Madrid Nurses’ Perceptions, Needs, and Expectations Regarding Extended Reality-Based Resilience Training: A Multicenter Qualitative Study

Background: Nurses routinely work under substantial emotional and organizational demands that may challenge their professional well-being and capacity to respond to stressful clinical situations. Resilience training may support healthcare professionals in managing these demands, while Extended Reality (XR) offers opportunities to recreate emotionally and clinically relevant situations within controlled learning environments. Objectives: To explore nurses’ perceptions, needs, and expectations regarding XR-based resilience training and to identify the organizational, professional, and technological conditions that may shape its future implementation. Methods: A multicenter qualitative descriptive-interpretive study was conducted between February and March 2025 across three hospitals and one out-of-hospital emergency medical service in Madrid, Spain. Twenty-six nurses participated in four focus groups. Following open recruitment, participants were purposively selected according to professional profiles to obtain variation in professional experience and clinical settings. Data were analyzed inductively using open coding, constant comparison, progressive category development, analytic memos, and examination of relationships among categories. These procedures were informed by Grounded Theory analytical strategies but were not used to claim a full Grounded Theory methodology. Three researchers independently participated in qualitative coding, and interpretive differences were discussed through consensus. A researcher-developed AI-assisted qualitative analysis tool was used as a complementary resource for corpus exploration, while category development and conceptual interpretation remained researcher-led. Results: Three interrelated categories were identified: expectations regarding XR, perceived barriers, and facilitators and opportunities. Their relationships converged in an interpretive pattern of conditioned openness toward XR. Participants perceived immersive resilience training as potentially valuable when it was realistic, clinically relevant, and provided a safe environment for experiential learning and reflection. However, willingness to engage with XR was constrained by workload, limited training time, technological concerns, and organizational conditions. Protected training time, institutional support, supportive leadership, technical assistance, and professional participation in scenario design emerged as enabling conditions. Conclusions: Participants perceived XR as a potentially useful approach to resilience training, but their openness to its implementation was conditional on clinical relevance and organizational feasibility. The findings do not establish the effectiveness of XR in improving resilience. Rather, they identify professional, organizational, and technological conditions that should inform the participatory design and future evaluation of XR-based resilience interventions.