Abstract:
 Background: Nursing education is evolving with technological advancements, including the adoption of virtual simulation. This protocol outlines a systematic review and meta-analysis aimed at evaluating the effectiveness of virtual simulation in improving nurses' knowledge.
 Methods: The study adheres to PRISMA guidelines and is registered in PROSPERO (registration number CRD42022352907). Eligible studies encompass randomized controlled trials (RCTs) that examine virtual simulation's impact on registered nurses, student nurses, or nursing professionals. The intervention involves various virtual simulation tools (virtual reality, augmented reality, serious games) compared against traditional methods or control groups. The primary outcome is improved nursing knowledge, measured through validated assessment tools. Methodological quality will be assessed using the Cochrane Risk of Bias tool.
 Results: Electronic databases (PubMed, Scopus, Web of Science, PsycINFO) will be systematically searched for eligible studies. The search strategy combines controlled vocabulary terms and keywords to ensure comprehensive retrieval. Two reviewers will independently screen titles, abstracts, and full texts. Data extraction will be standardized to collect study details, participant characteristics, intervention specifics, outcome measures, and findings related to knowledge enhancement.
 Analysis: Quantitative synthesis (meta-analysis) will be conducted if sufficient homogeneity exists among the included studies. Heterogeneity will be assessed using statistical tests, with subgroup and sensitivity analyses for further exploration. The GRADE approach will assess evidence quality and recommendation strength, considering bias risk, heterogeneity, indirectness, precision, and publication bias.
 Conclusion: The systematic review aims to provide evidence-based insights into the impact of virtual simulation on nurses' knowledge enhancement. By synthesizing data from RCTs, the study intends to guide educational practices and policy decisions for optimizing nursing education through innovative methods.