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HoloPatient-based simulation education to improve nursing students’ learning motivation and attitude: a mixed methods study

BMC Med Educ. 2025 Oct 3;25(1):1349. doi: 10.1186/s12909-025-07987-x.

ABSTRACT

BACKGROUND: The landscape of nursing education is rapidly evolving worldwide through the integration of innovative technologies such as mixed reality (MR). While MR-based HoloPatient education shows promise for enhancing nursing education globally, particularly in settings with limited clinical placement opportunities, current research indicates positive effects on nursing students’ learning outcomes. However, no evidence exists that HoloPatient-based education improves students’ learning motivation and attitude. This study aimed to examine nursing students’ learning motivation and attitudes following HoloPatient-based simulation education, and to explore students’ perception of their HoloPatient-based simulation learning experiences.

METHODS: This study used an explanatory sequential mixed methods design with a one group post-test only design followed by focus group interviews. This study was conducted from August to September 2023 at a university in South Korea. Quantitative data were collected from 100 third-year nursing students who participated in HoloPatient-based simulation education. Qualitative data were obtained through semi-structured interviews with two focus groups, conducted one week after HoloPatient-based simulation education. Statistical analyses included descriptive statistics, correlation analysis, and comparative analyses. Qualitative data underwent thematic analysis following established protocols.

RESULTS: This study showed high level of nursing students’ learning motivation (M = 4.42, SD = 0.42) and positive attitude (M = 4.08, SD = 0.50) following HoloPatient-based simulation education. A significant positive correlation was found between learning motivation and attitude (r = .59 or higher, p < .001). Qualitative findings revealed themes of positive experience, influencing factors on HoloPatient-based simulation, and barriers to HoloPatient-based simulation.

CONCLUSION: This exploratory study found high levels of learning motivation and positive attitudes among nursing students following HoloPatient-based simulation education. However, due to the one-group post-test design and small qualitative sample, these findings should be interpreted as preliminary evidence. Further studies are needed to establish its effectiveness with randomized controlled trials or quasi-experimental designs.

PMID:41044594 | DOI:10.1186/s12909-025-07987-x

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