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Effects of a hybrid delirium nursing competency enhancement program using the metaverse and standardized patients for intensive care unit nurses: a quasi-experimental study
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Juwon Yun, Miyang Jeon
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Received February 4, 2026 Accepted June 4, 2026 Published online June 29, 2026
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DOI: https://doi.org/10.4040/jkan.26013
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 Abstract
 ePub
- Purpose
This study evaluated the effects of a hybrid simulation program using the metaverse and standardized patients to enhance delirium nursing competency among intensive care unit (ICU) nurses. Outcomes included delirium nursing knowledge, attitudes, and performance confidence.
Methods
A quasi-experimental study with cluster allocation was conducted among 52 ICU nurses, including 28 in the experimental group and 24 in the control group. Data were collected from July 8 to August 28, 2024. The experimental group participated in a hybrid delirium nursing competency simulation program comprising two metaverse-based sessions (lectures, quizzes, discussions, and practice) followed by a face-to-face standardized patient simulation session. The control group received a conventional face-to-face lecture on delirium nursing. Data were analyzed using the chi-square test, the Fisher exact test, the independent t-test, and the paired t-test with IBM SPSS Statistics ver. 27.0.
Results
After the intervention, the experimental group demonstrated significantly greater improvement in delirium nursing attitude (t=2.05, p=.046) and performance confidence (t=3.35, p=.002) compared with the control group. However, the change in delirium nursing knowledge did not differ significantly between groups (t=0.71, p=.483).
Conclusion
The hybrid delirium nursing competency program using the metaverse and standardized patients was associated with greater positive changes in ICU nurses’ delirium nursing attitudes and performance confidence than conventional lecture-based education. This immersive and interactive hybrid simulation approach may be a sustainable continuing education strategy for strengthening delirium nursing competency among ICU nurses.
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