The use of 360-degree video to reduce anxiety and increase confidence in mental health nursing students: a mixed methods preliminary study

Background According to the 2022 NHS Survey, stress affects 45% of staff. More research is needed to explore how to develop resilient mental health nurses, who face multiple workplace stressors including interacting with a distressed client group. Higher Education Institutions are uniquely placed to introduce skills for coping to pre-registration nurses that help reduce their anxiety and increase their confidence, before entering placements for the first time. Methods In this study, we used a 360-degree virtual reality (VR) scenario alongside a cognitive reappraisal strategy and supportive clinical supervision technique to explore student mental health nurses’ experiences of VR as an educative tool and to help build emotional coping skills. Results Student’s behavioural responses to the distressed patient scenario were varied. There was some indication that the VR influenced how students responded. If students had prior experience in health work, they were more likely to feel detached from the distress of the service user. Although for some students VR provided a meaningful learning experience in developing emotional awareness, other students felt more like a ‘fly on the wall’ than an active participant and empathetic and compassionate responses were strongest in those who perceived a strong immersive effect. Overall, the supportive supervision decreased the anxiety of the small sample involved, but confidence was not affected. Conclusion The use of 360-degree VR technology as an educative, classroom-based tool to moderate anxiety and build confidence in pre-placement mental health nursing students was partially supported by this study. The effectiveness of such technology appeared to be dependent on the degree to which ‘immersion’ and a sense of presence was experienced by students. Our cognitive reappraisal intervention proved useful in reducing anxiety caused by ‘the patient in distress scenario’ but only for those students who achieved a deep immersive effect. Students with prior exposure to distressing events (both in their personal lives and in clinical setting) might have developed other coping mechanisms (e.g., detachment). These findings support the idea that ‘presence’ is a subjective feeling experienced by the user and can vary among users.