Can virtual reality plug the gaps in nursing training?

Virtual reality offers great potential to transform nursing education, allowing students to practise clinical skills safely and build confidence, regardless of location or resources. Its long-term success hinges on sustained investment and equitable implementation.

Virtual reality can train nurses anywhere, using nothing more than a US$300-headset and a cell phone hotspot. Photo: UbiSim

In a training room in Pasig City, Philippines, student nurses slip on virtual reality headsets and disappear into virtual hospital wards. They respond to deteriorating patients, administer medications, and manage emergencies, learning skills that might be difficult to master otherwise, not because they are hard to learn but because the equipment is too expensive to practise on or teaching hospitals too overcrowded to accommodate them. The students practise alone or work in teams, monitored by instructors who are either in the room or hundreds of kilometres away.

This is the promise of virtual reality in nursing education: train healthcare workers anywhere, using nothing more than a US$300-headset and a cell phone hotspot—no mannequins, sprawling simulation labs, or complicated infrastructure required.

With a global shortage of 5.8 million nurses and widening disparities in nurse density, the availability of this technology comes at a time when policymakers must expand nursing education rapidly to meet surging demand, but without sufficient teaching hospitals, faculty, or equipment.

The real challenge is whether it can reach the countries that need it most, rather than joining the long list of health innovations that flourish in high-income settings and falter elsewhere.

Virtual reality training for Philippines nurses

Gautier Dubruel is co-founder of UbiSim, a virtual reality simulation platform for nursing education. He says the technology is designed to be accessible, running on consumer-grade headsets and operating over standard mobile hotspots. It follows internationally accepted healthcare simulation standards, including the Healthcare Simulation Standards of Best Practice.

"When you put the headset on, you are at the bedside and your patient is looking at you," explains Dubruel’s colleague Christine Heid, who worked as a nurse educator for 15 years before joining UbiSim. "You can practise, without any risk of harm to a patient, as many times as you need to reach that benchmark. New nurses lack confidence because they haven't seen these situations before."

Virtual reality simulation platform UbiSim is being used to train nurses in the Philippines. It allows them to practise without risk of harm to patients. Photo: UbiSim

After each simulation, students remove their headsets for structured debriefing. "That's where the learning is also happening and being reinforced," Dubruel notes, as students analyse decisions, discuss alternative approaches, and prepare for repeated practice. He says the platform can fulfil up to 50% of clinical nursing training requirements through simulation, with a third of that time spent in immersive virtual reality.

The Philippines has become UbiSim's proving ground for deployment in low- and middle-income countries (LMICs), where limited resources can make it challenging to deliver high-quality, hands-on clinical training at scale.

"In a country like the Philippines, cost remains a major factor in access to quality healthcare education and this technology helps to limit the amount spent on equipment," says Armand del Rosario, president of HCT Academy, one of the Philippines' largest healthcare training providers and a UbiSim partner.

del Rosario adds that Filipino nursing students learn theory and practise basic skills as part of their education but may not get enough opportunities to show they can perform procedures correctly under supervision. “UbiSim helps to address that gap, and it also helps with scalability and standardisation,” he says.

“We are now training Gen Z and Gen Alpha students...We consistently hear from students that they appreciate the realism and autonomy virtual reality provides.”

The technology's effectiveness, del Rosario argues, stems from alignment with how contemporary students process information. "We are now training Gen Z and Gen Alpha students. They do not learn the same way previous generations did. Attention spans are shorter, digital fluency is instinctive, and interactive engagement is expected, not optional," he says. “We consistently hear from students that they appreciate the realism and autonomy virtual reality provides.”

With an estimated 50% of Filipino nurses migrating overseas for higher salaries and better working conditions, del Rosario says the benefits of virtual reality in nursing education are twofold: “Filipino nurses remain highly competitive and respected globally, and those who serve locally bring that same elevated standard into our hospitals and communities."

UbiSim’s model is straightforward: nursing schools and hospitals purchase headsets and license the platform, which includes pre-built scenarios and an editor that allows institutions to customise content for local contexts.

Beyond the Philippines, UbiSim has established a foothold in North America, Europe, Oman and Saudi Arabia and is exploring partnerships in Egypt. Dubruel acknowledges that sub-Saharan Africa, where nursing shortages are especially acute, remains a largely untapped market for the company.

Delivering nurse education in Mongolia

In Mongolia, a specially designed virtual reality platform allows student nurses to practise clinical skills in a fully simulated environment. By 2021, Covid-19 had effectively closed the country’s borders to international partnerships with universities and hospitals, mostly in the US, which facilitated training, research, and clinical rotations. Theoretical nursing courses moved online, but clinical training could not be replicated over Zoom.

But Mongolia's challenges ran deeper than the pandemic. The country is experiencing “a nursing shortage severe enough to endanger patient safety and wellbeing”, according to a 2022 paper. There are 42 nurses per 10,000 people, compared to an average of 108 per 10,000 in high-income countries.

Rural regions, vast stretches of the steppe where herders move between remote areas with their livestock, lack adequate hospitals and basic screening systems.

Geography compounds the problem. Mongolia's healthcare system, shaped by decades of Russian influence, remains highly centralised. More than 60% of medical institutions cluster in Ulaanbaatar, the capital, while rural regions, vast stretches of the steppe where herders move between remote areas with their livestock, lack adequate hospitals and basic screening systems.

