--- title: "VR empathy training study: what Mayo Clinic nurse leaders gained" description: "Nursing leaders who trained in VR improved on empathy and speaking-up measures against a control group. What the study measured and what buyers can use." canonical: https://peopletechrevolution.com/insights/vr-empathy-training-study --- [Insights](https://peopletechrevolution.com/insights) # 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](https://linkedin.com/in/kimberlyloza), Head of Product at People Tech Revolution Published 20 September 2026 · Last updated 24 September 2026 · Version 1.1 [Connect with Kim on LinkedIn ↗](https://linkedin.com/in/kimberlyloza) Cite this research 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. Left out, seen from inside the scene. Speaking up at the meeting table. A leader rehearses the words to use. 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. Rehearsal: responding as yourself, out loud. ### 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. A facilitator talks the attempt through. ### Who took part Nurse and social worker leaders across Mayo Clinic campuses in the United States. [Our summary of the Mayo Clinic research](https://peopletechrevolution.com/work/research-evidence/vr-nursing-leaders-mayo-clinic) 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. Talking it through after the scene. ### 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. A colleague leans in to speak. ### 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. A patient conversation, rehearsed before the ward. A consult with family and interpreter present. A leader practising the reply first. A nurse tries the headset on the ward. ### For hospitals and health services The same rehearsal method sits behind [de-escalation training for healthcare workers](https://peopletechrevolution.com/xr/de-escalation-training-healthcare) and [hospital training](https://peopletechrevolution.com/work/industries/healthcare-medical) built with Mater Education. For the wider picture, read [what the published research says about VR training](https://peopletechrevolution.com/learn/does-vr-training-work). 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. Pooled effect sizes from systematic reviews Standardised effect of training against a comparison group; a higher bar is a bigger difference. The reviews call these effects small to moderate. Communication skills, medical students (Cochrane review, 2021) 0.92 Empathy, medical students, rated by experts (Cochrane review, 2021) 0.64 Simulation and empathy, nursing students, studies after 2019 (meta-analysis, 2024) 0.52 VR and empathy, health care education (umbrella review, 2026) 0.47 Simulation and empathy, nursing students, all studies (meta-analysis, 2024) 0.35 Sources: the reviews listed under Sources below, each quoted from its published abstract. Rehearsing seated, before the real conversation. ### A moderate benefit, again and again An [umbrella review of eleven reviews](https://doi.org/10.1186/s12909-026-09862-9) found VR raised empathy in health care education by a standardised 0.47. A [2024 meta-analysis](https://doi.org/10.1186/s12912-024-01944-7) of simulation in nursing education found stronger effects in newer studies. Reviewing the attempt against the criteria. ### Where the evidence is mixed In a [2025 randomised trial](https://doi.org/10.2196/66925) with 180 mental health professionals, VR improved attitudes and stigma but not empathy scores, and the comparison group improved as much. A [Cochrane review](https://doi.org/10.1002/14651858.CD012418.pub2) found empathy gains when experts rated them, not when simulated patients did. For de-escalation training itself, [Cochrane](https://doi.org/10.1002/14651858.CD012034.pub2) 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. Practising the conversation with an AI partner. ### AI practice partners In a [2026 randomised trial](https://doi.org/10.1080/0142159X.2026.2681199), 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](https://peopletechrevolution.com/ai/ai-roleplay-practice) and [does VR training work?](https://peopletechrevolution.com/learn/does-vr-training-work) Questions ## What buyers ask about this study Short answers for training, clinical and people leaders. A ward round, with reply choices at hand. ### 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. A coordinator talks with a new tutor. ### 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](https://peopletechrevolution.com/xr/vr-de-escalation-training) applies that method to aggression. A librarian and a student talk across the counter. ### Where can I read the study? The paper is in Social Science and Medicine, linked below. See also [the Mater case study](https://peopletechrevolution.com/work/case-studies/mater-speaking-with-good-judgement). - [Research and evidence](https://peopletechrevolution.com/work/research-evidence) - [Does VR training work](https://peopletechrevolution.com/learn/does-vr-training-work) - [AI roleplay training](https://peopletechrevolution.com/ai/ai-roleplay-practice) - [NSQHS training for Directors of Clinical Services](https://peopletechrevolution.com/work/industries/healthcare-medical/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 Copy citation 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 24 September 2026 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 20 September 2026 First published. Weighing VR training for your team? [Open the contact form](https://peopletechrevolution.com/insights/vr-empathy-training-study#contact) Ask Simon’s Digital Twin a question ## Sources The published papers, on the publishers’ own sites. ### [Simulation technologies and virtual reality in enhancing empathy: an umbrella review](https://doi.org/10.1186/s12909-026-09862-9) BMC Medical Education, 2026 Eleven reviews pooled; VR SMD 0.47. ### [Simulation-based interventions on empathy among nursing students: a meta-analysis](https://doi.org/10.1186/s12912-024-01944-7) BMC Nursing, 2024 Twenty-eight studies pooled. ### [Interventions for improving medical students’ interpersonal communication](https://doi.org/10.1002/14651858.CD012418.pub2) Cochrane Database of Systematic Reviews, 2021 Communication and empathy, by who rated them. ### [VR and stigma, empathy and attitudes among mental health care professionals: RCT](https://doi.org/10.2196/66925) JMIR Mental Health, 2025 Attitudes improved; empathy did not. ### [AI-based virtual patient training for clinical communication skills: RCT](https://doi.org/10.1080/0142159X.2026.2681199) Medical Teacher, 2026 AI virtual patient against peer role-play. ### [De-escalation techniques for managing aggression in adults](https://doi.org/10.1002/14651858.CD012034.pub2) Cochrane Database of Systematic Reviews, 2018 One eligible trial; very low certainty. ### [A virtual reality intervention to increase interracial empathy and upstander behaviors in nursing leaders](https://doi.org/10.1016/j.socscimed.2024.117648) Phelan et al., Social Science and Medicine The controlled trial behind these results. ### [PubMed record and abstract](https://pubmed.ncbi.nlm.nih.gov/39740631/) National Library of Medicine The abstract, with the findings relative to the control group. ### [Promoting Nursing Diversity, Equity, and Inclusion Through Virtual Reality Learning](https://doi.org/10.1097/NNA.0000000000001503) Nelson et al., JONA The companion paper on the same program’s rollout and evaluation.