The aim of this study was to evaluate the effect of computer-based virtual reality (VR) simulation on students' knowledge, satisfaction and self-confidence in teaching oral care practice in the unconscious patient.

Oral care practice in the unconscious patient is one of the important nursing interventions in terms of patient health, which is given from the first years of nursing education.

This study is a randomized controlled experimental research. The study will be conducted with first-year nursing students enrolled in a university in Turkey. The sample of the study will consist of 68 nursing students. The data will be collected by Student Information Form, Oral Care Practice Information Form, Student Satisfaction in Learning and Self-Confidence Scale.

The aim of this study was to evaluate the effect of computer-based virtual reality (VR) simulation on students' knowledge, satisfaction and self-confidence in teaching oral care practices in the unconscious patient.

Oral care practice in the unconscious patient is one of the important nursing interventions in terms of patient health, which is given from the first years of nursing education.

This study is a randomized controlled experimental research. The study will be conducted with first year nursing students enrolled in a university in Turkey. The sample of the study will consist of 68 nursing students. Participants will be randomized into a computer-based virtual reality simulation group (n=34) and a low-reality patient manikin group (n=34). The research data will be collected by Student Information Form, Oral Care Practice Information Form, Student Satisfaction in Learning and Self-Confidence Scale.

Participants in the experimental and control groups will be informed about the methodology, aims and objectives of the study and their consent to participate in the study will be obtained both verbally and in writing. The theoretical content of the course will be given to the participants by the researcher faculty member using power point presentation and question-answer method. After the theoretical training, students will fill in the Student Information Form and Oral Care Practice Information Form.

After the forms are filled in, the students in both groups will be taken to the laboratory where the low-reality patient model is located. Students will be given a checklist showing the steps of oral care practice in the unconscious patient before the application. Oral care application steps in the unconscious patient will be shown to the students on the low-reality patient model by the researcher nurse faculty member. The participants in the control group will perform the oral care skill in the unconscious patient on the model.

The participants in the experimental group will then be taken by the researchers to the laboratory where the computer-based interactive VR simulation is used. Participants will be given a checklist showing the oral care application steps in the unconscious patient before the simulation application. Participants will be given preliminary information about the computer-based interactive VR simulation system and its application. Oral care practice in the unconscious patient will be demonstrated to the participants in the interactive VR simulation by the research nurse faculty member. Participants will be allowed to ask questions during the simulation and their questions will be answered. After the hands-on training, the participants will be taken to the laboratory one by one to practice oral care in the unconscious patient with the interactive VR simulation. While the participant is practicing oral care in the unconscious patient in the simulation application, the researcher faculty member will control the oral care practice of the participants. While the participant is practicing oral care in the unconscious patient in the simulation application, the researcher faculty member will check the skill steps on the participants' oral care practice checklist.

After a participant finishes the practice and leaves the laboratory, another participant will be called to the room for the practice and each participant will be given an average of 10 minutes for the practice. After the application is completed, each participant will fill in the Oral Care Application Information Form and the Student Satisfaction and Confidence in Learning Scale. After the implementation process, information sessions will be held with the participants in the experimental and control groups. These sessions will be held with groups of 5-6 students. Reassuring and open communication was established with the participants and they were encouraged to think. In the debriefing session, the participants will be asked "What did you do well?" and "What would you do differently if you had the opportunity to experience this simulation again?" and will be asked to give reflective answers. Participants will be given feedback about their performance by the trainer in line with the skill checklists used. Participants in the experimental and cortol groups will be asked to practice oral care in the unconscious patient in the simulation and low-reality patient mannequin 15 days after the oral care practice in the low-reality patient mannequin in the unconscious patient. Participants will fill in the Oral Care Practice Information Form and the Student Satisfaction and Self-confidence in Learning Scale after completing the practices.

Inclusion Criteria:

• Basic Principles and Concepts in Nursing course for the first time,
• Volunteering to participate in the study.

Exclusion Criteria:

• Graduating from a health-related high school or an associate's or bachelor's degree from a health-related university,
• Having received training on oral care practice in the unconscious patient.

It will be shared when requested from the researcher.

Statistical analyses and data reporting of the study will be carried out by statistical experts who are not among the researchers and are not familiar with the research application. The study was blinded in terms of outcome measures, statistical analysis and reporting to prevent statistical and reporting bias. In this context, the statistical expert was blinded; the researchers and students were not blinded.