Traditional simulation equipment offers no solution for training health workers in these regions. High-fidelity mannequins cost too much to buy and more to maintain, requiring technical specialists Mongolia does not have, and endless consumable medical supplies the budget cannot sustain.

Nursing students in Mongolia hone their skills on Medicrew, a virtual reality training programme introduced as part of a collaboration with Korean development agency KOICA. Photo: Newbase Inc.

Dr Oyungoo Badamdorj saw the problem clearly. As dean of the School of Nursing at the Mongolian National University of Medical Sciences, Mongolia's flagship institution for nursing education, she made the case in 2021: conventional training was not working, and Mongolia needed a new approach.

As a result, in 2023, Medicrew, a virtual reality training platform, was introduced at the Mongolian National University of Medical Sciences, the country’s flagship institution for nursing education, as part of a collaboration with the Korea International Cooperation Agency (KOICA).

Localised platform engages student nurses

The platform guides students through three progressive stages. First, they repeatedly practise fundamental nursing skills, including hand positioning, procedural sequences, and technical accuracy, with every movement logged as data. Next, they shift to clinical reasoning, interpreting medical orders and executing interventions. Then they face time pressure and prioritisation, managing multiple patients with evolving conditions that recreate the chaos of real ward work.

Crucially, Medicrew's medical professionals and translators localised the platform’s content into Mongolian, a language with no established virtual reality medical terminology, and customised it for the local culture.

"From the initial design stage, Medicrew incorporated Asian patient avatars, reflecting Asian body types, skin tones, facial features, and behavioural expressions," explains Momo Mo Hyo-jung, chief strategy officer at Newbase Inc., the Korean company that developed Medicrew.

“The scenarios...reflect Asian healthcare culture, including family-centred communication and caregiver presence, and are based on diseases and clinical situations frequently encountered in Asian medical settings.”

"The scenarios also reflect Asian healthcare culture, including family-centred communication and caregiver presence, and are based on diseases and clinical situations frequently encountered in Asian medical settings. As a result, learners practise in an environment that closely resembles their future workplace rather than a foreign clinical context," he adds.

Badamdorj believes the training platform has improved the standard of nurse education. "Our university is now recognised as an institution that embraces new technology and leads innovation in education," she says.

Tuyatsatsral Lkhagvasuren, a lecturer in the midwifery and maternal child nursing department at the Mongolian National University of Medical Sciences, where she has taught for 15 years, says virtual reality has enhanced her teaching because it makes it easier to deliver consistent, standardised training. "Before virtual reality training entered our school, we used to train our students with traditional teaching methods, such as using a mannequin in a clinical skills centre and assessing their skills."

Students can repeatedly diagnose and treat virtual patients without consuming supplies or risking real harm. The platform automatically records all learner actions, procedural sequences, time spent, errors, and clinical decision flows, generating objective, data-driven feedback for educators. In large class settings, where personalised attention from overstretched faculty can be rare, this automated assessment becomes invaluable.

Lkhagvasuren says the impact on teaching has been immediate. "With the introduction of virtual reality training, we see that students are more likely to perform tasks independently; their attitude towards the lessons has changed and they are more engaged," she notes.

Looking ahead, Lkhagvasuren highlights the importance of balancing technology with traditional training and the need to promote “the basic attitudes of a nurse, such as loving, respecting, and empathising with the patient, which are acquired through bedside training”.

Towards sustained faculty transformation

The real test of any educational technology pilot is not maintaining initial enthusiasm, but what happens over the long term. The collaboration between Medicrew and the Mongolian National University of Medical Sciences lasted two years, though the relationship continues informally. Both parties agree that Mongolia's experience represents genuine success.

Medicrew has been used since September 2023, and the platform has expanded from undergraduate nursing education into master's degree programmes, with the university now leveraging it as part of broader virtual reality dissemination efforts across Mongolia.

Likewise, UbiSim’s rollout demonstrates that student nurses can practise clinical procedures, develop decision-making skills, and build confidence through immersive simulation in settings with modest infrastructure.

Both virtual reality platforms emphasise wireless systems, intuitive interfaces, and designs that require minimal training and maintenance. The technology clearly works, but reaching the countries that need these solutions most remains a challenge.

UbiSim's commercial model prioritises markets that generate revenue to sustain product development. The company adjusts pricing by region and has shown the technology is effective on basic infrastructure, but business imperatives still determine access. Deployment in African countries, for example, remains dependent on overcoming complex procurement systems and establishing local partnerships in markets that may not generate immediate returns.

"You will always need educators," Dubruel says, pushing back against concerns that virtual reality displaces jobs. "You're just getting more people, at lower cost, through training opportunities. Virtual reality increases the capacity of the entire team; it doesn't replace anyone."

Medicrew's development-driven deployment demonstrates what systematic, well-funded adaptation can achieve, but raises questions about scalability. The project succeeded because KOICA, the Korean development agency, provided sustained support for localisation, faculty training, and institutional integration.

The real test of virtual reality nursing education pilots is not maintaining initial enthusiasm, but what happens over the long term in low- and middle-income countries. Photo: UbiSim

The fundamental question remains: can virtual reality break free from the pattern that afflicts so many health innovations that work brilliantly in high-income settings while remaining perpetually "in pilot" where the need is greatest? There is a risk that nursing education may join the long list of global health challenges where technology exists to solve the problem, but the economics of deployment mean it never reaches those who need it most.

For now, the answer depends less on headsets and software than on whether commercial incentives can align with development priorities—and if international health institutions can move beyond short-term projects toward sustained investment in educational infrastructure.