Background:
Immersive virtual reality (IVR), a form of virtual reality, offers the highest degree of immersion into a real life scenario using game technology. IVR includes the use of a software platform where the animation, video or image can be transmitted into a three dimensional (3-D) format and be experienced using a headset and handset. Clinical learning through gamification methods like IVR can enhance healthcare provider learning and can improve procedural skills, clinical decision-making and real time responses to complex clinical situations in a safe learning environment. IVR is a new and novel way to support nurse practitioner education and offer alternatives to traditional learning methods, use of live simulated patients and mannequin-based simulation. IVR use in simulation practice offers the nurse practitioner student access to a realistic clinical setting so that they can practice clinical skills and make real-time decisions in complex clinical situations that they may not be able to consistently access in clinical placements. Due to a scarce supply of clinical placement opportunities for nurse practitioner students, IVR can help supplement learning with the provision of diverse case scenarios or clinical encounters with specific populations. Even with these potential benefits, little is known about how IVR specifically supports current nurse practitioner student education or continuing education for practicing nurse practitioners.

Objectives:
This systematic review aims to examine the effectiveness of immersive virtual reality and other virtual reality technologies for nurse practitioner education and continuing education.

Methods:
For this systematic review we completed a search across six bibliographic databases including Medline (OVID), Embase, CINAHL, APA PsycNET, Web of Science, and ERIC. Two levels of screening were conducted with at least two independent reviewers. Any disagreements were resolved by discussion or a third independent reviewer as needed. Handsearching of all reference lists for included articles post Level 2 screening was conducted. We used DistillerSR software for this review and verified our screening with the AI screener built into the software. Results: The search yield across the six databases resulted in 471 citations. Level one screening of titles and abstracts resulted in 13 citations moving forward to full text screening. Level 2 screening of the 13 full-text articles resulted in 11 citations included. IVR has the potential to offer a safe and unique means to access education for nurse practitioners.

Conclusions:
Next steps are critical appraisal and data extraction of included studies. The conclusions from this review will offer insights into how IVR and other forms of virtual reality are used to support nurse practitioner learning, the strengths and barriers to using this approach for nurse practitioner clinical education and recommendations for future education using this modality.

Keywords: Virtual reality, education, healthcare, nurse practitioner, gamification.