Earticle

국방 분야 무기체계 연구개발 계획을 수립하기에 앞서 사전 기획단계에서 관련 기술의 수준 과 발전 동향을 분석하는 단계가 필수적이다. 그러나 ‘폐쇄성’, ‘보안성’이라는 국방분야의 특성 상 공개된 정보를 활용한 기술정보의 공유·분석·현업 재활용이 쉽지 않은 것이 현실이다. 이에 본 연구는 텍스트마이닝과 토픽모델링을 기반으로 국방기술의 동향 분석 체계를 수립하는 것을 목표로 한다. 텍스트마이닝과 토픽모델링을 통해 산재해있는 국방 빅데이터의 체계적·정형적 분 석이 가능하다. 본 연구에서는 최근 인공지능, 로봇의 발전과 함께 미래 무인체계 개발의 첫 걸 음으로서 국방 연구기관에서 활발히 연구 중인 장갑전투차량을 대상으로 사례분석을 실시하였 다. 본 연구를 통해 국방 기술의 변화 추세와 미래 개발 이슈를 도출하고, 향후 국방과학기술의 연구개발 기획에 활용되기를 기대한다.

Establishing an R&D plan for the weapon system in the defense sector requires a preliminary step to analyze the current level and development status of the related technologies. However, the closed and confidential characteristics of the defense sector make it difficult to share, analyze, and utilize technology information available to researchers. In light of the above, this study seeks to establish a systematic analysis system for defense technologies based on the text mining and the topic modeling technologies. Text mining and topic modeling enable a systemic and programmed analysis of the big data scattered throughout the defense sector. For this study, we carried out a case analysis on the Armoured Fighting Vehicle development actively pursued by a defense research institute as the first step in the development of future unmanned systems along with artificial intelligence and robot development. Keywords:

치위생과 학생들의 스트레스 부분을 스트레스 반응 척도를 이용하여 체계적으로 분석하여 대학생활 만족도와의 관련성을 파악하기 위하여 경남지역에 소재한 치위생과 학생 299명을 대상으로 스트레스, 스트레스 반응척도, 대학생활 만족도를 융합연구 하였다. 스트레스 반응척도에 따라 체계적으로 분석한 결과 피로와 좌절, 우울, 분노에서 높은 수치를 나타내었다. 또한 스트레스를 경험한 경우 만족도에도 부정적인 영향을 미쳤다. 스트레스는 심각한 경우 질병으로 이어질 수 있는 부정적인 영향을 줄 수 있다. 대학생활의 스트레스가 부적응과 불만족을 가중 시킬 것을 예상 할 때 스트레스 반응 척도를 이용한 체계적인 분석 연구는 스트레스를 줄이고 대학생활 만족도 향상에 분명히 도움이 될 것으로 판단된다. 이에 대한 방안으로 치위생과에 맞는 스트레스 반응 도구의 개발과 분석을 제안한다.

To investigate the relationship between dental hygiene students' stress and college life satisfaction, 299 dental students and students in Gyeongnam area studied stress, stress response scale, and university life satisfaction. The results of systematic analysis according to the scale of stress response showed high values in fatigue, frustration, depression and anger. In addition, satisfaction with stress experienced negatively. Stress can give you a negative impact that can lead to serious illness. A systematic analysis using the stress response scale is expected to help reduce stress and improve college life satisfaction when the stress of college life is expected to increase maladjustment and dissatisfaction. We suggest the development and analysis of a stress response tool suitable for dental hygienists.

Purpose: This study systematically analyzed cases in South Korea wherein nurses were prosecuted for involuntary manslaughter or injury due to professional negligence in pediatric care. Methods: We analyzed the precedents using the methodology of Hall and Wright (2008) and Austin (2010). Of the 618 cases retrieved from the Supreme Court Decisions Retrieval System in South Korea, we selected the 12 cases in which children were the victims and nurses were the defendants, using a case screening methodology. Results: The most frequent penalty was a fine, and newborns were the most frequent victims. The distribution of cases according to Austin's violation categories was: improper administration of medications (n=5), failure to monitor for and report deterioration (n=4), ineffective communication (n=4), failure to delegate responsibly (n=4), failure to know and follow facility policies and procedures (n=1), and improper use of equipment (n=1). Conclusion: To ensure the safety of children, nurses are required to teach and practice a high standard of care. Nursing education programs must improve nurses’ awareness of their legal obligations. Nursing organizations and leaders should also work towards enacting effective nursing laws and ensuring that nurses are aware of their legal rights and responsibilities.

