Virtual reality (VR) is often described as immersive, innovative, and exciting. While all of those things may be true, the real question for simulation educators is much more important: Does VR meaningfully support learning?
In our early work incorporating VR into simulation-based education, the answer from students was overwhelmingly positive. Learners described the VR environment as engaging, realistic, and helpful for building confidence before entering the simulation lab or clinical environment. For many students, VR offered something traditional preparation could not always provide: a safe, repeatable space to practice decision-making, recognize patterns, and work through clinical actions without fear of harming a patient or “getting it wrong” in front of others.
One of the most meaningful observations was how strongly VR supported our kinesthetic learners. These students did not simply want to read about a process or watch someone else perform it. They needed to move through the experience, make decisions, interact with equipment, repeat actions, and connect cognitive knowledge with physical workflow. VR gave them that opportunity. It allowed them to rehearse the “doing” of anesthesia care before they were expected to perform in the simulation lab.
But one of our most interesting findings challenged an assumption many of us may have about immersive learning: more time in VR did not necessarily translate into better performance in the simulation lab.
Students who spent several hours in the virtual environment were not always the highest performers. Instead, students who completed more VR modules, and often repeated modules with intentionality, demonstrated stronger progression. In other words, it was not simply time in the headset that mattered. It was the structure, repetition, and completion of purposeful learning activities.
That distinction is important.
As educators, we sometimes equate time-on-task with learning. VR reminds us that time alone is not enough. A learner can spend hours in an immersive environment without making meaningful progress if that time is passive, unfocused, or disconnected from clear objectives. However, when VR is intentionally aligned with simulation outcomes, structured around deliberate practice, and used to support repetition, it can become a powerful bridge between classroom knowledge and simulation performance.
This has changed how we think about VR integration. The headset is not the intervention. The learning design is.
When VR is used well, it can create opportunities for students to practice clinical reasoning, repeat challenging workflows, build confidence, and enter the simulation lab more prepared to engage. It can also help faculty identify learners who may need additional support earlier in the learning process. Rather than replacing simulation, VR can strengthen the preparation that happens before simulation and extend the learning that happens after it.
For simulation educators, the opportunity is not simply to add VR because it is innovative. The opportunity is to ask how immersive technology can help us design more equitable, flexible, and effective learning experiences. How can VR support the learner who needs repetition? How can it help students who learn best through action? How can it prepare learners for the complexity of clinical practice before they are standing at the bedside?
As VR becomes more accessible in simulation education, the most important question may not be whether we should use it, but how intentionally we are designing it.
Are we using VR as an engaging add-on, or are we building purposeful, repeatable learning experiences that move students closer to confident clinical performance?