Peer-reviewed article

Development and effects of a pediatric intensive care unit fire disaster evacuation simulation program using the metaverse: A quasi-experimental study.

So Hee An, Sang A Cha, Yeon Woo Lee, Bobae Park, In Young Cho · 28 Jul 2026

Abstract

BACKGROUND: Critically ill children in pediatric intensive care units (PICUs) are highly vulnerable during fires. Metaverse-based education platforms such as Roblox offer immersive, accessible training in clinical disaster preparedness for nursing students. AIM: To develop a PICU disaster evacuation simulation program using Roblox and evaluate its effectiveness vs. lecture-only education in improving nursing students' disaster evacuation competency, learning presence, learning flow, and learning satisfaction. DESIGN: A nonrandomized, quasi-experimental, pretest-posttest design was used to develop, implement, and verify a metaverse-based disaster evacuation enhancement program at nursing schools in South Korea. SETTINGS: Nursing schools in South Korea; the program was delivered in an online, metaverse-based learning environment. PARTICIPANTS: Forty-seven fourth-year nursing students who had completed pediatric nursing theory and practice were assigned to two groups: the experimental and control groups. METHODS: We developed the metaverse-based FLAME-SIM (Fire Learning and Metaverse-Based Evacuation Simulation) program to enhance disaster evacuation competency by creating a pediatric field using the metaverse platforms Gather Town and Roblox. The program included an online lecture, a Gather Town-based pre-briefing, a Roblox-based simulation on managing fire disasters, and a debriefing. Disaster evacuation competency, learning presence, learning flow, and learning satisfaction were measured before and after the program. RESULTS: The experimental group showed higher disaster evacuation competency than the control group (t = 2.141, p = .038). Learning presence increased in the experimental group, including cognitive presence (z = -2.008, p = .045) and emotional presence (z = -2.174, p = .030). No statistically significant differences were observed in learning flow (z = -1.873, p = .061) or learning satisfaction (z = -1.484, p = .138). CONCLUSIONS: The FLAME-SIM program improved disaster evacuation competency and learning presence. This program could help students to prepare disaster evacuation competency by navigating the nature and complexities of pediatric nursing practice.