Comparison of students’ use of cognitive and metacognitive strategies between live demonstration and complementary immersive virtual reality simulation in fundamental skills learning: A mixed-methods study

Aim: This study aimed to compare the differences in students’ use of “elaboration,” “critical thinking,” and “metacognitive self-regulation” strategies after exposure to either a conventional live demonstration or a complementary immersive virtual reality simulation in fundamental skills learning. Background: Immersive virtual reality simulation has emerged as an innovative instructional modality. However, limited research has explored its influence on students’ use of cognitive and metacognitive strategies when compared with conventional live demonstrations in learning fundamental nursing skills. Design: This study was a quasi-experimental convergent mixed-methods study. Methods: The study was conducted at a university in XXXXXXXX from September to December 2024. Seventy participants from 595 first-year nursing students were recruited and divided into a control group (live demonstration only) or an intervention group (live demonstration plus immersive virtual reality simulation). The adapted Motivated Strategies for Learning Questionnaire was used to assess students’ learning strategies. Fifteen students (7 from the CG and 8 from the IG) were invited to individual interviews. Survey data were analyzed using descriptive statistics, Mann-Whitney U test and analysis of covariance, while interview data were analyzed thematically. Results: The study illustrated that “elaboration” and “metacognitive self-regulation” were the significantly executed learning strategies where “elaboration” strategy was most predominant. Critical thinking skills showed not statistically significant among two groups. Interview data identified two themes: (1) Impact of teaching activities on students’ execution of learning strategies and (2) Development of personalized learning strategies. Conclusion: The study illustrates different instructional modalities can shape students’ cognitive and metacognitive learning strategies.