Purpose: This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness. Methods: A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Dataanalysis was performed using descriptive statistics and the Comprehensive Meta-Analysis program. Results: XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001). Conclusion: Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, theapplication of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Class imbalance in datasets presents a significant challenge in machine learning, often causing traditional classification algorithms to exhibit bias towards majority classes while underrepresenting minority classes, which may be of crucial importance in various applications. This classification challenge is further exacerbated by the presence of label noise, which impedes the identification of optimal decision boundaries between classes and potentially leads to model overfitting. While extensive research has addressed class imbalance and label noise as separate phenomena, there remains a notable gap in the literature regarding their concurrent occurrence in datasets, specifically in the domain of imbalanced classification with label noise (ICLN). This review aims to bridge this gap by conducting an extensive analysis of existing methodologies addressing ICLN challenges. Our review encompasses approaches across diverse categories, including resampling techniques, ensemble methods, cost-sensitive learning, deep learning, active learning, meta-learning, and hybrid methodologies. Through rigorous empirical evaluation, we compare representative methods from each category using synthetic and real-world datasets, revealing a trade-off between minority class preservation, noise robustness, and computational efficiency. Our findings reveal that algorithm effectiveness is fundamentally dataset-dependent, with deep learning methods excelling on complex datasets while resampling approaches achieve competitive performance with lower computational cost. Statistical significance analysis validates our empirical observations, and we identify concrete future research directions for advancing ICLN methodologies.

Systematic reviews and meta-analyses have become central in many research fields, particularly medicine. They offer the highest level of evidence in evidence-based medicine and support the development and revision of clinical practice guidelines, which offer recommendations for clinicians caring for patients with specific diseases and conditions. This review summarizes the concepts of systematic reviews and meta-analyses and provides guidance on reviewing and assessing such papers. A systematic review refers to a review of a research question that uses explicit and systematic methods to identify, select, and critically appraise relevant research. In contrast, a meta-analysis is a quantitative statistical analysis that combines individual results on the same research question to estimate the common or mean effect. Conducting a meta-analysis involves defining a research topic, selecting a study design, searching literature in electronic databases, selecting relevant studies, and conducting the analysis. One can assess the findings of a meta-analysis by interpreting a forest plot and a funnel plot and by examining heterogeneity. When reviewing systematic reviews and meta-analyses, several essential points must be con-sidered, including the originality and significance of the work, the comprehensiveness of the database search, the selection of studies based on inclusion and exclusion criteria, subgroup analyses by various factors, and the interpretation of the results based on the levels of evidence. This review will provide readers with helpful guidance to help them read, understand, and evaluate these articles.

Purpose: Fatigue is the third most common “extraintestinal” complaint of patients with irritable bowel syndrome (IBS), but it is still poorly understood. This study aimed to review characteristics of IBSassociated fatigue and to examine pooled frequency, severity of fatigue, and correlations of related factors with fatigue in IBS via meta-analyses. Methods: Publications were searched in eight databases from 1995 to 2014. Random effects metaanalyses were applied with standard error, weighted effect size, and correlation-based measure of effect size. Results: Twenty-four studies were included in systematic review. Seventeen studies were used for metaanalyses (2 studies were excluded in the frequency of fatigue analysis due to data unavailability). Using “tiredness” to define fatigue, and Fatigue Impact Scale to assess fatigue were the most frequently used across the studies. Gastrointestinal symptoms, psychological distress, and health-related quality of life were the most common correlates with fatigue. The pooled frequency of fatigue was 54.2% [95% confidence interval (38.5, 69.4)]. Metaregression on the frequency of fatigue showed positive and significant relations with tertiary care settings, female sex, and younger age. There was a negatively moderate relationship between the severity of fatigue and health-related quality of life score (correlation-based measure of effect size: -.378). Conclusions: Fatigue is prevalent among patients with IBS and commonly co-occurs with other symptoms. This is the first study to fully examine fatigue in IBS, which shed light on the comprehensive management of fatigue in this patient group. Future research is warranted to further explore fatiguerelated factors and underlying mechanisms of fatigue in IBS.

