Stress (Psychology)NCT07574203
Virtual Reality to Reduce Stress Among Nursing Students Before Final Exams
A study testing Self-Selected Virtual Reality Relaxation Session in people with Stress (Psychology) and Anxiety and Fear, run by University of Bisha at 1 site in Saudi Arabia.
Trial summary
The goal of this clinical trial is to evaluate whether a brief virtual reality (VR) relaxation session can reduce pre-exam stress levels among undergraduate nursing students enrolled in nursing courses. Read more about this study
- Who is it for?
- Ages 20 years and olderHealthy volunteers can take part
- Conditions the study is for
- Stress (Psychology), Anxiety and Fear, Student Nursing
- What is being tested?
- Self-Selected Virtual Reality Relaxation Session
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteSaudi Arabia
- Study dates
- 25 Jul 2025to 15 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Undergraduate nursing students enrolled in the Critical Care Nursing course at the University of Bisha.
- Both male and female students aged 20 and above.
- Scheduled to take the final practical exam during the study period.
- Able and willing to provide informed consent.
Who cannot join
- History of severe motion sickness, vertigo, or epilepsy triggered by visual stimuli.
- Current diagnosis of severe psychiatric disorders (e.g., psychosis, major depressive disorder) that could interfere with participation.
- Visual, auditory, or cognitive impairments that prevent effective use of VR equipment.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Virtual Reality-Based Relaxation to Reduce Stress Among Nursing Students Before Final Exams: A Randomized Controlled Trial
The goal of this clinical trial is to evaluate whether a brief virtual reality (VR) relaxation session can reduce pre-exam stress levels among undergraduate nursing students enrolled in nursing courses.
The participant population includes male and female nursing students, aged 20-26 years, who are preparing to take their final practical exam.
Read more
The main questions it aims to answer are:
- Does a 10-minute, self-selected VR relaxation session significantly reduce stress levels immediately before a high-stakes clinical exam?
- Are certain types of virtual environments (e.g., beach, island, space, ocean) more effective than others in promoting relaxation?
Researchers will compare pre- and post-intervention stress scores to see if the VR experience results in a statistically significant reduction in perceived stress.
Participants will:
- Complete a brief pre-intervention stress survey (e.g., using a validated scale such as the State-Trait Anxiety Inventory).
- Explore several calming VR environments (e.g., tropical beaches, islands, deep ocean, space, savanna, and tourist destinations).
- Choose one preferred scene based on personal relaxation preference.
- Engage in a 10-minute immersive VR relaxation session.
- Complete a post-intervention stress survey to assess any changes.
Read the detailed description
High-stakes clinical assessments, such as final practical examinations, represent a critical component of nursing education but are frequently associated with elevated stress levels among students. Excessive stress during such assessments has been linked to impaired cognitive processing, reduced psychomotor performance, and diminished clinical decision-making, potentially affecting both educational outcomes and student well-being. Despite this, interventions aimed at mitigating acute pre-exam stress in authentic educational contexts remain limited.
Immersive virtual reality (VR) has emerged as a promising modality for emotional regulation due to its ability to create engaging, multisensory environments that facilitate attentional distraction and psychological detachment from stressors. Unlike traditional relaxation techniques, VR allows users to experience a heightened sense of presence, which may enhance emotional engagement and promote rapid stress reduction within short exposure periods. Prior studies in healthcare education and clinical populations suggest that even brief VR-based relaxation sessions can yield meaningful reductions in perceived stress and anxiety.
A key methodological consideration in stress-reduction interventions is individual variability in emotional response to relaxation stimuli. Allowing participants to self-select preferred virtual environments may enhance engagement, perceived control, and emotional resonance, thereby maximizing intervention effectiveness. This preference-based approach also reflects real-world feasibility and scalability in educational settings, where time and resources are often constrained.
The present study embeds a brief, self-selected VR relaxation intervention within a real examination context, immediately prior to a final practical assessment in a Critical Care Nursing course. By situating the intervention at a moment of peak stress, the study seeks to capture ecologically valid changes in perceived stress that are directly relevant to educational performance and student experience. In addition to evaluating stress reduction, the study examines feasibility and acceptability of VR as an adjunctive support strategy in nurse education, contributing to the growing body of methodological work addressing the complexity of demonstrating meaningful educational outcomes.
