UTS makes VR violence training compulsory for nurses

The University of Technology Sydney will require first-year nursing students to complete virtual reality violence prevention training before clinical placements, in what it describes as the first mandate of its kind in Australia.

The training will be built into the nursing curriculum for more than 600 new students. It places them in simulated healthcare situations involving aggression and escalating behaviour. Using virtual reality headsets, students identify warning signs, make decisions under pressure and practise de-escalation techniques before entering hospitals and other clinical settings.

The decision comes amid growing concern about violence against healthcare staff. A survey by the NSW Nurses' and Midwives' Association found 88% of nurses, midwives and carers had witnessed violence or aggression at work.

UTS developed the program with Sydney-based immersive learning company Start Beyond, with input from work health and safety and psychosocial risk consultancy The Risk Collective. In a pilot, 90% of participants said the simulation helped them identify early warning signs and take appropriate action to de-escalate situations and stay safe.

The initiative reflects a broader challenge for nursing educators, as students can encounter difficult behaviour early in their training. Clinical placements are central to nursing education, but they can also expose students to stressful environments before they have experience handling confrontations.

Professor Jacqui Pich, Deputy Head of School (Teaching and Learning), UTS School of Nursing & Midwifery, said: "We've seen enough evidence of violence against nurses to know we must give students practical strategies to recognise escalating situations and keep themselves safe before they encounter such threats in the real world. Traditional teaching methods can only go so far, whereas VR creates a much more immersive learning experience while ensuring our students' physical and psychological safety.

"We know this is a gap in healthcare education and we would love to see other universities explore similar approaches because we all have a duty of care to prepare students as best we can for the environments they'll be working in."

The simulations are designed to let students practise responses without the risks associated with live incidents. That gives educators a way to expose students to situations that would be difficult to recreate safely in classrooms or role-play exercises.

Lucy Rosenberg, Clinical Academic Lead, UTS School of Nursing & Midwifery, said: "Students can find themselves exposed to challenging situations very early in their careers. While most placements are positive experiences, incidents involving aggression occur more often than we'd like. Students now have an opportunity to learn in a safe environment and understand both best-practice responses and the consequences of poor decisions. The immersive nature of VR makes it much closer to real life than traditional classroom role play. Students aren't responding to a colleague pretending to be a patient. They feel like they're actually in the situation."

Industry input

Start Beyond said the project builds on work in other sectors where staff deal with conflict, including retail and hospitality. It argued simulated training can expose users to the emotional pressure of an encounter while allowing them to make mistakes without physical harm.

"The power of VR is that it can make people feel something. When people feel something, they remember it. When they remember it, they learn from it," said Angus Stevens, Chief Executive Officer, Start Beyond.

He linked the nursing project to broader workplace safety concerns in customer-facing and care roles.

"Healthcare professionals often do their invaluable work in high-stress environments, where they are exposed to unpredictable situations that can escalate rapidly and become dangerous. Our training uses VR to recreate that complexity and emotional intensity in a safe environment where students can practise, make mistakes and build confidence," Stevens said.

Behaviour patterns

The Risk Collective said the scenarios draw on behavioural research and workplace data from several industries, including healthcare, aged care, retail and hospitality, where workers can face similar patterns of verbal abuse, threats and rapidly changing behaviour.

"We analysed common patterns of aggressive behaviour across multiple sectors, including healthcare, aged care, retail and hospitality. The goal was to help people recognise behaviours before situations escalate. The scenarios are designed around evidence-based behavioural profiles and de-escalation strategies. The training we developed with Start Beyond gives participants practical skills they can apply in high-pressure situations while reducing the emotional and physical risks associated with learning those lessons in real life," said Amy Towers, Founder and Principal Consultant, The Risk Collective.

The UTS rollout adds to growing debate in Australian healthcare about how universities and employers should prepare workers for rising levels of abuse and aggression. For nursing schools, the question is not only whether students can deliver care, but whether they can recognise danger early and respond in ways that protect both themselves and patients.

More than 600 incoming nursing students at UTS are expected to complete the training before entering clinical environments.