Purpose: We investigated factors associated with malnutrition in nursing home residents and estimated pooled effect sizes of those associations. Methods: We report this study according to the PRISMA checklist 2020. After registering the protocol, we conducted a systematic search using the keywords “malnutrition,” “nursing home,” and “factor” on PubMed, EMBASE, CINAHL, and Scopus and conducted a hand search of relevant sources in November 2023. We conducted the meta-analysis using R4.3.1 software. Results: We included 46 studies and entered 35 studies into the meta-analysis. Meta-analysis results showed that (1) demographic factors included being female: pooled odds ratio (pOR) 1.38 (95% confidence interval [95% CI], 1.29~1.47) and higher body mass index: pOR 0.74 (95% CI, 0.66~0.83); (2) health functional factors including dependence with activities of daily living: pOR 3.70 (95% CI, 2.97~4.60) and being immobile: pOR 2.50 (95% CI, 1.39~4.47); (3) eating and oral intake factors including: eating <50% of offered food portions: pOR 3.56 (95% CI, 2.05~6.19) and loss of appetite: pOR 3.60 (95% CI, 1.36~9.57); (4) disease-related factors including dementia: pOR 1.98 (95% CI, 1.59~2.46), depression: pOR 1.84 (95% CI, 1.18~2.85), diabetes: pOR 0.76 (95% CI, 0.58~0.99), and pressure ulcers: pOR 2.14 (95% CI, 1.54~2.97); and (5) medication-related factors such as taking polypharmacy pOR 1.75 (95% CI, 1.24~2.47) were found to have a significant association with malnutrition in nursing homes. Conclusion: These results contribute to updating knowledge about factors associated with malnutrition in nursing homes. Results supported that demographic status, health function, eating and oral intake, and disease, and medication factors significantly aligned with malnutrition. Study results contribute to improving nutritional care in nursing homes and long-term-care settings.

Purpose: It is important to examine the attitudes of future nurses toward adopting a sustainabilityapproach in their nursing practice. This study aimed to test the Sustainability Attitudes in Nursing Survey2 psychometrically. Methods: The methodological, descriptive study was conducted in November 2019 on nursing students(n ¼ 286) at a university in Turkiye. Data were analyzed for reliability and validity tests. Statistics of thelinguistic content validity analysis and exploratory/confirmatory factor analysis were performed todetermine the scale's validity. Cronbach Alpha coefficient, floor and ceiling impacts, Tukey's test, andHotelling's T2 test, test-retest reliability were determined for the scale's reliability. Results: The content validity index of the scale, which consists of five items and one dimension, is .98. Factor loadings were above .30, all the fit indices were >.95, c2/df was 1.58, and the root means squareerror of approximation was .045. Cronbach's a was .75. The floor and ceiling impacts were 0.0% and 3.1%. In Tukey's test, F was 3.43 and p was .064. In Hotelling's T2 test, Hotelling's T2 was 265.59 and F was 65.68(p < .001). Item-total correlation coefficients were between .37 and .63. The test-retest correlation coefficientwas .39. Conclusion: The scale is a valid and reliable instrument in the Turkish language. It is advised to use thescale in determining attitudes towards sustainability among nursing students, evaluating the effectivenessof training, and taking student opinions in curriculum revisions. Also, the study allowed crosscountrycomparisons, and it is thought that it can guide studies on the inclusion of sustainability principlesin nursing practices.

Purpose The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics. Methods A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression, or physiological parameters in humans. We assessed the risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias-corrected standardized mean difference as effect size metric, Hedges’ ? for all outcomes. Results Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' ? = ?0.72, 95% confidence interval [CI] ?0.90 to ?0.55, p value <.001), depression (Hedges' ? = ?0.43, 95% CI, ?0.59 to ?0.27, p value <.001), and systolic blood pressure (Hedges' ? = ?0.23, 95% CI, ?0.41to ?0.05, p value = .01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p value = .187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p value = .055), and participants’ health state accounted 8.9% (p value = .131) for the variance in anxiolytic effects. Conclusion Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on the effect of lavender on depression were scarce. Future trials on depression and physiological parameters are recommended, and increasing the sessions of administration is recommended.

Purpose This study was to systematically review randomized controlled trials and conduct a meta analysis. The results of randomized controlled trials were integrated and analyzed to assess the effects of mind-body programs on anxiety, depression, quality of life, and pregnancy rate in infertile women. Methods Using electronic databases (i.e., Research Information Sharing Service, Korean Studies Information Service System, Korean Medical Database, National Digital Science Library, Cochrane Library, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES), 10 of 2,259 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. Results The mind?body program was effective in relieving anxiety [standardized mean difference (SMD) = ?3.44; 95% confidence interval (CI) = ?5.94, ?0.95; p = .007; I2 = 69%] and depression (SMD = ?5.79; 95% CI = ?10.36, ?1.22; p = .010; I2 = 86%). Furthermore, it was effective in enhancing the quality of life (SMD = 7.40; 95% CI = 2.92, 11.88; p = .001; I2 = 53%) and pregnancy rate (SMD = 2.06; 95% CI = 1.08, 3.95; p = .030; I2 = 73%). The mind?body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. Conclusion The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. The mind-body program needs to be considered to a wider audience for positive effects on emotions and pregnancy outcomes of infertile women.

