Effect of Virtual Reality-Based Handwashing Education on Knowledge, Skills, and Emotional Indicators in Preschool Children

Hand hygiene is one of the most effective and cost-efficient methods for preventing infectious diseases, particularly among preschool children, who are more vulnerable due to their developing immune systems and limited awareness of hygiene practices. Although traditional educational approaches can improve children's knowledge of hand hygiene, these methods may not always be sufficient to maintain long-term behavioral change or engagement. Therefore, innovative, interactive, and developmentally appropriate educational strategies are needed to enhance both cognitive learning and behavioral performance in early childhood. Virtual reality (VR) technology has emerged as an innovative educational tool that provides immersive, interactive, and multisensory learning experiences. By increasing children's attention, motivation, and active participation, VR-based education may contribute to improved learning outcomes, skill acquisition, and emotional engagement.

This study is designed as a randomized controlled trial with three parallel groups: a virtual reality-based handwashing education group, a traditional handwashing education group, and a control group receiving no intervention. The study will be conducted in a preschool setting in Istanbul, Turkey. A total of 66 children aged 5-6 years who meet the inclusion criteria will be enrolled in the study and randomly assigned to one of the three groups. Children in the virtual reality group will receive handwashing education supported by virtual reality technology in an immersive learning environment. Children in the traditional education group will receive standard handwashing education through conventional teaching methods, including verbal instruction and demonstration. Children in the control group will continue their routine preschool activities without receiving any handwashing education during the study period. Data will be collected using the Sociodemographic Information Form, Handwashing Knowledge Form, Handwashing Skill Assessment Form, and the Children's Emotional Indicators Scale. Outcome measures, including handwashing knowledge, handwashing skills, and emotional indicators, will be assessed at baseline and 2 weeks after the intervention. This study aims to compare the effectiveness of virtual reality-based and traditional handwashing education on improving knowledge, practical skills, and emotional responses related to hand hygiene in preschool children. The findings are expected to contribute to the development of evidence-based, technology-supported educational interventions in pediatric health promotion and infection prevention.

Inclusion criteria

• Children aged 5-6 years
• Enrolled in a preschool institution
• Able to understand and follow instructions in Turkish
• No physical, visual, auditory, or cognitive impairment that would prevent participation in the intervention
• Willing to participate in the study
• Written informed consent obtained from parents

Exclusion criteria

• Children aged below 5 or above 6 years
• Children with neurological, visual, auditory, or balance disorders that may interfere with virtual reality use
• Children with orthopedic or motor impairments affecting handwashing ability
• Children who have previously used virtual reality devices
• Children whose parents do not provide consent
• Children who experience discomfort, fear, or adverse reactions during the intervention