Additional Details Study Design: This randomized controlled trial employed a pre-test and post-test model. Data for the intervention group were collected at baseline (T1) and immediately after the virtual reality intervention (T2). Similar data collection timings were applied to the control group.
Sample and Inclusion Criteria:
Study population consisted of 260 third-year nursing students enrolled in a communication course during the Fall Semester of the 2024-2025 academic year at a nursing faculty in western Turkey.
Inclusion criteria
nursing students aged 18 years or older, taking the communication course for the first time, and volunteering to participate.
Exclusion criteria
any health condition preventing the use of VR devices, experience of nausea or vomiting due to VR headset use, and prior participation in training on breaking bad news.
Sample size was calculated as 60 students (30 in the intervention group and 30 in the control group) based on power analysis using G-Power software and previous study parameters.
Assessment Instruments:
Student Descriptive Information Questionnaire Questionnaire on Knowledge of Breaking Bad News (33 items, Likert-type scale, Cronbach's alpha = 0.86, content validity index = 0.82) Questionnaire on Knowledge of Approaching a Crying Patient (19 items, Likert-type scale, Cronbach's alpha = 0.71, content validity index = 0.81)
Intervention Protocol:
The intervention consisted of three sessions: orientation, virtual reality viewing (15 minutes), and debriefing (40 minutes).
The scenario involved delivering a lung cancer diagnosis to a young female patient and approaching a crying patient.
The scenario was structured according to the SPIKES protocol. Virtual reality content was produced using 360° high-resolution videos and audio recordings filmed in real settings.
The development team included oncology and psychiatric nursing specialists as well as researchers experienced in animation and virtual reality.
Control Group: The control group received the standard curriculum course. After the study, control participants were offered the opportunity to voluntarily participate in the virtual reality application.