VR Nursing

Posted on by Steven McDermott

Team Name

VR Nursing

Timeline

Summer 2025 – Fall 2025

Students

  • Armando Castillo – Computer Science
  • Dustin Do – Software Engineering
  • Kevin Phong – Computer Science
  • Mahfuza Siddiqua – Software Engineering

Sponsor

Jennifer Roye, Assistant Dean for Simulation and Technology, UTA College of Nursing and Health Innovation

Abstract

VR Nursing is an interactive training simulation for nursing students to interact with virtual patients and practice their skills in four scenarios. Our team has worked in conjunction with the College of Nursing and Health Innovation at UT Arlington to create this virtual reality simulation on Unity to align with the needs of nursing education. It has been developed with the Meta XR SDK to support a range of VR headsets and controllers, including the Meta Quest 2 and 3.

The project’s four scenarios are as follows: Scenario 1 takes place in the hospital, where the user assesses a patient and chooses care actions through dialogue options. Scenario 2 is at the patient’s home, where the user must identify safety hazards before the patient begins hospice care at home. The student is scored based on the number of hazards they find. In Scenario 3, the user must perform a focused assessment of the patient to determine his vitals and scale of pain to administer morphine to the patient. The student must decide the correct order for these steps. Scenario 4, which is currently in development by another team, involves the user providing terminal care after the patient has passed.

The goal of the VR simulation is to help nurses in training develop essential skills, gain confidence, and become emotionally prepared to provide compassionate hospice and palliative care.

Background

Virtual Reality (VR) has emerged as a transformative tool in healthcare education, offering immersive and repeatable learning experiences that traditional methods struggle to provide. While classroom instruction and clinical rotations form the foundation of nursing education, they often neglect preparing students for emotionally intense, high-pressure scenarios involving end-of-life care. Many nursing students complete their training without witnessing the final stages of terminal illness, the moment of death, or the nuanced support required by families during this time because of the relative rarity of such events. As a result, newly graduated nurses frequently feel unprepared to manage these situations or deliver appropriate support.

End-of-life care is a critical yet underemphasized area in traditional nurse training. Existing simulations are often expensive or fail to convey the full emotional and clinical complexity of hospice and palliative care. Resource constraints, limited clinical placements, and the sensitive nature of these scenarios make hands-on exposure difficult to achieve at scale for nursing trainees. This gap highlights the growing need for accessible, effective, and emotionally grounded learning tools.

The VR Nursing simulation was developed to address these challenges by offering a safe, controlled environment where students can practice essential hospice competencies, including pain management, communication with families, and ethical decision-making, in accordance with the needs and curriculum of the UTA College of Nursing and Health Innovation. Through immersive experience and exposure to realistic end-of-life situations, this simulation aims to better prepare nursing students to deliver compassionate, high-quality care while meeting the rising demand for improved hospice and palliative services.

Project Requirements

  • Four Realistic Scenarios: Simulation must include four nursing education scenarios that accurately represent real-world hospice and palliative care situations.
  • Accurate and Responsive Medical Interactions: Users must be able to interact with medical tools, patients, and environmental objects with realistic physics, animations, and feedback.
  • System Performance: Application must run smoothly on the Meta Quest 2 and 3 to avoid motion sickness and meet VR comfort guidelines.
  • Meta Quest 2 & 3 Full Compatibility: The software must use Meta XR SDK and support standalone wireless operation and touch controllers.
  • User Guidance and Tutorial Mode: An onboarding tutorial to teach locomotion, menu navigation, object grabbing, and dialogue decision-making.
  • Assessment & Feedback System: Each scenario must record user actions, determine correctness, and present feedback through scoring on certain scenarios.
  • Scenario Management & Progression: A centralized scenario manager loads and unloads scenes dynamically, tracks user state, and monitors for completion triggers.
  • Accessibility & Usability: The system must include readable UI elements, buttons appropriate for VR, intuitive interactions, and minimized physical movement of objects.
  • Audio & Dialogue Integration: NPCs must support audio, dialogue-triggered events, and interaction-based branching logic.
  • Safety and User Comfort: Locomotion must be limited to teleportation or constrained movement to reduce motion sickness, all interactions must follow VR comfort standards.

Design Constraints

  • Accessibility: VR Nursing must be usable by students with varying levels of VR experience, from beginner to expert. UI elements must meet minimum size and contrast guidelines for readability in VR.
  • Performance & Hardware: The simulation must run on Meta Quest 2 and 3, which have limited GPU/CPU specifications compared to PC VR.
  • Cost: This project uses existing Meta Quest headsets provided by the System Designs department. All development is done using low-cost tools and assets.
  • Interoperability Constraints: Must integrate well with Meta XR SDK, Unity’s XR Interaction ToolKit. Scenarios must be designed so that additional teams can extend the system without breaking existing logic.
  • Safety & Public Welfare: VR interactions must follow guidelines to prevent physical discomfort or simulator sickness. The simulation must represent medical procedures ethically aligned with nursing education standards.

