at least 5%, or as much as 25%, since implementing UbiSim. Once enrolled and learning in simulation, 91% of nurse learners said they liked UbiSim the same or better than other simulation modalities.

94%

Nursing Learners Say UbiSim Prepares Them for Licensure and Practice

There was broad agreement among nurse educator respondents that incoming nursing students are ill-prepared for the rigor of nursing education. 55% of both nursing instructors and program directors agreed that the top challenge facing their nursing program is “students’ lack of academic preparation”. These concerns were closely followed by a “lack of clinical sites/preceptors”, cited as a top challenge by 50% of nursing instructors and program directors. Given these concerns, nursing schools must find a way to overcome skills gaps with fewer resources. Fortunately, students enrolled in nursing programs that use UbiSim viewed it as an effective learning tool, with 94% of nurse learners agreeing that UbiSim helps prepare them for the clinical setting and 90% agreeing that UbiSim helps them prepare for the Next Generation NCLEX. 

78%

Simulation Directors Say UbiSim Helps Develop Clinical Judgment

Nearly four out of five simulation directors ranked headset-based immersive VR simulation as the most effective simulation modality for developing clinical judgment skills, superseding both high-fidelity manikin simulation and computer screen-based virtual reality simulation. Suspending disbelief and engaging in hands-on experiences in highly realistic scenarios can help nurse learners develop essential clinical reasoning, collaboration skills, and resilience to become adequately prepared for high-pressure, life-or-death situations.

50%

Nurse Learners Say UbiSim is the Most Psychologically Safe Sim Modality

50% of nurse learners said they felt safer and more comfortable learning in UbiSim than in other simulation modalities. They commented that they appreciated the chance to practice without consequences. Respondents said, “UbiSim lets me be immersed in situations I may encounter in the hospital setting but in a safe environment” and “it can help me face and overcome fears.” Nursing instructors who teach with UbiSim agreed, saying “The students are able to do things with less fear when compared to a manikin simulation.” 

Implications  

UbiSim's immersive VR technology has made a significant impact on nursing programs, with 82% of program leaders reporting it aids in student recruitment and 72% saying it helps them accept more students. The platform is widely viewed as an effective learning tool, with 94% of nurse learners agreeing it prepares them for clinical settings and 90% feeling it helps with Next Generation NCLEX preparation. Moreover, 78% of simulation directors say UbiSim is the most effective simulation modality for developing clinical judgment skills. 

Conclusion: UbiSim and the Future of Nursing Simulation

This research brief synthesizes multiple lines of evidence demonstrating how UbiSim addresses critical challenges in contemporary nursing education through evidence-based immersive simulation technology.

The convergent findings across independent studies present a compelling case for UbiSim's effectiveness. With 78% of simulation directors ranking it as the most effective modality for developing clinical judgment, showing a documented 57% improvement over traditional methods, UbiSim directly addresses a core competency required for safe practice. This improvement occurs within an environment that enhances psychological safety by 72%, creating optimal conditions for learning that 50% of students identify as feeling more psychologically safe with UbiSim than with other simulation approaches.

UbiSim demonstrates versatility across the educational continuum—from pre-licensure programs where 94% of learners confirm it prepares them for clinical practice, to professional development settings where 98.3% of practicing nurses report enhanced knowledge retention. This adaptability makes UbiSim particularly valuable in addressing diverse challenges, from limited clinical sites to the need for specialized training in areas like mental health nursing, where it reduced stigma by 32%.

While implementation considerations exist, including equipment maintenance and the supplementation of kinesthetic learning opportunities, the current evidence base establishes UbiSim as an effective platform that helps nursing programs expand capacity while maintaining educational quality and preparing nurses for the complexities of contemporary clinical practice.​​​​​​​​​​​​​​​​