What question did this study set out to answer?

This trial aims to assess whether virtual reality training enhances hand-disinfection performance compared to conventional video instruction.

June 8, 2026Open Access

Effect of a short virtual reality training on first-attempt hand-disinfection performance in an OSCE: a randomized controlled trial

BRBenjamin RoszipalSt. Pölten University of Applied Sciences MEMartin ErnstSt. Pölten University of Applied Sciences AHAlexander HoffelnerMedical University of Vienna

Key Points

This trial aims to assess whether virtual reality training enhances hand-disinfection performance compared to conventional video instruction.
Randomized controlled trial with 2025 first-year nursing students
Participants received either VR training with feedback or a non-interactive instructional video
Performance was evaluated through an Objective Structured Clinical Examination across five stations.
VR training group showed significantly better performance at station 1 with an adjusted OR of 6.06 (95% CI [1.84, 19.92])
Exploratory analysis indicated improved performance across all OSCE stations for the VR group
No adverse events were reported during the trial.

Abstract

BACKGROUND: Reliable hygienic hand-disinfection is essential for infection prevention and control. It remains unclear whether a short VR training module improves objectively assessed procedural performance compared with conventional instruction. This single-center, parallel-group randomized controlled trial examined first-opportunity hand-disinfection performance in an Objective Structured Clinical Examination (OSCE) after VR training versus a video control. METHODS: In 2025, first-year nursing students at a single Austrian University of Applied Sciences were randomized (1:1) to a 20-minute VR training module with contamination visualization feedback or a time- and headset-matched instructional video control without interactivity. Randomization used block allocation (blocks of six); instructions were standardized via audio playback. Three days later, students completed a routine five-station OSCE. Hygienic hand-disinfection was required at the beginning of each of five OSCE stations and was documented within routine station checklists. Hand-disinfection ratings from the five stations were extracted from routine OSCE checklists and coded (0 = incorrect, 1 = partially correct, 2 = correct). The preregistered primary endpoint was station 1 performance. The primary hypothesis was tested with adjusted proportional-odds regression, adjusting for age, gender, and prior hygiene-course grade as a baseline indicator of hygiene-related academic performance; all other analyses were exploratory. RESULTS: ), supported by a binary pass/fail sensitivity analysis (adjusted OR = 6.06, 95% CI 1.84, 19.92). Exploratory analyses suggested higher performance across stations, with group differences varying by station. No harms or adverse events were observed during the trial. CONCLUSION: A short VR training module for hand-disinfection with contamination visualization was associated with better first-opportunity OSCE hand-disinfection performance compared with a headset-delivered instructional video control. This suggests that short, feedback-rich VR training may support immediate procedural readiness under standardized assessment conditions. TRIAL REGISTRATION: This study was preregistered within a larger longitudinal project and later registered as a stand-alone study in the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/3B6SC). CLINICAL TRIAL NUMBER: Not applicable.

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