Engineering Standards

  • ISO/IEC 23270:2021 – C# language specification enforced by the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC). It is used for specifying syntax, rules, and requirements.
  • ISO/IEC 27001:2013 – Information security management standard is enforced by ISO and IEC. It is used for setting requirements for secure handling, storage, and transmission of information. This
    1. VR Nursing meets these standards by not using real patient data. As well as access to development repositories being limited to team members.
  • IEEE 610.12-1990 – Standard glossary of software engineering terminology is enforced by the Institute of Electrical and Electronic Engineers (IEEE). It is used for defining formal terminology for the software engineering processes, documentation, and testing.
    1. VR Nursing meets these standards by the use of project documentation using standardized terms ensuring clarity between teams, sponsor, and faculty.
  • NFPA 70 – National electrical code is enforced by the National Fire Protection Association (NFPA). This standard specifies safety requirements for electrical wiring, equipment installation to prevent electric shock and fire hazards.
    1. VR Nursing meets these standards by the physical VR equipment needing to be used with compliant outlets and surge protection in the UTA System Design labs. The project is software-only but the use of VR is compliant.
  • ISO/IEC/IEEE 12207:2017 – Software life cycle processes enforced by the ISO, IEC, and IEEE. This standard defines a framework for the lifecycle of a software system, including development, documentation, testing, quality assurance, operation, and maintenance.

System Overview

In order to build such a complex system compatible with VR headsets, we broke down the project into several layers. The architecture of the simulation separates logical components into the following core layers: Data Objects, Game Objects, and Managers.

The Data Objects Layer is the central point of reference for all in-simulation data used to drive user interactions, system responses, and scenario progression. It acts as a mediator between various system components, handling the retrieval, update, and tracking of environmental objects, entities, and player-related information throughout each simulation scenario.

The Game Objects Layer encompasses the visual and interactive elements that users see, hear, and engage with throughout the simulation. This layer can be further broken down into temporary and persistent game objects. Temporary game objects are loaded into the simulation based on the scenario they are needed in, and they are off-loaded otherwise. These include NPCs and objects that relate to one particular scene. Permanent game objects are those that persist throughout the simulation, such as UI elements like the controllers, menus , and displays.

Finally, the Managers Layer controls the flow of the program and determines what operations to perform depending on the data that it receives.Managers coordinate scenario flow, patient behavior, interactions, audio, and player input.

Together, these layers create a modular, scalable product that allows the VR Nursing simulation to run smoothly, remain flexible, and support multiple headsets.

Results

Our team has worked diligently to improve and expand on the VR Nursing project we inherited from the team before us. We have completed up to scenario 3 as close to the specifications of our sponsor as possible, adapting as needed to overcome bugs and software challenges along the way.

In this demonstration video we will walk through scenario 3, showing the line of questioning to confirm the patient’s identity, his condition (level of pain, vitals, allergies), and then administering intravenous morphine in the correct steps to account for the patient’s pain. The system will encourage the user to administer the morphine in the correct order (saline flush, then morphine, and saline flush once again) and ensure the user is not pushing the solutions too fast or too slow.

Future Work

We leave scenario 4 to be finished by one more team, handing off to them all that we know and all that we’ve worked on to ensure a smooth and productive conclusion to this project. This project will also benefit from robust user testing, which is intended to be done with existing UTA nursing students in the future to collect data on usefulness, accuracy, comfort, and other important metrics for refinement.

Project Files

Project Charter
System Requirements Specification
Architectural Design Specification
Detailed Design Specification
Poster

References

IEEE Standards Association. (1990). IEEE standard glossary of software engineering terminology (IEEE Std 610.12-1990). https://doi.org/10.1109/IEEESTD.1990.101064

International Organization for Standardization; International Electrotechnical Commission; IEEE. (2017). ISO/IEC/IEEE 12207:2017 – Systems and software engineering—Software life cycle processes. https://www.iso.org/standard/63712.html

International Organization for Standardization. (2025, March 17). ISO 75178: Information technology—Programming languages—C#. https://www.iso.org/standard/75178.html

International Organization for Standardization. (2013). ISO/IEC 27001:2013 – Information technology—Security techniques—Information security management systems—Requirements. https://www.iso.org/standard/54534.html

Federal Register. (2025, July 1). Pipeline safety: Standards update—NFPA 70. https://www.federalregister.gov/documents/2025/07/01/2025-12080/pipeline-safety-standards-update-nfpa-70

Steven McDermott

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