Simulation boosts nursing students’ home-visit training immersion, skills still under study

Home visits are where community nursing stops being theory and starts becoming judgment—spotting hazards, sensing family dynamics, and tailoring communication on the fly. For nursing students, that “messy realism” is difficult to reproduce in a classroom, where role-players follow scripts and environments stay tidy.

A new study in the Chinese Journal of Medical Education Research reports tests of a virtual–physical integrated scenario simulation designed to close that gap. Researchers from Peking Union Medical College School of Nursing and Beijing community health centers compared the approach with conventional laboratory-based scenario training.

A total of 143 third-year undergraduate nursing students (enrolled in 2022) participated in the March–April 2025 intervention period. After the same three-hour teaching block, 128 students completed pre- and post-questionnaires, while 24 students in the integrated-simulation arm also took part in semi-structured interviews.

Both groups trained on the same home-visit workflow: preparing the encounter, conducting inquiry and physical assessment, measuring rapid blood glucose, delivering health education, and finishing documentation and post-visit summaries. The difference was how uncertainty was generated during the scenario.

In the conventional group, classmates acted as the older adult and family member according to a written script. In the integrated group, students worked in a “smart eldercare” laboratory featuring multimedia displays, physical models, and a wireless simulation system in which an intelligent agent represented the older adult.

The system supported AI-assisted inquiry, blood pressure and glucose measurement, and transitions between a community health center context and a simulated home environment. In interviews, students described the intelligent simulator as responsive—questioning, showing impatience, and altering emotional cues in ways that scripts rarely capture.

The strongest quantitative result was “learning immersion.” Students trained with the integrated setup achieved a higher total immersion score than the conventional group (72.42±8.19 vs 69.44±8.41), with gains also reported in emotional engagement and perceived learning experience.

However, immersion did not translate cleanly into immediate competence. After teaching, there was no significant between-group difference in home-visit skills or attitudes. Skill scores were similar (virtual–physical: 60.60±6.85; conventional: 60.89±6.62), suggesting three hours may be insufficient for measurable skill consolidation.

Students also reported friction: response delays, imperfect speech recognition, the need to press buttons during interaction, and occasional breakdowns in conversational flow. The authors argue that technology can increase realism, but instructional design, repeated practice, and smoother interfaces are essential before simulated engagement becomes durable nursing competence.