This qualitative descriptive study explored participants’ experiences and confidence in skill development after completing an immersive simulation. Data were collected from February 13 to March 20, 2026. Of 14 people purposively recruited via snowball sampling, 9 health informatics professionals provided informed consent and completed either a desktop web-based or head-mounted display (Meta Quest 3) version of the simulation, custom-built using the Cornerstone Immerse CoPilot Designer, which enables emotionally realistic role-play with virtual human characters [7] (Figure 1).

After simulation completion, participants concluded with a semistructured online Qualtrics interview. The three coauthors conducted reflexive thematic analysis by each familiarizing themselves with the data, iteratively summarizing responses into categories at weekly meetings, developing and reviewing themes, and contextualizing findings against the study aims, with disagreements resolved by consensus [8]. Weekly discussions focused particularly on responses to questions addressing confidence, decision-making, application to daily work, and usefulness, allowing the team to track the depth and consistency of responses across interviews. The team collectively decided to discontinue data collection after 9 participants, judging that continued interviews were enriching existing categories rather than substantively expanding them.

The change management module “Guiding Lasting Change” was created to allow real-time conversations with change-resistant health care staff in a realistic health IT change scenario. Informed by various change management models [2-4], the simulation provided structured practice in core interpersonal skills essential for health informatics professionals, including communication, conflict management, self-awareness, and understanding others’ perspectives.

The module used instructional scaffolding during gameplay. Participants began by observing Jade, the nurse manager of a cardiac unit, delivering a discharge-planning project update. After a brief change management knowledge lesson from two virtual coaches, participants role-played as health informatics consultants negotiating one-on-one interactive exercises with Wanda, MD, and Keegan, PharmD. These change-resistant clinical team members allowed participants to practice active listening, empathy, and asking probing questions. Participants began the interactions by selecting from branching, dialogue-driven exchanges accompanied by immediate feedback, then advanced to an open-ended, unscripted dialogue with a role-based prompted AI avatar. A final postassessment activity with James, RN, provided participants with scored feedback. The entire 5-lesson module was completed in an average of 12.3 minutes.

Ethics approval was obtained from the institutional review board of the University of Southern Indiana, Evansville, Indiana (2411349‐1). Written informed consent was obtained from all participants before enrollment. Participant confidentiality was maintained by using deidentified data.

Overall, these results suggest that immersive simulation training could be an effective skill-building tool for developing change management competencies and may serve as a valuable addition to professional development in health informatics. The immersive simulation enabled practiced engagement with followers, laying a foundation for project success. Participants expressed that the simulation allowed them to apply empathy and critical thinking to mitigate end user frustration and coformulate solutions, and they emphasized that the simulation helped them recognize the importance of de-escalation practices in handling change-related situations productively.

Participants reported intending to apply active listening strategies in daily practice to address concerns and problem-solve with resistant coworkers—interpersonal skills identified as desirable in health informatics job postings [5]. They also described the authentic hospital simulation as useful for entry-level professionals learning to acknowledge end user frustration, further supporting VR’s value as a safe practice environment [6]. These findings support future research into lower-cost immersive simulation and AI alternatives to help health informatics professionals build the change management skills needed for sustained health IT project success.

Although snowball sampling ensured reach among active health informatics professionals, nonprobability sampling may introduce sampling bias, limiting generalizability and the diversity of viewpoints reported [9]. Findings reflected immediate, self-reported perceptions and do not demonstrate long-term behavior change or skill acquisition.

This study has laid the groundwork for future research while highlighting the potential value of developing immersive simulation training modules for nonclinical, change management, and interpersonal skill development among health informatics professionals.