AbstractDementia patients may have language barriers and decreased comprehension ability. Their family caregivers can feel frustrated when communicating with them. Poor communication hinders family caregivers from obtaining accurate health information about patients, and may also increase their emotional burden, affecting patient care quality. The present study developed a virtual reality‐based simulated communication training (VRSCT) system and applied it to a training course for family caregivers of dementia patients. It allowed family caregivers to simulate real‐world situations in a VR environment, experience the daily communication barriers and stress with dementia patients, and apply their acquired knowledge and skills to solve related problems. This study used a randomised control experimental design with mixed analysis methods. A total of 63 family caregivers were recruited and randomly divided into the experimental group (N = 32) learning with the VRSCT system to interact with virtual dementia patients and practice communication skills, and the control group (N = 31) using the traditional role‐playing method for practice. Quantitative data were analysed to determine participants' knowledge of dementia care, attitudes, communication confidence and skills. In addition, the qualitative method was used to analyse the participants' discussion records. The results showed that by using the VRSCT approach, participants significantly improved their knowledge of dementia care, attitudes, communication confidence and communication skills compared to the control group. In addition, participants reported that through the real‐time feedback of the VRSCT system, they could recognise their previous incorrect communication approach. As a result, they adjusted their communication strategies and increased their self‐confidence. Practitioner notesWhat is already known about this topic Situational simulation helps learners improve their communication skills in a safe environment. Virtual reality (VR) creates a realistic, highly interactive learning environment, allowing users to be deeply immersed in the learning experience. What this paper adds This study proposed a VR‐based simulated communication training (VRSCT) approach; moreover, seven dementia cases of different degrees of severity were designed in the VR system to enable family members to experience possible challenges of taking care of dementia patients they might encounter in their daily lives. Each case in the VRSCT system has its unique symptoms and communication barriers. The learner in the story plays a caregiver, experiencing and solving the problems and challenges posed by the system. The experimental results show that the proposed method improves learners' knowledge, attitudes, communication confidence, and communication skills related to dementia care. Implications for practice and/or policy Utilising VR training can amplify awareness and secure enhanced social support for dementia‐related challenges. Using VRSCT, as governments and institutions recognise the effectiveness of VR training, they will provide more resources and promote its widespread application.