Virtual reality (VR) means a virtual environment where computer simulation is used to build a virtual world within a three-dimensional space (Passig et al., 2016). Virtual reality provides a high-potential chance for obtaining clinical skills. Learners can have the opportunity to practice in a safe environment and learn from mistakes without harming real patients (Cochrane, 2016; Jong et al., 2018). Users feel they are in the real world of three-dimensional space with a sense of spatial presence so that when the user moves, the computer calculates and returns accurate 3D images to give a realistic context using five kinds of virtual methods (Chang et al., 2019). Thus, students are provided with interactive experiences in alternative reality where they appear to sense, move, act upon and touch simulated objects that seem real (Ghanbarzadeh et al., 2014). The actual perception of the digital world is a first character active learning experience with the power to perform actions or interact with objects in this digital environment (Chen et al., 2020); thus, VR is becoming an effective tool for supplementary teaching (Shin et al., 2019).

VR simulation may bridge the theory to practice gap (Foronda et al., 2016; Kalisch et al., 2015) as students feel they are in real-world situations (Lim and McIvor, 2015). Additionally, it provides students with a safe learning environment capable of providing feedback and self-correction until they reach competency of skills by consistent experiences (Aebersold, 2018). VR simulation permits endless practice of procedures, provides quick feedback to student and faculty members. Furthermore, engagement and presence of VR can provide the opportunity to effectively replicate dangerous or difficult to repeat real-world situations in a virtual environment. Furthermore, VR is not location- or time-bound unlike other learning methods (Chang and Lai., 2021). A systematic review was conducted regarding VR simulation skills training for healthcare education and founds that the body of evidence is limited, and the methodological quality of studies is of “variable quality” (Rourke, 2020).

Traditionally, nurse educators have used teaching methods allowing for hands-on practice to develop proficiency in basic nursing abilities. Hands-on practice is essential, but alternative teaching strategies must be considered and developed to meet new challenges. Factors like client safety, medication errors, inadequate practicum instruction time and raised competition for clinical areas determines that faculty pursue and incorporate technology-motivated simulation strategies (Nagle et al., 2009).

Previous evidence demonstrated that VR adds to high satisfaction for interaction and operational efficiency (Chen et al., 2016). It has been documented that nursing students’ motivation status and satisfaction increased after VR education (Davis, 2015; Sultan et al., 2019). Additionally, VR simulation sessions increased self-confidence among students (Mickiewicz et al., 2021) and enhanced performance in education programs (Government Technology, 2003). Few studies have looked at changes in physiological parameters to comprehend the effect on the human body of VR (Babini et al., 2020).

VR application in nursing education has little research support due to its early nature. This results in a gap in the literature (Jerald, 2016), although researchers have recently begun to consider using VR in nursing and medical education (Vávra et al., 2017). Additionally, there is a lack of studies about VR simulation practices in Mediterranean countries including Jordan. Furthermore, there is little attention given to the effect of VR simulation on physiological measures, reactions and satisfaction of university students internationally and in Mediterranean countries. There is limited research available examining how VR simulation affects nursing students’ physiological measures, in addition to self-efficacy and learning satisfaction. This study aims to provide an accurate, appropriate assessment and a comprehensive picture of the effect of VR on physiological measures and behaviors of students before, during and after implementing VR. Identification of this nontraditional technology could provide the opportunity for educators, especially in nursing fields, to implement a teaching method that provides solutions for the nursing education sector in efforts to improve outcomes and performance. Additionally, it could be essential for health care professionals, educators and policymakers to evaluate the nature of VR simulation in reducing the stress accompanying real practice, and to implement awareness about this computerized technology for students themselves, educators, nurses and the public.