An Andragogical Evaluation of Immersive Virtual Reality for Nursing and Midwifery Education: A Descriptive Pilot Mixed-Methods Study in Uganda.

Abstract

Background: Nursing and midwifery education in low‑resource settings often has limited access to simulation facilities and opportunities for repeated practice. This study examined how immersive Virtual Reality (VR) supports learning among healthcare professionals in Uganda. Methods: This pilot mixed‑methods study involved forty healthcare professionals (nurses, midwives, emergency care providers, and instructors). Participants completed a two‑day VR training using four locally developed modules: postpartum hemorrhage (EMOTIVE), cardiopulmonary resuscitation, ABCDE (Airway, Breathing, Circulation, Disability, Exposure) emergency assessment, and eclampsia management. A retrospective pre-post questionnaire assessed perceived knowledge, engagement, relevance, usability, and adoption. Cronbach’s alpha for learning and adoption domains was 0.853 (95% CI 0.776-0.913). Qualitative responses were thematically analyzed to capture participant perspectives. Results: Self‑rated knowledge increased across all groups, with the largest gains among those with less than one year of experience. Engagement (M = 4.88), motivation (M = 4.60), and theory-practice connection (M = 4.42) received consistently high ratings across professional groups. Module use matched professional roles: midwives preferred the EMOTIVE and Eclampsia modules, whereas emergency care providers preferred the ABCDE and Resuscitation modules. Usability challenges included motion discomfort (23/40; 58%), controller use (23/40; 58%), limited practice time (21/40; 53%), and navigation difficulties (20/40; 50%). Despite these, 97.5% of participants supported recommending VR and integrating it into curricula. Qualitative findings reinforced quantitative results, highlighting stronger theory-practice links, active participation, confidence building, and learning through repetition. Conclusion: Immersive VR was feasible and acceptable for continuing professional development in nursing and midwifery education in Uganda. These findings suggest that VR can complement existing training in resource-constrained settings. Recommendation: Future studies should assess long‑term learning outcomes, cost‑effectiveness, and implementation across larger, more diverse cohorts.