RT null T1 Mixed reality undergraduate nursing education: a sistematic review and meta-analysis of benefis and challenges A1 Guillen Aguinaga, Laura A1 Rayón Valpuesta, Esperanza A1 Guillen Aguinaga, Sara A1 Rodriguez Diaz, Blanca A1 Montejo, Rocío A1 Alas Brun, Rosa A1 Aguinaga Ontoso, Enrique A1 Onambele, Luc A1 Guillen Aguinaga, Miriam A1 Guillen Grima, Francisco A1 Aguinaga Ontoso, Ines AB Abstract: Background: Nursing Schools are incorporating Mixed Reality (MR) into student training to enable them to confront challenging or infrequently encountered scenarios in theirpractice and ensure their preparedness. This systematic review evaluates the benefits and challenges of implementing MR in nursing curricula. Materials and Methods: A search wasconducted in PubMed, WOS, Scopus, Embase, and CINAHL for studies published between 2011 and 2023. The search strategy used was “(nurses OR nurse OR nursing) AND mixedreality AND simulation”. Inclusion criteria required that studies focus on undergraduate nursing students and be written in English or Spanish. Exclusion criteria included reviews,bibliometric studies, and articles that did not separately report undergraduate nursing student results. Quality was evaluated with the JBI Critical Appraisal Checklist for QualitativeResearch and the Newcastle-Ottawa Scale. A meta-analysis was conducted on studies with control groups to compare MR’s effectiveness against traditional teaching methods. Results:Thirty-three studies met the inclusion criteria. MR was widely used to improve clinical judgment, patient safety, technical skill acquisition, and student confidence. The meta-analysisfound that MR reduced anxiety (Cohen’s d = −0.73, p < 0.001). However, its impact on knowledge acquisition and skill development was inconsistent. There was no improvementover traditional methods (p = 0.466 and p = 0.840). Despite positive qualitative findings, methodological variability, small sample sizes, and publication bias contributed to mixedquantitative results. The main challenges were cybersickness, usability, high costs, and limited institutional access to MR technology. Conclusions: Although MR can help nursingeducation by decreasing students’ anxiety, its efficacy remains inconclusive. Future research should use larger, randomized controlled trials to validate MR’s role in nursing education. PB MDPI SN 2039-439X YR 2025 FD 2025-04-22 LK https://hdl.handle.net/20.500.14352/130754 UL https://hdl.handle.net/20.500.14352/130754 LA eng NO Guillen-Aguinaga, L.; Rayón-Valpuesta, E.; Guillen-Aguinaga, S.; Rodriguez-Diaz, B.; Montejo, R.; Alas-Brun, R.; Aguinaga-Ontoso, E.; Onambele, L.; Guillen-Aguinaga, M.; Guillen-Grima, F.; et al. Mixed Reality in Undergraduate Nursing Education: A Systematic Review and Meta-Analysis of Benefits and Challenges. Nurs. Rep. 2025, 15, 137. https://doi.org/10.3390/nursrep15050137 DS Docta Complutense RD 27 mar 2026