This study meta-analyzed interventions for symptom constructs of complex posttraumatic stress disorder related to complex trauma, such as child abuse, multiple interpersonal trauma, and organized violence. From 42 randomized controlled studies, 164 effect sizes were calculated comprising various treatment comparisons and outcomes. Cognitive processing therapy/cognitive therapy (CPT/CT), narrative exposure therapy (NET), phase-based trauma-focused cognitive behavior therapy (phased TF-CBT), single-phased TF-CBT (single TF-CBT), prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and present-centered therapy (PCT) each showed moderate to large effect sizes on PTSD. For depression, CPT/CT, phased TF-CBT, single TF-CBT, NET, and PE showed moderate to large effect sizes. Meta regression revealed that efficacy on PTSD and depression was greater with trauma-focused than with present-centered interventions. Limited evidence made it impossible to compare phased treatments and single-phase treatments. Outcomes of disturbance in self organization (DSO) were relatively scarce; however, among those, CPT/CT, PE, and PCT showed large to moderate effect sizes on negative self-concept. For emotion regulation and interpersonal problems, phased TF-CBT seemed to be promising. Treatment completion rates were similar between trauma-focused and present-centered. Population and study characteristics did not affect efficacy; however, we discussed related clinical issues.

Purpose: The aim of this study was to identify factors influencing meal satisfaction in older adults. Methods: Authors searched four databases Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, and KoreaMed using the following key search terms: “(elderly-mp. OR aged), AND (meal OR food OR eating OR feeding), AND satisfaction.” Only articles published between January 1946 and May 2018 were considered. The preferred reporting items for systematic reviews and meta-analyses guidelines were adopted for quality assessment. The authors ultimately selected 7 of 1,695 references for review and meta-analysis. Results: A meta-analysis was conducted to determine the factors influencing meal satisfaction in older adults aged more than 60 years. The results showed that meal satisfaction was low when age increased and the individual was served frozen meals. Satisfaction with meals was high when food choices were available and individuals were served high-quality food and when the food smelled and tasted good or was personally tailored. Satisfaction was also high when individuals ate with their families. Moreover, meal satisfaction seemed to be influenced by physical health, whereas it did not show a significant correlation with mental health. Conclusion: Intending to improve the quality of life of older adults by increasing their meal satisfaction, the authors pointed out factors that institutions should attend to when providing meals to older adults. To contribute to the lack of any existing conceptual and theoretical framework in this field, further steps to be taken by the authors shall involve concept analysis that would assist in building a conceptual framework.

Background/Purpose: Few clinical trials have investigated the antidiabetic effects of ginger to date. Several recent clinical trials published in 2013 and 2014, although small, have added contradictory but compelling new evidence about the use of ginger in treating diabetes in humans. Therefore, a systematic review and meta-analysis was conducted to clarify the evidence for using ginger to treat diabetes. Methods: Five randomized clinical trials (RCTs) were identified and included in the meta-analysis. Four of the RCTs were considered high quality and lasted 8 weeks; one lasted only 30 days and was considered low quality. Outcomes measured included fasting blood glucose and insulin, homeostatic model assessment (HOMA)-insulin resistance (IR), and hemoglobin A1c (HbA1c) levels, and were assessed as mean differences in the meta-analysis. Results: Ginger supplementation significantly lowered fasting blood glucose concentrations and HbA1c levels, but did not significantly lower fasting blood insulin or HOMA-IR. Conclusion: Ginger root supplementation significantly lowers blood glucose and HbA1c levels. When combined with dietary and lifestyle interventions it may be an effective intervention for managing Type 2 diabetes mellitus.

Purpose: This study conducted a systematic literature review and meta-analysis on the effectiveness of aromatherapy in reducing restless legs syndrome (RLS) in hemodialysis patients. Methods: Using the population, intervention, comparison, outcome, study design framework, a search was conducted of eight electronic databases: PubMed, Cochrane, Embase-Ovid, CINAHL, Web of science, Scopus, PQDT, and RISS. The population was hemodialysis patients, and the intervention included aromatherapy aiming at RLS, compared to control groups receiving placebo or usual care. The outcome measured was RLS, and the study design was randomized controlled trials. Results: The analysis included seven articles presenting results from 10 studies, and the pooled overall effect of aromatherapy on RLS in hemodialysis patients was shown by a Hedge’s g of ?1.84 (95% confidence interval: ?2.45 to ?1.23). Meta-regression analysis revealed greater effectiveness in studies that received funding. Age over 60, lavender oil use, intervention duration of less than 4 weeks, sessions longer than 30 minutes, a routine care control group, and quality assessment score of 10 or less were associated with RLS reduction. Conclusion: The study concluded that aromatherapy is effective for managing RLS in hemodialysis patients.

