Nursing students’ perception of extended reality in anatomy teaching: A cross-sectional study

Objective: Extended Reality (XR) applications offer immersive, interactive environments that may enhance nursing students’ understanding of complex anatomical content, yet there is limited evidence on motivational outcomes and learning strategies in this context. This study examined nursing students’ perceptions of an XR Brain (XRB) application and explored how demographic characteristics and motivational and learning strategy variables, as measured by selected Motivated Strategies for Learning Questionnaire (MSLQ) subscales, relate to self-efficacy for learning and performance. 
Methods: A cross-sectional study was conducted with 146 nursing students enrolled in an Anatomy and Physiology course at a tertiary institution in Singapore. The XRB application was integrated into teaching on the nervous system, and data were collected using a two-part questionnaire that captured demographics and six MSLQ subscales: intrinsic value, task value, metacognitive self-regulation, peer learning, task anxiety and self-efficacy for learning and performance.
Results: Self-efficacy demonstrated strong positive correlations with all the other five MSLQ subscales, indicating that greater perceived importance and enjoyment of the XR-based content, along with stronger strategic learning tendencies, were associated with higher confidence in learning. 
Conclusions: The findings highlight the important role of intrinsic value and task value in shaping nursing students’ self-efficacy during XR-based anatomy learning. Gender and digital literacy also influence self-efficacy, but their effects are smaller. Recommendations: Instructional designs that connect XR activities to meaningful, real-world nursing practice can further enhance students’ confidence. Providing targeted technical orientation may also strengthen their academic self-belief and improve the overall educational impact of immersive XR tools.