VR training for nurse leaders at Mayo Clinic

Two peer-reviewed papers examine the same VR diversity, equity and inclusion training, built by People Tech Revolution and offered to 1,149 eligible Mayo Clinic nurse and social worker leaders.

A person wearing a Meta Quest VR headset smiles and holds out a cup while another looks on, part of Mayo Clinic's VR nursing training scenario. — A participant wears a headset, mid-scenario.

Built by People Tech Revolution

People Tech Revolution built the training through Equal Reality, a subsidiary of People Tech Revolution. JONA states that the VR developers were contracted from outside Mayo Clinic, through Equal Reality, and Social Science & Medicine states the module "was created in partnership with Equal Reality."

The authors are Mayo Clinic researchers. Both papers name Equal Reality, a subsidiary of People Tech Revolution, as the outside developer of the VR program, which People Tech Revolution built.

The scenes, and where they are set

Scenarios were co-designed with nursing staff who had lived experience of workplace racism and microaggressions, many of whom identify as Black, Indigenous or people of colour, working with People Tech Revolution's developers.

A nurse leader stands in a ward corridor facing a colleague, deciding whether to say something, embodying the study's bias scenario. — A leader decides whether to speak up.

An embodiment component, then a rehearsal component

Four VR situations were built around two settings, a staff breakroom and a patient room, each pairing an embodiment component (the participant experiences bias as a Black nurse avatar) with a rehearsal component (the participant practises responding as themselves).

Delivery was synchronous and virtual: 100 VR headsets were distributed, and 28 two-hour class sessions ran over 4 months, combining VR immersion with small-group debriefing led by trained facilitators.

Both studies move from design to reported results.

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What the JONA paper reports

Of 1,131 leaders who attended, 593 (52.4%) completed the post-class education survey. A separate program evaluation was completed by 366 nurse leaders.

A nurse leader alone in a headset on a ward round, the kind of session the JONA survey covered. — A ward round, seen through the headset.

91.9%

agreed or strongly agreed they achieved the learning objectives

90.3%

agreed the debrief was effective

61.1%

rated the overall activity "very good" or "excellent"

86.2%

felt the VR simulation was valuable to their professional growth

The lower 61.1% figure is the more mixed result; the authors suggest technical issues, discomfort with the content, or the class's mandatory nature as possible reasons.

A separate, randomised program evaluation found 89.2% would repeat it, but fewer felt the simulation represented real people (66.3%) or that the avatar felt like them (55.8%).

What the Social Science & Medicine paper reports

A quasi-experimental trial: 841 of the 1,149 eligible leaders completed a baseline survey and were assigned to intervention or a control group. The comparison below was measured in the week after the class, against controls who had not yet trained.

A group of nurse leaders on a ward round, the kind of cohort the trial measured. — A ward round, the cohort the trial measured.

p = .002

the intervention group's increase in empathic feeling and expression, relative to a control group

p < .001

the intervention group's increase in upstander-behaviour predictors, relative to controls

6 to 8 months later, the same measures (except empathic awareness, which never changed significantly) remained significantly higher than the sample's baseline. There was no longer a control group for comparison.

The authors describe this durability as one of the study's most notable findings.

Limitations the authors note

Both papers flag real constraints on what the results can support.

A quiet hospital courtyard, one health system's own grounds, the single-site sample the authors note as a limit. — A single health system's own grounds.

A nurse pausing outside, some sessions delivered on a flatscreen instead of a headset, a limitation the JONA authors note. — Some sessions ran on a flatscreen, not a headset.

A consult room conversation, a self-reported measure the authors flag as a limit rather than observed behaviour. — Measures were self-reported, not observed behaviour.

The Social Science & Medicine authors write that 176 of 841 baseline participants were not randomised. There was no control group at the 6 to 8 month mark.

The sample was mostly white (about 94-95%) and female (about 89-90%), reflecting who held these leadership roles at Mayo Clinic at the time.

A participant rehearses in the headset while observers watch from another part of the room. — Your cohort is measured across the campuses and regions it works in, with the format named in the write-up.

What the format and the funding allowed

The JONA authors add that the fully virtual, COVID-era format limited in-person technical support, and that scope was limited to racial DEI because that was what its funding targeted.

Both papers study the same four-scenario VR module, offered to 1,149 eligible leaders, of whom 1,131 attended, across 3 major campuses and 4 regions of Mayo Clinic's network (Southwest, Midwest, Southeast United States).

Rooms a nurse leader stood in

Corridors, wards and consult rooms: the everyday settings the module recreated for the cohort. Each room is entered through a headset; the XR overview shows how PTR builds and runs sessions like these.

A clinician rehearses a hard conversation, the kind of moment the module was built to practise. — Rehearsing the hard conversation.

A triage decision moment, one of the module's patient-room scenes. — A triage decision, in the patient room.

A mental-health assessment conversation, one of the module's rehearsal scenes. — A mental-health assessment, rehearsed.

"As organizations tighten budgets and adapt to remote workforces, VR offers scalability, efficiency, and deep behavioural impact. Beyond training technical skills, it enables leadership, resilience, de-escalation techniques, and inclusive decision-making, all essential for thriving in today's workplace."

Simon Lowe, CEO of People Tech Revolution, presenting. Simon Lowe
CEO, People Tech Revolution. Forbes, 13 June 2025