- Conditions
- Stress (Psychology), Anxiety and Fear, Student Nursing, Education Nursing, Virtual Reality, Relaxation Therapy
- Being tested
- Self-Selected Virtual Reality Relaxation Session
- Keywords
- Virtual Reality, Stress Reduction, Nursing Students, Exam Anxiety, Nursing Education, Technology in Education
- Medical subject headings
- Anxiety Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Self-Selected Virtual Reality Relaxation SessionDevice
Also called virtual reality
This intervention is distinguished by allowing participants to preview and personally select from multiple immersive virtual environments tailored to promote relaxation, followed by a standardized 10-minute VR session conducted immediately before a high-stakes clinical exam, specifically targeting stress reduction in nursing students preparing for their final practical assessment in Critical Care Nursing.
| Study group | Role | What they receive |
|---|---|---|
| VR Relaxation Intervention for Exam Stress Reduction in Nursing Students | Experimental | In this arm, participants will explore a range of immersive virtual environments-including beaches, islands, deep ocean, savanna, space, and popular tourist destinations-using a VR headset. After previewing the scenes, each participant will select the environment they find most relaxing and engage in a 10-minute guided VR session prior to their final practical exam in the Critical Care Nursing course. The intervention is designed to promote relaxation, reduce stress, and support emotional well-being immediately before high-stakes assessment. Receives: Device: Self-Selected Virtual Reality Relaxation Session |
| Control Group - No VR Intervention | No intervention | Participants in this arm will not receive any virtual reality intervention prior to the final practical exam in the Critical Care Nursing course. They will follow the standard pre-exam routine without exposure to VR or other structured relaxation methods. Pre- and post-intervention surveys will still be administered to assess baseline and post-exam stress levels for comparison with the intervention group. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perceived Stress
Perceived stress will be assessed using the Perceived Stress Scale-10 (PSS-10), a validated 10-item self-report questionnaire assessing the degree to which situations in one's life are appraised as stressful. Total scores range from 0 to 40, with higher scores indicating greater perceived stress. The outcome will be evaluated immediately before and immediately after the 10-minute virtual reality relaxation session on the day of the final practical exam.
Measured: Immediately before and immediately after the 10-minute VR session on the day of the final practical exam.
Secondary outcomes (2)
Test Anxiety Measured by the Test Anxiety Inventory (TAI)
Test anxiety will be measured using the Test Anxiety Inventory (TAI), a standardized self-report questionnaire assessing anxiety related to examinations. Scores range from 20 to 80, with higher scores indicating greater test anxiety. Measurement will occur immediately before and after the 10-minute VR relaxation session.
Measured: Immediately before and immediately after the VR session on the day of the final practical exam.
Participant Satisfaction with the VR Relaxation Intervention Measured by a Structured Questionnaire
Participant satisfaction with the VR relaxation intervention will be assessed using a brief structured self-administered questionnaire, evaluating comfort, enjoyment, immersion, and perceived usefulness. Each item is rated on a 5-point Likert scale ranging from 1 (very dissatisfied) to 5 (very satisfied), with higher scores indicating greater satisfaction.
Measured: Immediately after completion of the VR session.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2026
- Study start25 Jul 2025
- Primary completion15 Sep 2025
- Study completion15 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Stress (Psychology)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This interventional study uses a parallel assignment model with randomized allocation and no masking, comparing a 10-minute self-selected VR relaxation session to no intervention in reducing pre-exam stress among undergraduate nursing students.
- Masking
- None (open label)
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Bisha
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohammed Alanazi, University of Bisha
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07574203
- Sponsor's protocol ID
- UBisha
- Status last verified
- May 2026
- First submitted
- 31 Jul 2025
- Last updated
- 7 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Due to the sensitive nature of the data collected, including personal stress and psychological measures from nursing students, maintaining participant confidentiality and privacy is a priority. Additionally, data sharing may be restricted by institutional policies and ethical approvals that limit dissemination of individual-level information. Therefore, IPD will not be shared beyond the research team to ensure compliance with these protections.
