What a controlled trial of VR empathy training found
Mayo Clinic nursing leaders who trained in VR improved on empathy and speaking up, measured against a control group.
By Kim Loza, Head of Product at People Tech Revolution
The moment
A colleague is treated unfairly, and a leader is in the room
The training put nursing leaders in a staff breakroom and a patient room where a colleague meets racial bias, then asked them to respond.
The study
A controlled trial by Mayo Clinic researchers
Researchers compared leaders who took the training with a control group and published the results in Social Science and Medicine.
Two ways into each scene
Each situation paired embodiment, where the participant experiences bias as a Black nurse avatar, with rehearsal, where they practise responding as themselves.
Classes combined the VR scenes with small-group debriefs led by trained facilitators.
Who took part
Nurse and social worker leaders across Mayo Clinic campuses in the United States. Our summary of the Mayo Clinic research sets out both published papers and how each was run.
The results
Empathy and speaking up rose against the control group
The training group improved relative to the control group on empathic feeling, perspective-taking and the intention to speak up.
Empathic feeling and expression
Scores in the intervention group rose by an average of 0.11 points while the control group’s fell by 0.02. The difference between the groups carried a p-value of 0.002.
Empathic perspective-taking
The intervention group rose 0.20 points, against 0.02 for the control group.
Speaking up for a colleague
The paper reports gains, relative to the control group, in the predictors of upstander behaviour and in the likelihood of acting when a coworker is treated in a racially biased way.
Months later
When the leaders were measured again months after the training, the increases were still significant.
Why it matters
Change measured against a control group
A comparison group shows what the training added over the same months. That is the question a budget holder asks.
For hospitals and health services
The same rehearsal method sits behind de-escalation training for healthcare workers and hospital training built with Mater Education.
For the wider picture, read what the published research says about VR training.
The wider evidence
What reviews of many studies find, and where they disagree
This trial sits inside a larger body of research. Reviews that pool many studies find moderate gains; single trials, and the evidence on de-escalation itself, are more mixed.
Standardised effect of training against a comparison group; a higher bar is a bigger difference. The reviews call these effects small to moderate.
Sources: the reviews listed under Sources below, each quoted from its published abstract.
A moderate benefit, again and again
An umbrella review of eleven reviews found VR raised empathy in health care education by a standardised 0.47. A 2024 meta-analysis of simulation in nursing education found stronger effects in newer studies.
Where the evidence is mixed
In a 2025 randomised trial with 180 mental health professionals, VR improved attitudes and stigma but not empathy scores, and the comparison group improved as much. A Cochrane review found empathy gains when experts rated them, not when simulated patients did.
For de-escalation training itself, Cochrane found one eligible trial and rated the evidence very low. Ask any provider for a comparison group and a measure of behaviour, not only self-report.
AI practice partners
In a 2026 randomised trial, dental students who practised with an AI virtual patient outscored classmates who role-played with each other on consultation completeness, 86.4 against 73.8, with gains still present three months later. See AI roleplay practice and does VR training work?
Questions
What buyers ask about this study
Short answers for training, clinical and people leaders.
What did the VR training involve?
Scenes set in a staff breakroom and a patient room, each with an embodiment part and a rehearsal part, delivered in facilitated classes.
Is empathy training the same as de-escalation training?
Both are built the same way: a realistic moment, a response rehearsed out loud, and a debrief. VR de-escalation training applies that method to aggression.
Where can I read the study?
The paper is in Social Science and Medicine, linked below. See also the Mater case study.
- Research and evidence
- Does VR training work
- AI roleplay training
- NSQHS training for Directors of Clinical Services
Cite this research
Free to quote and cite with a link to this page. Name the version you read, so readers can see what has changed since.
APA 7
Loza, K. (2026, September 24). What a controlled trial of VR empathy training found (Version 1.1). People Tech Revolution. https://peopletechrevolution.com/insights/vr-empathy-training-study
Data: The published trial (Social Science & Medicine) and its companion paper (JONA), read in full. Every figure is the authors’ own.
Version history
| Version | Date | What changed |
|---|---|---|
| Version 1.1 | Added the wider evidence: pooled effect sizes from systematic reviews, trials where the evidence is mixed, and an AI virtual patient trial. | |
| Version 1.0 | First published. |
Weighing VR training for your team?
Sources
The published papers, on the publishers’ own sites.
Simulation technologies and virtual reality in enhancing empathy: an umbrella review
Eleven reviews pooled; VR SMD 0.47.
Simulation-based interventions on empathy among nursing students: a meta-analysis
Twenty-eight studies pooled.
Interventions for improving medical students’ interpersonal communication
Communication and empathy, by who rated them.
VR and stigma, empathy and attitudes among mental health care professionals: RCT
Attitudes improved; empathy did not.
AI-based virtual patient training for clinical communication skills: RCT
AI virtual patient against peer role-play.
De-escalation techniques for managing aggression in adults
One eligible trial; very low certainty.
A virtual reality intervention to increase interracial empathy and upstander behaviors in nursing leaders
The controlled trial behind these results.
PubMed record and abstract
The abstract, with the findings relative to the control group.
Promoting Nursing Diversity, Equity, and Inclusion Through Virtual Reality Learning
The companion paper on the same program’s rollout and evaluation.
