Effectiveness of an Immersive Virtual Reality Simulation Speak-Up Training Program for Patient Safety in Novice Nurses: A Quasi-Experimental Study

Background/Objectives: Novice nurses often struggle to assertively voice patient safety concerns due to limited clinical experience and hierarchical healthcare environments. Immersive virtual reality simulation (IVRS) may provide opportunities to practice asser-tive communication skills essential for interprofessional collaboration in a psychological-ly safe environment. This study aimed to evaluate the short- and long-term effectiveness of an IVRS speak-up training program in enhancing communication clarity and collabora-tive attitudes, as well as reducing experiences of nursing malpractice among novice nurs-es. Methods: A quasi-experimental study was conducted with 36 novice nurses (18 partici-pants each in control and experimental groups). Communication clarity and collaborative attitudes were measured at baseline, immediately post-intervention, and 6 weeks post-intervention. Nursing malpractice experiences were assessed at 6 weeks post-intervention. Results: Communication clarity showed no significant interaction effect between groups and time points (F = 0.84, p = 0.437), though both groups demonstrated immediate post-intervention improvements. Collaborative attitudes showed a significant interaction effect (F = 4.23, p = 0.020), with the experimental group exhibiting significantly greater and sustained improvements at immediate and 6-week follow-up compared with the control group. No significant difference in nursing malpractice experiences was ob-served between groups (Z = 0.16, p = 0.872). Conclusions: The IVRS speak-up training program effectively enhanced novice nurses’ assertive communication skills in immersive, interactive environments tailored for realistic practice. This program improved commu-nication clarity in the short term and enhanced collaborative attitudes up to 6 weeks. Inte-grating or boosting IVRS training into novice nurses’ communication education may fos-ter interprofessional collaboration and advance patient safety in clinical practice.