Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review

Abstract BackgroundMidwifery students often experience anxiety due to several factors, such as the clinical experiences faced. Simulation-based learning in nursing and midwifery studies using extended reality (XR) tools offers the opportunity to manage better educational proce...

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Main Authors: Clara Pérez de los Cobos Cintas, Nicolas Vuillerme, Guillaume Thomann, Lionel Di Marco
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:JMIR Nursing
Online Access:https://nursing.jmir.org/2025/1/e68984
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author Clara Pérez de los Cobos Cintas
Nicolas Vuillerme
Guillaume Thomann
Lionel Di Marco
author_facet Clara Pérez de los Cobos Cintas
Nicolas Vuillerme
Guillaume Thomann
Lionel Di Marco
author_sort Clara Pérez de los Cobos Cintas
collection DOAJ
description Abstract BackgroundMidwifery students often experience anxiety due to several factors, such as the clinical experiences faced. Simulation-based learning in nursing and midwifery studies using extended reality (XR) tools offers the opportunity to manage better educational processes while reducing this anxiety. ObjectiveThis study aims to evaluate the current knowledge and understanding of how the use of XR gesture-simulation-based tools allows a better understanding of the anxiety levels of midwives and nurses in educational settings. MethodsWe conducted a systematic review, a scientific literature search following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using PubMed, IEEE, Scopus, and Web of Science, up to March 2024, 1005 articles were found to identify studies that reported the effectiveness of these technologies for gesture simulation in education and training on nursing and midwifery student anxiety. The inclusion-exclusion criteria were based on the PICO (population, intervention, control, and outcomes) framework. The population included nurses, midwives, and nursing and midwifery students of any kind using any virtual or augmented or mixed reality simulation training tool to perform a procedure aimed at reducing anxiety. In addition, the Cochrane risk of bias tool was used to evaluate the quality of the systematic review and the bias in the included studies. A narrative synthesis was conducted due to the heterogeneity of study designs and outcome measures. Key findings were summarized in a structured table and grouped according to the learning objective, simulating and performing procedures in an educational setting. ResultsOverall, 7 articles, involving a total of 428 participants, were included in this review. The findings indicate that XR can effectively reduce anxiety in midwifery and nursing education. However, the limited number of studies highlights a research gap in the field, particularly in the area of mixed reality, which warrants further exploration. ConclusionsThis systematic review highlights the potential of XR-based gesture-simulation tools in reducing anxiety among midwifery and nursing students. The included studies suggest that XR-enhanced training provides a more immersive and controlled learning environment, helping students manage stress and improve procedural confidence. However, the limited number of studies, methodological variations, and the underrepresentation of mixed reality applications indicate the need for further research. Future studies should focus on standardized anxiety measurement tools, larger sample sizes, and long-term impact assessments to strengthen the evidence base. Expanding research in this field could enhance the integration of XR technologies into midwifery and nursing education, ultimately improving both learning experiences and clinical preparedness.
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spelling doaj-art-04ee64d5530f463e9f9e26cf2d70b2ad2025-08-20T03:30:32ZengJMIR PublicationsJMIR Nursing2562-76002025-06-018e68984e6898410.2196/68984Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic ReviewClara Pérez de los Cobos Cintashttp://orcid.org/0009-0009-3887-0064Nicolas Vuillermehttp://orcid.org/0000-0003-3773-393XGuillaume Thomannhttp://orcid.org/0000-0001-7676-6262Lionel Di Marcohttp://orcid.org/0000-0002-5666-5517 Abstract BackgroundMidwifery students often experience anxiety due to several factors, such as the clinical experiences faced. Simulation-based learning in nursing and midwifery studies using extended reality (XR) tools offers the opportunity to manage better educational processes while reducing this anxiety. ObjectiveThis study aims to evaluate the current knowledge and understanding of how the use of XR gesture-simulation-based tools allows a better understanding of the anxiety levels of midwives and nurses in educational settings. MethodsWe conducted a systematic review, a scientific literature search following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using PubMed, IEEE, Scopus, and Web of Science, up to March 2024, 1005 articles were found to identify studies that reported the effectiveness of these technologies for gesture simulation in education and training on nursing and midwifery student anxiety. The inclusion-exclusion criteria were based on the PICO (population, intervention, control, and outcomes) framework. The population included nurses, midwives, and nursing and midwifery students of any kind using any virtual or augmented or mixed reality simulation training tool to perform a procedure aimed at reducing anxiety. In addition, the Cochrane risk of bias tool was used to evaluate the quality of the systematic review and the bias in the included studies. A narrative synthesis was conducted due to the heterogeneity of study designs and outcome measures. Key findings were summarized in a structured table and grouped according to the learning objective, simulating and performing procedures in an educational setting. ResultsOverall, 7 articles, involving a total of 428 participants, were included in this review. The findings indicate that XR can effectively reduce anxiety in midwifery and nursing education. However, the limited number of studies highlights a research gap in the field, particularly in the area of mixed reality, which warrants further exploration. ConclusionsThis systematic review highlights the potential of XR-based gesture-simulation tools in reducing anxiety among midwifery and nursing students. The included studies suggest that XR-enhanced training provides a more immersive and controlled learning environment, helping students manage stress and improve procedural confidence. However, the limited number of studies, methodological variations, and the underrepresentation of mixed reality applications indicate the need for further research. Future studies should focus on standardized anxiety measurement tools, larger sample sizes, and long-term impact assessments to strengthen the evidence base. Expanding research in this field could enhance the integration of XR technologies into midwifery and nursing education, ultimately improving both learning experiences and clinical preparedness.https://nursing.jmir.org/2025/1/e68984
spellingShingle Clara Pérez de los Cobos Cintas
Nicolas Vuillerme
Guillaume Thomann
Lionel Di Marco
Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
JMIR Nursing
title Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
title_full Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
title_fullStr Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
title_full_unstemmed Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
title_short Effect of an Extended Reality Simulation Intervention on Midwifery Students’ Anxiety: Systematic Review
title_sort effect of an extended reality simulation intervention on midwifery students anxiety systematic review
url https://nursing.jmir.org/2025/1/e68984
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