Research Article| Volume 77, P13-22, April 2023

An Immersive Virtual Reality Simulation for Cross-Cultural Communication Skills: Development and Feasibility

Published:February 25, 2023DOI:


      • Virtual reality simulation could close a gap in cultural competence education.
      • The content of a new virtual simulation was designed based on theoretical models.
      • The immersive virtual simulation had high levels of usability and satisfaction.


      Educational approaches proven to produce cultural competence among nurses, consistently and cost-effectively, are not yet widely available. This study describes the development and feasibility of an immersive virtual reality simulation to improve cross-cultural communication skills. We used a multi-methods approach, recruiting 15 nursing students from a nursing college in South Korea to assess the simulation's feasibility according to sense of presence, usability, simulation design, task difficulty, and satisfaction. This theory-based immersive virtual reality simulation was developed through content and face validity testing by expert panels. We identified high levels of usability, simulation design, and satisfaction, a low level of task difficulty, and a good level of sense of presence. Participants were satisfied with the simulation “feeling real and immersive,” “improved cultural competence,” “useful for repetitive learning,” “appropriate difficulty for learning,” and “easy to control.” Reports of “insufficient prior information,” “insufficient cognitive fidelity,” “limited to dialogue selection,” and “discomfort for wearers of glasses” indicate needed improvements. Virtual reality simulation could contribute to filling a critical gap in cultural competence in nursing education.


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