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Journals / Hemşirelik Bilimi Dergisi / 2026 / Cilt: 9 Sayı: 2

Effect of Virtual Reality-Based Hand Hygiene Training on Nursing Students’ Knowledge and Behavior: A Quasi-Experimental Study

Sanal Gerçeklik Tabanlı El Hijyeni Eğitiminin Hemşirelik Öğrencilerinin Bilgi ve Davranışları Üzerindeki Etkisi: Yarı Deneysel Bir Çalışma

Gülengül Mermer(IĞDIR ÜNİVERSİTESİ, IĞDIR SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU)0000-0002-9220-6262
Ceren Karaköse(Ege Üniversitesi Hemşirelik Fakültesi)0009-0000-0169-5391
Büşra Gürtekin(EGE UNIVERSITY)0009-0009-9942-5714
Melisa Çelik(EGE UNIVERSITY)0009-0008-9966-3416
Pages
275–291
Publication Date
2026-08-21
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: It was concluded that virtual reality-based hand hygiene education positively influences students’ knowledge, attitudes, beliefs, and practices regarding hand hygiene and may serve as an effective, innovative, and practical educational method that supports the learning process in nursing education.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study aimed to evaluate the effect of virtual reality-based hand hygiene training on nursing students’ knowledge, attitudes, beliefs, and behaviors regarding hand hygiene.
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Key Findings & Data:Method: A quasi-experimental study using a single-group pretest-posttest design was conducted with 102 nursing students.
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Conclusion & Impact:Conclusion: It was concluded that virtual reality-based hand hygiene education positively influences students’ knowledge, attitudes, beliefs, and practices regarding hand hygiene and may serve as an effective, innovative, and practical educational method that supports the learning process in nursing education.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:El Hijyeni · Hemşirelik Eğitimi · Hemşirelik Öğrencileri

Abstract

Objective: This study aimed to evaluate the effect of virtual reality-based hand hygiene training on nursing students’ knowledge, attitudes, beliefs, and behaviors regarding hand hygiene. Method: A quasi-experimental study using a single-group pretest-posttest design was conducted with 102 nursing students. Data were collected using the Demographic Information Form, the Social Handwashing Knowledge Scale, the Social Handwashing Attitude Scale, the Hand Hygiene Belief Scale, and the Hand Hygiene Practice Inventory. The Cronbach’s alpha coefficients of the scales were found to be at an acceptable level of reliability. Students received training via virtual reality devices using the “Tork VR Clean Hands Training” application, which included interactive scenarios and educational videos covering routine and clinical hand hygiene practices. Results: Statistically significant differences were found between the pre-test and post-test scores on the Social Handwashing Attitude Scale, the Hand Hygiene Practice Inventory, the Hand Hygiene Belief Scale, and the “importance of hand hygiene” subscale (p<0.05). Strong, positive correlations were identified between the pretest scores of the Social Handwashing Attitude Scale and the Hand Hygiene Practice Inventory, as well as between the Hand Hygiene Belief Scale and its subdimensional score (p<0.001). Conclusion: It was concluded that virtual reality-based hand hygiene education positively influences students’ knowledge, attitudes, beliefs, and practices regarding hand hygiene and may serve as an effective, innovative, and practical educational method that supports the learning process in nursing education. The findings support the use of virtual reality in hand hygiene education.

Özet

Amaç: Bu çalışma, sanal gerçeklik temelli el hijyeni eğitiminin hemşirelik öğrencilerinin el hijyenine ilişkin bilgi, tutum, inanç ve davranışları üzerindeki etkisini değerlendirmeyi amaçlamıştır. Yöntem: Tek grup ön test-son test tasarımlı yarı deneysel çalışma, 102 hemşirelik öğrencisiyle yürütülmüştür. Veriler; Tanımlayıcı Bilgi Formu, Sosyal El Yıkama Bilgi Ölçeği, Sosyal El Yıkama Tutum Ölçeği, El Hijyeni İnanç Ölçeği ve El Hijyeni Uygulama Envanteri ile toplanmıştır. Ölçeklerin Cronbach alfa katsayılarının kabul edilebilir güvenirlik düzeyinde olduğu belirlenmiştir. Öğrencilere, rutin ve klinik el hijyeni uygulamalarını kapsayan etkileşimli senaryolar ve eğitici videolar içeren “Tork VR Clean Hands Training” uygulaması kullanılarak sanal gerçeklik cihazları aracılığıyla eğitim verilmiştir. Bulgular: Sosyal El Yıkama Tutum Ölçeği, El Hijyeni Uygulama Envanteri, El Hijyeni İnanç Ölçeği ve “el hijyeninin önemi” alt boyutunun ön test-son test puanları arasında istatistiksel olarak anlamlı farklılıklar bulunmuştur (p<0,05). Sosyal El Yıkama Tutum Ölçeği ile El Hijyeni Uygulama Envanteri ön test puanları arasında ve El Hijyeni İnanç Ölçeği ile alt boyutu arasında güçlü, pozitif korelasyonlar belirlenmiştir (p<0,001). Sonuç: Sanal gerçeklik temelli el hijyeni eğitiminin öğrencilerin el hijyenine ilişkin bilgi, tutum, inanç ve uygulamalarını olumlu etkilediği ve hemşirelik eğitiminde öğrenme sürecini destekleyen etkili, yenilikçi ve uygulanabilir bir eğitim yöntemi olabileceği sonucuna ulaşılmıştır. Bulgular, sanal gerçekliğin el hijyeni eğitiminde kullanımını desteklemektedir.