Publications
Alanazi MO. A randomized controlled trial of virtual reality-based relaxation to reduce pre-exam stress among nursing students. Front Psychiatry. 2026 Jul 10;17:1859945. doi: 10.3389/fpsyt.2026.1859945. eCollection 2026.
PubMed 42500320
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Virtual Reality-Based Relaxation to Reduce Stress Among Nursing Students Before Final Exams: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07574203
- Acronym / sponsor ID
- UBisha
- Conditions
- Stress (Psychology), Anxiety and Fear, Student Nursing, Education Nursing, Virtual Reality, Relaxation Therapy
- Keywords
- Virtual Reality, Stress Reduction, Nursing Students, Exam Anxiety, Nursing Education, Technology in Education
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- University of BishaUniversity, hospital or other
- Study start
- 25 Jul 2025 (actual)
- Primary completion
- 15 Sep 2025 (actual)
- Study completion
- 15 Jan 2026 (actual)
- First posted
- 7 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to evaluate whether a brief virtual reality (VR) relaxation session can reduce pre-exam stress levels among undergraduate nursing students enrolled in nursing courses.
The participant population includes male and female nursing students, aged 20-26 years, who are preparing to take their final practical exam.
The main questions it aims to answer are:
- Does a 10-minute, self-selected VR relaxation session significantly reduce stress levels immediately before a high-stakes clinical exam?
- Are certain types of virtual environments (e.g., beach, island, space, ocean) more effective than others in promoting relaxation?
Researchers will compare pre- and post-intervention stress scores to see if the VR experience results in a statistically significant reduction in perceived stress.
Participants will:
- Complete a brief pre-intervention stress survey (e.g., using a validated scale such as the State-Trait Anxiety Inventory).
- Explore several calming VR environments (e.g., tropical beaches, islands, deep ocean, space, savanna, and tourist destinations).
- Choose one preferred scene based on personal relaxation preference.
- Engage in a 10-minute immersive VR relaxation session.
- Complete a post-intervention stress survey to assess any changes.
Detailed description
High-stakes clinical assessments, such as final practical examinations, represent a critical component of nursing education but are frequently associated with elevated stress levels among students. Excessive stress during such assessments has been linked to impaired cognitive processing, reduced psychomotor performance, and diminished clinical decision-making, potentially affecting both educational outcomes and student well-being. Despite this, interventions aimed at mitigating acute pre-exam stress in authentic educational contexts remain limited.
Immersive virtual reality (VR) has emerged as a promising modality for emotional regulation due to its ability to create engaging, multisensory environments that facilitate attentional distraction and psychological detachment from stressors. Unlike traditional relaxation techniques, VR allows users to experience a heightened sense of presence, which may enhance emotional engagement and promote rapid stress reduction within short exposure periods. Prior studies in healthcare education and clinical populations suggest that even brief VR-based relaxation sessions can yield meaningful reductions in perceived stress and anxiety.
A key methodological consideration in stress-reduction interventions is individual variability in emotional response to relaxation stimuli. Allowing participants to self-select preferred virtual environments may enhance engagement, perceived control, and emotional resonance, thereby maximizing intervention effectiveness. This preference-based approach also reflects real-world feasibility and scalability in educational settings, where time and resources are often constrained.
The present study embeds a brief, self-selected VR relaxation intervention within a real examination context, immediately prior to a final practical assessment in a Critical Care Nursing course. By situating the intervention at a moment of peak stress, the study seeks to capture ecologically valid changes in perceived stress that are directly relevant to educational performance and student experience. In addition to evaluating stress reduction, the study examines feasibility and acceptability of VR as an adjunctive support strategy in nurse education, contributing to the growing body of methodological work addressing the complexity of demonstrating meaningful educational outcomes.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This interventional study uses a parallel assignment model with randomized allocation and no masking, comparing a 10-minute self-selected VR relaxation session to no intervention in reducing pre-exam stress among undergraduate nursing students.
