Effects of a dementia educational program using virtual reality and a card game among nursing students: A pilot randomized clinical trial

This study aimed to examine the preliminary effects and feasibility of a dementia educational program using virtual reality (VR) and a card game to enhance nursing students’ attitudes toward people living with dementia. A four-arm pilot randomized controlled trial was conducted with undergraduate nursing students during a course at a Japanese university. A total of 108 participants were randomly assigned to one of four groups: VR only, card game only, combined VR and card game, or control. Attitudes were evaluated using the Attitude Toward People with Dementia Scale. Data were analyzed using paired t-tests and analysis of covariance (ANCOVA). Fifty-six students completed all assessments and were included in the final analysis. No adverse events were reported. ANCOVA showed a significant main effect between groups (F = 6.911, p = .001, ηp2 = 0.289). Bonferroni post-hoc tests showed that the VR-only group had a significantly higher mean change in attitude scores than the control group (p = .022, 95% CI: 0.39–7.33) and the card‑game‑only group (p = .003, 95% CI: 1.26–8.26). The combined VR and card game group also showed a significantly greater attitude change than the card‑game‑only group (p = .013, 95% CI: 0.60–7.39). No significant differences were found between the card‑game‑only and control groups. VR-based education effectively improves nursing students’ attitudes toward people living with dementia in pragmatic settings. These findings highlight the potential of immersive VR as a feasible and effective tool for healthcare education.