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Cite This Article

Mermer, G., Karaköse, C., Gürtekin, B., Çelik, M. (2026). Effect of Virtual Reality-Based Hand Hygiene Training on Nursing Students’ Knowledge and Behavior: A Quasi-Experimental Study. Hemşirelik Bilimi Dergisi, Cilt: 9 Sayı: 2, 275–291. https://doi.org/10.54189/hbd.1808499

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References (50)

  1. Abate HK, Salih MH. (2024). Knowledge and practice about hand hygiene among medical and health sciences students in a clinical setting during the COVID-19 pandemic. International Journal of Africa Nursing Sciences, 100685. doi:10.1016/j.ijans.2024.100685
  2. Aygin D, Yılmaz AÇ. (2022). The effect of technology in nursing education and current applications. Izmir Democracy University Health Sciences Journal, 5(1), 32-46. doi:10.52538/iduhes.1012220
  3. Bakare, O. G., & Bayraktar, N. (2025). Nurses’ hand hygiene beliefs and practices: A cross-sectional study. Global Nursing Insights, 12(2), 141-147. https://doi.org/10.31125/globnursinsights.1744010
  4. Bayram Ş, Çalışkan N, Gülnar E, Aydın M. (2019). The effect of planned education on hand-washing beliefs and practices of nursing students. Gazi Journal of Health Sciences, 4(2), 20-30.
  5. Bodur G, Turhan Z, Kucukkaya A, Goktas P. (2024). Assessing the virtual reality perspectives and self-directed learning skills of nursing students: A machine learning-enhanced approach. Nurse Education in Practice, 75, 103881. doi:10.1016/j.nepr.2024.103881
  6. Bryant R, Miller CL, Henderson D. (2015). Virtual clinical simulations in an online advanced health appraisal course. Clinical Simulation in Nursing, 11(10), 437-444. doi:10.1016/j.ecns.2015.08.002
  7. Centers for Disease Control and Prevention (CDC). (2021). Hand hygiene in healthcare settings-healthcare providers. (Erişim tarihi: 22 Aralık 2024). https://www.cdc.gov/handhygiene/providers/index.html.
  8. Chang CY, Sung HY, Guo JL, Chang BY, Kuo FR. (2022). Effects of spherical video-based virtual reality on nursing students’ learning performance in childbirth education training. Interactive Learning Environments, 30(3), 400-416. doi:10.1080/10494820.2019.1661854
  9. Chen FQ, Leng YF, Ge JF, Wang DW, Li C, Chen B, et al. (2020). Effectiveness of virtual reality in nursing education: Meta-analysis. Journal of Medical Internet Research, 22(9), e18290. doi:10.2196/18290
  10. Choi DH, Noh GY. (2020). The effect of presence in virtual reality video on handwashing intention. Asian Journal of Communication, 30(3-4), 261-278. doi:10.1080/01292986.2020.1781218
  11. Clack L, Hirt C, Kunz A, Sax H. (2021). Experiential training of hand hygiene using virtual reality. In Recent advances in technology for inclusive well-being (ss. 31-42). Springer. doi:10.1007/978-3-030-59608-8_3
  12. Demiray EKD, Alkan S, Akyüz HÖ, Demirci H. (2022). Evaluation of hand hygiene knowledge and compliance among nursing students. Medical Research Reports, 5(2), 68-76. doi:10.55517/mrr.1125453
  13. Efendi D, Apriliyasari RW, Massie JGEP, Wong CL, Natalia R, Utomo B, et al. (2023). The effect of virtual reality on cognitive, affective, and psychomotor outcomes in nursing staffs. BMC Nursing, 22(1), 170. doi:10.1186/s12912-023-01312-x
  14. Eichel VM, Brandt C, Brandt J, Jabs JM, Mutters NT. (2022). Is virtual reality suitable for hand hygiene training in health care workers? Evaluating an application for acceptability and effectiveness. Antimicrobial Resistance & Infection Control, 11(1), 91. doi:10.1186/s13756-022-01127-6
  15. Farra SL, Smith S, Gillespie GL, Nicely S, Ulrich DL, Hodgson E. (2015). Decontamination training: With and without virtual reality simulation. Advanced Emergency Nursing Journal, 37(2), 125-133. doi:10.1097/TME.0000000000000059