Purpose: This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). Methods: Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. Results: Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. Conclusion: Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

Purpose: Sleep quality was considered a priority concern facing pregnant women. Conventional wisdom argues that good sleep quality benefits pregnant women and their fetuses. The aim of this study is to assess the effects of a specific exercise program on the　sleep quality in pregnant women. Methods: Searches were executed in seven databases since their inceptions until February 28, 2019, for randomized controlled trials evaluating the effects of an exercise program on the sleep quality and insomnia in pregnant women. A random-effects model was applied for meta-analysis, and odds ratio, mean differences (MDs), and 95% confidence intervals (CIs) are shown as parts of outcomes. Results: Seven studies were included for meta-analysis. Compared with their not-exercising counterparts, analyses showed that regularly exercising women had significantly enhanced sleep quality, with an odds ratio of 6.21 (95% CI, 2.02?19.11;p = .001; I2 = 80.2%), with a standardized MD of ?0.93 (95% CI, ?1.19 to ?0.67; p < .001; I2 = 30.0%). However, exercising women showed no significant insomnia improvement, with an standardized MD of ?2.85 (95% CI, ?7.67 to 1.98; p = .250; I2 = 97.0%), relative to their not-exercising counterparts. Conclusion: This research indicated that exercise has a positive impact on the sleep quality of pregnant women. Despite the aforementioned positive impact on sleep quality, the present study did not find evidence to support that exercise may also improve insomnia for pregnant women.

Purpose: A systematic review and meta-analysis was conducted to evaluate the effects of smartphonebased mobile learning for nurses and nursing students. Methods: Electronic literature search of PubMed, Cochrane Library, Embase, SCOPUS, Web of Science, ProQuest Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resource Information Center (ERIC) was conducted. Two authors independently reviewed empirical studies for inclusion and extracted the design, sample size, intervention method, outcome variables, and statistical values of them. Methodological quality was assessed using Cochrane collaboration risk of bias tool. To estimate the effect size, meta-analysis was performed using R meta program. Results: Authors identified 11 randomized or nonrandomized controlled trials of a total of 3,419 studies. Overall effect sizes by random-effects model was large [Hedges'g (g) ¼ 1.12, 95% confidence interval (CI) 0.72e1.52], with learning attitude (g ¼ 1.69), skills (g ¼ 1.41), knowledge (g ¼ 1.47), and confidence in performance (g ¼ 1.54). For heterogeneity, subgroup analyses using meta-analysis of variance were performed, but no significant difference was found. Finally, a funnel plot and Egger's regression test along with trim-and-fill analysis and fail-safe N were conducted to check for publication bias, but no significant bias was detected. Conclusion: Smartphone-based mobile learning had significantly positive influence on nursing students' knowledge, skills, confidence in performance, and learning attitude. Smartphone-based mobile learning may be an alternative or supportive method for better education in nursing fields.

Purpose: This study conducted a systematic analysis of the effects of virtual reality (VR)-based simulation education on nursing students’ learning outcomes.Methods: Studies involving undergraduate nursing students who received immersive or non-immersive VR?based simulation education, compared with conventional nursing education, were identified from Cochrane CENTRAL, EMBASE, PubMed, CINAHL, ACM Digital Library, NDSL, KISS, DBpia, and RISS, from database inception through February 28, 2025. The primary outcomes were nursing skill performance and knowledge, while the secondary outcomes were self-efficacy and confidence in nursing performance. Only randomized controlled trials were included. A total of 21 studies met the inclusion criteria and were synthesized using a random-effects meta-analysis. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs).Results: Across 21 randomized controlled trials, the meta-analysis showed that VR-based simulation education had no statistically significant effects on nursing skill performance (n = 759, SMD = 0.18; 95% CI: ?0.47 to 0.82) or confidence in nursing performance (n = 1,157, SMD = 0.12; 95% CI: ?0.20 to 0.43). In contrast, statistically significant positive effects were observed for knowledge (n = 1,009, SMD = 0.32; 95% CI: 0.08 to 0.57) and self-efficacy (n = 696, SMD = 0.46; 95% CI: 0.11 to 0.81).Conclusion: VR-based simulation education represents an effective educational approach for improving nursing students’ knowledge and self-efficacy. Future implementations should align the type and complexity of VR simulations with specific educational goals and content, while accounting for potential variation related to instructional design, learner characteristics, and outcome measures.