Table 3.

Self-assessment categorizations

Core Categories	Sub-categories	Key words	Examples
Mastering IV infusion knowledge/skills	IV infusion understanding	Vivid illustration; Deepening the comprehension and retention	CG4: “The teacher’s live demonstration offered me an intuitive and vivid illustration of the learning process.” EG7: “This pre-practice learning approach enabled to engage more actively in the educational process, thereby deepening the comprehension and retention of IV infusion knowledge and skills.”
	Systematic practical ability	Handle unexpected situations; Establishing a solid foundation for practice; Emergency protocols	CG2: “Practicing IV infusion in VR made me feel like a real nurse, increasing my engagement and confidence to handle unexpected situations.” CG3: “During the pre-course preparation, I attentively review videos, take notes on unclear concepts, and document areas that require mastery, thereby establishing a solid foundation for practice.” EG5: “When confronted with an emergency situation, such as a simulated patient exhibiting a reaction to an infusion, we were able to respond in a systematic manner in accordance with the emergency protocols we had acquired through the VR platform.”
	Learning efficiency	Engagement and confidence; Made progress	CG2: “Practicing IV infusion in VR made me feel like a real nurse, increasing my engagement and confidence to handle unexpected situations.” EG11: “Through such collaborative efforts, we can successfully accomplished the IV infusion task and made progress collectively.”
Offline training experience	Learning interest and participation	Active engagement; Monotonous and disheartening	EG1: “I was actively engaged and significantly enhancing my motivation to learn.” CG7: “Practicing independently can sometimes feel somewhat monotonous and disheartening.”
	Training environment	Sharing insights; Prosthetic for the practice; Fostered a positive learning vibe	EG7: “When the team member responsible for the operation is administering IV fluids, I will provide close assistance by handing over the instruments and monitoring the patient’s reaction.” CG5: “Merely utilizing a prosthetic for the practice of intravenous infusion creates a somewhat monotonous training environment.” EG11: “Teamwork helped us complete IV infusion tasks and fostered a positive learning vibe, where we learned and progressed together.”
Critical thinking development	Independent learning	Visual comprehension; Reviews operational demonstrations	EG5: “When confused about IV infusion theory, I visually grasped infusion speed’s impact via teacher’s videos & VR simulations.” CG42: “Lacking practical training skills, I’ll review VR demos, compare techniques, and find areas to improve.”
	Critical analysis skills through training challenges	Negative experiences; VR collaborative role - play; Mechanical repetition; No immediate feedback; Cognitive overload	EG5 & EG2: “Negative experiences (e.g., lag, needing to restart after accidental exit) may reduce motivation.” Some students: “Unskilled operation in practical training wastes time, lowers efficiency, and may foster negative attitudes. We expected to use VR collaborative role - play to explore virtual environments and boost skills/confidence for unexpected situations.” Some students: “When using VR for training, learners get no immediate feedback on operational errors; feedback comes only after the whole process, reducing learning motivation.” CG9: “Self-practice often led to a mechanical repetition of steps, which impeded the ability to navigate complex situations and resulted in a lack of deep thinking.” EG6 & CG13: “The cognitive overload and stress resulting from excessive pre-class work.”