The students in EG received VR-based training for elderly oral health care at 2-week (Time 2), 4-week (Time 3), and 6-week (Time 4) follow-ups. The learning module was divided into three sessions according to the physical condition (1) Mild disability, (2) Semi-disability, (3) Total disability and oral condition, (1) wearing dentures, (2) missing teeth of the elderly. Students simulate the different physical and oral conditions of the elderly through virtual situations and provide suitable oral care methods. The whole training session took approximately two hours for each student; First, students were first given a short introduction to the VR system's use (10 minutes). Second, they were able to carry out oral care for the elderly while wearing VR goggles and using hand-controllers with the teaching and audio guides during the process (90 minutes), and an evaluation was taken after the intervention (20 minutes).

The students in CG do not receive any of the interventions. However, the same VR-based curriculum of oral health care on dependency elderly were provided at the end of the study.

Students simulate the different physical and oral conditions of the elderly through virtual situations and provide suitable oral care methods. The whole training session took approximately two hours for each student; First, students were first given a short introduction to the VR system's use (10 minutes). Second, they were able to carry out oral care for the elderly while wearing VR goggles and using hand-controllers with the teaching and audio guides during the process (90 minutes), and an evaluation was taken after the intervention (20 minutes).

Twenty items measured elderly oral care-related knowledge; for example, 'There is no need to consider the size of the interdental brush.' Possible responses included True (1), False (0), and I do not know (0), with possible scores ranged from 0 to 20; a higher score indicated a higher degree of oral-care-related knowledge. The KR-20 coefficient was 0.56 for this scale

Seven items measured attitude toward elderly oral care, for example, 'Assist disabled elderly to clean their teeth is annoying.' Each item was scored on a five-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). Possible scores ranged from 5 to 35; a higher score indicated a more positive attitude toward oral care for the elderly. Cronbach's alpha was 0.70 for this scale.

Eleven items were used to evaluate the self-efficacy of elderly oral care. Students indicated their degrees of agreement with statements related to perceptions of personal ability concerning oral care for the elderly. For example, 'I am confident to remind disable elderly having regular dental visits every six months.' Each item was scored on a five-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). Possible scores ranged from 5 to 55; a higher score indicated more substantial confidence toward oral care for the elderly. Cronbach's alpha was 0.87 for this scale.

Twelve items were used to evaluate the intention to elderly oral care behavior for elderly. Students indicated their goals of adding new behaviors or modifying existing behaviors of oral care for the elderly. For example, 'I will take the initiative to assist disabled elderly to clean their dentures.' Each item was scored on a five-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree).