Introduced an AI–VR escape room for disaster nursing and midwifery training.

Applied a quasi-experimental design with 247 survey and 25 interview participants.

Training significantly improved acceptance, skills, and confidence in disaster response.

Findings highlight AI–VR’s feasibility as a low-cost, immersive nursing education tool.

This study aims to assess the acceptance of a VR-based disaster emergency nursing escape room teaching method among nurses and midwives and to explore the main factors influencing their acceptance. Background: The increasing frequency of natural disasters due to global climate change poses a significant threat to human health. Effective training for nurses and midwives is critical as they are frontline responders in disaster relief. Design: A quasi-experimental pretest-posttest design was used with a non-random sample to assess changes in acceptance and identify influencing factors. The study followed the TREND guidelines. Methods: Questionnaires (n = 281) were distributed across four types of medical centers in China (obstetrics, public health, pediatrics, orthopedics) using targeted sampling. After analyzing valid responses (n = 247), participants with scores below the average (3.67) were selected (n = 160) for in-depth interviews. Data were analyzed using NVivo 11.0. A novel quasi-experimental project was developed that pioneered the integration of AI-driven narrative design (ChatGPT) and immersive VR production tools (Insta360 X3, Blender, After Effects) to create a disaster-themed escape room, deployed via an interactive online platform (Bilibili).Following the intervention, participants completed the System Usability Scale (SUS) and a post-intervention acceptance questionnaire. Results: The intervention significantly increased participants' acceptance, with scores rising from 3.24 to 4.29, highlighting both its educational value and its feasibility for real-world training integration. Conclusion: The AI+VR-based escape room teaching method enhances disaster response capabilities and offers a new direction for nursing education. Further optimization of content and technical support will improve practical application.

Virtual reality (VR)

Artificial intelligence (AI)

Disaster emergency

Escape room teaching method

Acceptance

Quasi-experimental study

© 2025 The Authors. Published by Elsevier Ltd.