VR Learning Program for Sexual-and-gender-diversity Care

The Caring Behaviors Scale (CBS) with Chinese version, with 27 items, was used to measure students' caring behaviors. The three domains of the scale are patient advocacy, knowing the patient, and helping the patient through the illness trajectory. The CBS is a four-point Likert scale to measure the frequency of caring behavior. The range of total scores was between 0 and 81. Higher scores indicate a greater frequency of caring behaviors.

Empathy was measured using the Chinese version of the Jefferson Scale of Empathy- Healthcare Providers (JSE-HP), developed based on a literature review. The components of the scale included perspective-taking, compassionate care, and standing in the patient's shoes. The JSE-HP is a 7-point Likert scale, with a score of 1 indicating strong disagreement and 7 indicating strong agreement. Ten of the 20 questions were negative, and 10 were positive, with a total score of 20-140, with higher scores indicating more positive empathy.

The Nursing Student Competence Scale (NSCS) with Chinese version was used to measure students' nursing competence. The NSCS with 30 items includes six dimensions: medical-related knowledge (5 itesm), basic nursing skills (5 itesm), communication and cooperation (5 itesm), lifelong learning (5 itesm), global vision (5 itesm), and critical thinking (5 itesm). The responses to each item were based on a 5-point Likert scale, with a score of 1 indicating strong disagreement and 5 indicating strong agreement. A higher scale score meant a greater nursing ability. The range of total scores was between 5 and 150.