The effect of virtual education on novice nurses’ self-efficacy in managing emergency deliveries: A systematic review

Introduction: Emergency deliveries demand rapid decision-making, technical expertise, and confident judgment. Novice nurses often experience stress and low self-efficacy due to limited exposure to real-life obstetric emergencies. Traditional training may not provide sufficient hands-on experience. Virtual education—including e-learning, simulation-based training, and virtual reality (VR)—offers safe, interactive, and repeatable learning environments that enhance competence and confidence. This review examines the effectiveness of virtual education in improving novice nurses’ self-efficacy during emergency deliveries and identifies essential program elements. Methods: Following PRISMA ۲۰۲۰ guidelines, PubMed, Scopus, ScienceDirect, and CINAHL were searched for studies published between ۲۰۱۵ and ۲۰۲۵. Quantitative, qualitative, and mixed-method studies evaluating virtual or simulation-based interventions aimed at improving confidence or performance in obstetric emergencies were included. Data on design, sample, intervention type, and outcomes were extracted, and methodological quality was assessed using JBI Critical Appraisal Tools. Results: Twenty-eight studies (۱۹ quantitative, ۵ mixed-method, ۴ qualitative) met inclusion criteria. Interventions included e-learning, computer-based simulations, high-fidelity, and VR-based training. Most reported significant gains in self-efficacy, faster decision-making, enhanced technical skills, and reduced anxiety. Effective features included realism, interactivity, immediate feedback, and repetitive practice. High-fidelity and VR simulations produced superior immersion and critical thinking. Barriers included high costs, limited technology, and inconsistent program quality. Few studies focused exclusively on emergency obstetric scenarios. Conclusion: Virtual education effectively boosts novice nurses’ confidence and competence in managing obstetric emergencies, bridging theory and practice through experiential learning. Addressing cost, accessibility, and sustainability challenges, along with conducting long-term studies on skill retention, can further strengthen maternal and neonatal safety through standardized virtual training integration.

کلیدواژه ها:

virtual education ، simulation-based learning ، self-efficacy ، emergency delivery