The Effectiveness of Virtual Reality Air-to-Ground Handoff Education in Realistic Operations on Learning Among Emergency Nurses in Taiwan.
Journal of nursing management · 2026-01-01 · Quasi-experimental
Abstract
AIM: This study evaluated the effectiveness of virtual reality (VR) simulation training in enhancing emergency room (ER) nurses' preparedness for air-to-ground patient handoff and psychological safety, defined as participants' perceived confidence and comfort within the training environment. BACKGROUND: Aeromedical transport is critical in regions with complex terrain or limited resources. The reception phase poses time-sensitive and environmental challenges, and insufficient training increases the risk of handoff errors and patient harm. Existing programs focus mainly on in-flight care, with little attention to reception. VR offers an immersive, standardized, and safe platform for reception training. DESIGN: A quasiexperimental design using a nonrandomized, sequential cohort allocation by training date with two-group repeated measures was employed. METHODS: Seventy-six emergency nurses from a northern Taiwan medical center were assigned by training date to a traditional drill group (n = 33) or a VR simulation group (n = 43). The "H.A.N.D.O.F.F." curriculum, based on the 2024 CDC air-to-ground handoff protocol, was implemented. Outcomes included the Air-to-Ground Patient Handoff Preparedness Inventory and Psychological Safety Scale. Data were collected at baseline, postintervention, and 8 weeks and analyzed using generalized estimating equations. RESULTS: Baseline score refers to participants' initial preparedness prior to the intervention, and no significant differences were found between groups at baseline (p > 0.05). Postintervention, the VR group reported significantly higher preparedness and psychological safety than controls (p < 0.001), and these improvements were sustained at the 8-week follow-up (p < 0.001). CONCLUSIONS: This study demonstrated that VR simulation significantly improves preparedness for air-to-ground patient handoff, highlighting its practical value. Future applications may extend to military, police, and fire departments to foster interprofessional collaboration and enhance emergency response capabilities.