| Arm | Type | Receives |
|---|---|---|
| VR Relaxation Intervention for Exam Stress Reduction in Nursing Students | Experimental | Device: Self-Selected Virtual Reality Relaxation SessionIn this arm, participants will explore a range of immersive virtual environments-including beaches, islands, deep ocean, savanna, space, and popular tourist destinations-using a VR headset. After previewing the scenes, each participant will select the environment they find most relaxing and engage in a 10-minute guided VR session prior to their final practical exam in the Critical Care Nursing course. The intervention is designed to promote relaxation, reduce stress, and support emotional well-being immediately before high-stakes assessment. |
| Control Group - No VR Intervention | No intervention | –Participants in this arm will not receive any virtual reality intervention prior to the final practical exam in the Critical Care Nursing course. They will follow the standard pre-exam routine without exposure to VR or other structured relaxation methods. Pre- and post-intervention surveys will still be administered to assess baseline and post-exam stress levels for comparison with the intervention group. |
Who may qualify
- Ages
- 20 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Undergraduate nursing students enrolled in the Critical Care Nursing course at the University of Bisha.
- Both male and female students aged 20 and above.
- Scheduled to take the final practical exam during the study period.
- Able and willing to provide informed consent.
Key exclusion criteria (3 listed)
- History of severe motion sickness, vertigo, or epilepsy triggered by visual stimuli.
- Current diagnosis of severe psychiatric disorders (e.g., psychosis, major depressive disorder) that could interfere with participation.
- Visual, auditory, or cognitive impairments that prevent effective use of VR equipment.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Self-Selected Virtual Reality Relaxation SessionAlso: virtual realityThis intervention is distinguished by allowing participants to preview and personally select from multiple immersive virtual environments tailored to promote relaxation, followed by a standardized 10-minute VR session conducted immediately before a high-stakes clinical exam, specifically targeting stress reduction in nursing students preparing for their final practical assessment in Critical Care Nursing. | Device | VR Relaxation Intervention for Exam Stress Reduction in Nursing Students |
Primary outcome
Perceived Stress
Time frame: Immediately before and immediately after the 10-minute VR session on the day of the final practical exam.
Perceived stress will be assessed using the Perceived Stress Scale-10 (PSS-10), a validated 10-item self-report questionnaire assessing the degree to which situations in one's life are appraised as stressful. Total scores range from 0 to 40, with higher scores indicating greater perceived stress. The outcome will be evaluated immediately before and immediately after the 10-minute virtual reality relaxation session on the day of the final practical exam.
2 secondary outcomes
Test Anxiety Measured by the Test Anxiety Inventory (TAI)
Time frame: Immediately before and immediately after the VR session on the day of the final practical exam.
Participant Satisfaction with the VR Relaxation Intervention Measured by a Structured Questionnaire
Time frame: Immediately after completion of the VR session.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2026.
- Derived from this study: PubMed 42500320Alanazi MO. A randomized controlled trial of virtual reality-based relaxation to reduce pre-exam stress among nursing students. Front Psychiatry. 2026 Jul 10;17:1859945. doi: 10.3389/fpsyt.2026.1859945. eCollection 2026.
- Individual participant dataSharing planned: No. Due to the sensitive nature of the data collected, including personal stress and psychological measures from nursing students, maintaining participant confidentiality and privacy is a priority. Additionally, data sharing may be restricted by institutional policies and ethical approvals that limit dissemination of individual-level information. Therefore, IPD will not be shared beyond the research team to ensure compliance with these protections.
Related trials for Stress (Psychology)
Not yet recruiting
Coping and Adaptation for Recovery From Moral Injury: A Group Intervention for Clinical Psychology Residents
Moral Distress, Moral Injury
Recruiting
Child Cognitive-Affective Resilience Following 13-11 Event : A Pluridisciplinary Study of Intergenerational Transmission of a Traumatic Event
Intergenerational Trauma
Not yet recruiting
Influence Of Different Relaxation Techniques On Stress Level For Patients With Bruxism Using Salivary Biomarkers.
Bruxism, Stress (Psychology)
Not yet recruiting
Stress Through Audition: Uptake, Recovery, Oscillations During Nature Exposure
Stress (Psychology), Environment
Not yet recruiting
CBT-Based Stress Management Program for Healthcare Students
Stress (Psychology), Stress Management
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Self-Selected Virtual Reality Relaxation Session in people with Stress (Psychology) and Anxiety and Fear, run by University of Bisha at 1 site in Saudi Arabia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Saudi Arabia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perceived Stress (time frame: Immediately before and immediately after the 10-minute VR session on the day of the final practical exam.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07574203, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 May 2026.