  16. Fernandes DR, Santos BND, Guimarães CS, Ferreira EB, Margatho AS, Reis PEDD, et al. (2024). Educational technologies for teaching hand hygiene: Systematic review. PLOS ONE, 19(1), e0294725. doi:10.1371/journal.pone.0294725
  17. Foronda CL, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. (2020). Virtual simulation in nursing education: A systematic review spanning 1996 to 2018. Simulation in Healthcare, 15(1), 46-54. doi:10.1097/SIH.0000000000000411
  18. Gasteiger N, van der Veer SN, Wilson P, Dowding D. (2024). Virtual reality and augmented reality smartphone applications for upskilling care home workers in hand hygiene. Journal of the American Medical Informatics Association, 31(1), 45-60. doi:10.1093/jamia/ocad200
  19. Hagiya H, Tanaka S, Otsuka Y, Otsuka F. (2024). Development of virtual reality educational clips for improving hand hygiene compliance among healthcare providers. Teaching and Learning in Nursing, 19(1), e17-e20. doi:10.1016/j.teln.2023.08.004
  20. Jeong Y, Lee H, Han JW. (2022). Development and evaluation of virtual reality simulation education based on coronavirus disease 2019 scenario for nursing students. Nursing Open, 9(2), 1066-1076. doi:10.1002/nop2.1145
  21. Jung AR, Park EA. (2022). The effectiveness of learning to use HMD-based VR technologies on nursing students. International Journal of Environmental Research and Public Health, 19(8), 4823. doi:10.3390/ijerph19084823
  22. Kanazawa A, Asai T, Minazuki A, Hayashi H. (2014). Construction of a MR space using projection mapping to promote hand hygiene. 2014 IIAI 3rd International Conference on Advanced Applied Informatics, 247-252. doi:10.1109/IIAI-AAI.2014.59
  23. Kang KA, Kim SJ, Lee MN, Kim M, Kim S. (2020). Comparison of learning effects of virtual reality simulation on nursing students caring for children with asthma. International Journal of Environmental Research and Public Health, 17(22), 8417. doi:10.3390/ijerph17228417
  24. Karadağ M, Yıldırım N, İşeri ÖP. (2016). The validity and reliability study of Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory. Cukurova Medical Journal, 41(2), 271-284. doi:10.17826/cutf.206317
  25. Kayar AN, Daloğlu M, Şenol Y. (2020). Diş hekimliği bozukluklarının el hijyeni durumları ve özellikleri. Selçuk Dent J., 7(3), 488-93. doi:10.15311/selcukdentj.698732
  26. Kim SK, Lee Y, Yoon H, Choi J. (2021). Adaptation of extended reality smart glasses for core nursing skill training among undergraduate nursing students. Journal of Medical Internet Research, 23(3), e24313. doi:10.2196/24313
  27. Liu K, Zhang W, Li W, Wang T, Zheng Y. (2023). Effectiveness of virtual reality in nursing education: A systematic review and meta-analysis. BMC Medical Education, 23(1), 710. doi:10.1186/s12909-023-04662-x
  28. Ma J, Wang Y, Joshi S, Wang H, Young C, Pervez A, et al. (2024). Using immersive virtual reality technology to enhance nursing education. Applied Ergonomics, 115, 104159. doi:10.1016/j.apergo.2023.104159
  29. Mäkinen H, Haavisto E, Havola S, Koivisto JM. (2023). Graduating nursing students’ user experiences of immersive virtual reality simulation in learning. Nursing Open, 10(5), 3210-3219. doi:10.1002/nop2.1571
  30. Martos-Cabrera MB, Mota-Romero E, Martos-García R, Gómez-Urquiza JL, Suleiman-Martos N, Albendín-García L, et al. (2019). Hand hygiene teaching strategies among nursing staff: A systematic review. International Journal of Environmental Research and Public Health, 16(17), 3039. doi:10.3390/ijerph16173039
  31. Ordu Y, Çalışkan N. (2023). The effects of virtual gaming simulation on nursing students’ diagnosis, goal setting, and diagnosis prioritization. Nurse Education in Practice, 68, 103593. doi:10.1016/j.nepr.2023.103593
  32. Padilha JM, Machado PP, Ribeiro A, Ramos J, Costa P. (2019). Clinical virtual simulation in nursing education: Randomized controlled trial. Journal of Medical Internet Research, 21(3), e11529. doi:10.2196/11529
