Virtual reality simulation (VRS) is a cutting-edge educational approach that offers nursing students immersive and authentic learning experiences beyond what traditional simulation-based education (SBE) with standardized participants can provide. This study examined the impact of four fully immersive VRS scenarios compared to conventional SBE on learning outcomes among vocational and higher education pre-registration nursing students at a Melbourne-based training and further education institute. Using a mixed-methods quasi-experimental design over two academic semesters (2019–2020), 675 students participated, with 393 assigned to the VRS group and 282 to the SBE group. The VRS group demonstrated markedly higher engagement, with 95% of students actively participating compared to an average of 15% in the SBE group. Initial knowledge assessments favored VRS participants (p < 0.01), although these differences were not sustained following clinical placements. Students reported that VRS provided realistic clinical scenarios that enhanced their preparedness for practice, despite some technical limitations. Moreover, VRS proved to be more cost-efficient than SBE. Overall, VRS facilitated critical thinking and offered a scalable, effective platform for teaching complex clinical situations in nursing education.
