Abstract
Developing learners’ achievement, self-efficacy, empathy, and critical thinking is central to professional education; however, authentic triage training often faces constraints related to cost, safety, and limited opportunities for real-world practice. These challenges highlight the need for effective virtual learning environments that support self-directed learning and foster complex professional competencies. For this study, we designed a metaverse game-based learning environment grounded in the self-directed learning framework to enhance cognitive, affective, and behavioral learning outcomes. A quasi-experimental study was conducted with 62 undergraduate nursing students enrolled in a foundational skills course. Thirty-one students participated in the metaverse game–assisted self-directed learning intervention, while thirty-one received conventional instruction. The results showed that learners in the metaverse game group achieved significantly higher learning outcomes, including learning achievement, self-efficacy, empathy, and critical thinking, compared with those receiving traditional instruction. Learning analytics further revealed distinct behavioral patterns between high- and low-self-efficacy learners within the metaverse environment. These findings provide triangulated evidence by integrating learning outcomes, self-reported measures, and behavioral analytics, supporting the effectiveness of metaverse game-based self-directed learning in professional training, and offering practical implications for integrating immersive, data-informed virtual environments into future curriculum design.
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