  33. Parsons TD, Gaggioli A, Riva G. (2017). Virtual reality for research in social neuroscience. Brain Sciences, 7(4), 42. doi:10.3390/brainsci7040042
  34. Peden RG, Mercer R, Tatham AJ. (2016). The use of head-mounted display eyeglasses for teaching surgical skills. International Journal of Surgery, 34, 169-173. doi:10.1016/j.ijsu.2016.09.002
  35. Plotzky C, Lindwedel U, Sorber M, Loessl B, König P, Kunze C, et al. (2021). Virtual reality simulations in nurse education: A systematic mapping review. Nurse Education Today, 101, 104868. doi:10.1016/j.nedt.2021.104868
  36. Plotzky C, Loessl B, Kuhnert B, Friedrich N, Kugler C, König P, et al. (2023). My hands are running away–learning a complex nursing skill via virtual reality simulation. BMC Nursing, 22(1), 222. doi:10.1186/s12912-023-01384-9
  37. Saab MM, Hegarty J, Murphy D, Landers M. (2021). Incorporating virtual reality in nurse education: A qualitative study of nursing students’ perspectives. Nurse Education Today, 105, 105045. doi:10.1016/j.nedt.2021.105045
  38. Samadbeik M, Yaaghobi D, Bastani P, Abhari S, Rezaee R, Garavand A. (2018). The applications of virtual reality technology in medical group teaching. Journal of Advances in Medical Education and Professionalism, 6(3), 123-129.
  39. Sen S, Usta E, Bozdemir H. (2022). The effect of mobile virtual reality on operating room nursing education. Teaching and Learning in Nursing, 17(2), 199-202. doi:10.1016/j.teln.2022.01.008
  40. Shimada S, Funahashi K, Ito K, Tanase Y, Iwazaki K. (2017). VR hand hygiene training system that visualizes germs to be washed and removed. 2017 IEEE 6th Global Conference on Consumer Electronics, 1-4. doi:10.1109/GCCE.2017.8229333
  41. Shorey S, Ng ED. (2021). The use of virtual reality simulation among nursing students and registered nurses: A systematic review. Nurse Education Today, 98, 104662. doi:10.1016/j.nedt.2020.104662
  42. Şensoy E. (2021). Hemşirelik öğrencilerinin el hijyeni ve eldiven kullanma alışkanlıklarının belirlenmesi. Lokman Hekim Dergisi, 11(2), 353-363. doi:10.31020/mutftd.876950
  43. Tomczyk S, Twyman A, de Kraker ME, Rehse APC, Tartari E, Toledo JP, et al. (2022). The first WHO global survey on infection prevention and control in health-care facilities. The Lancet Infectious Diseases, 22(6), 845-856. doi:10.1016/S1473-3099(21)00809-4
  44. Tsai SL, Chai SK, Hsieh LF, Lin S, Taur FM, Sung WH, et al. (2008). The use of virtual reality computer simulation in learning Port-A cath injection. Advances in Health Sciences Education, 13, 71-87. doi:10.1007/s10459-006-9025-3
  45. Ulupınar F, Toygar ŞA. (2020). The use of technology in nursing education and sample practices. Fiscaoeconomia, 4(2), 524-537. doi:10.25295/fsecon.2020.02.013
  46. Üner S, Sevencan F, Başaran E, Balcı C, Bilaloğlu B. (2009). Bir sağlık ocağına başvuran bireylerin sosyal el yıkama ile ilgili bazı bilgi ve tutumlarının saptanması. TAF Preventive Medicine Bulletin, 8(3), 207-216.
  47. Van de Mortel T. (2009). Development of a questionnaire to assess healthcare students’ hand hygiene knowledge, beliefs and practices. Australian Journal of Advanced Nursing, 26(3), 9-16.
  48. Woon APN, Mok WQ, Chieng YJS, Zhang HM, Ramos P, Mustadi HB, et al. (2021). Effectiveness of virtual reality training in improving knowledge among nursing students. Nurse Education Today, 98, 104655. doi:10.1016/j.nedt.2020.104655
  49. World Health Organization (WHO). (2009). WHO guidelines on hand hygiene in health care: First global patient safety challenge clean care is safer care. (Erişim tarihi: 10 Aralık 2024). World Health Organization. https://www.who.int/publications/i/item/9789241597906.
  50. World Health Organization (WHO). (2022). Global report on infection prevention and control. (Erişim tarihi: 8 Şubat 2025), World Health Organization. https://www.who.int/publications/i/item/9789240051164.