Abstract
Background: Radiation plays a vital role in medical diagnosis and treatment. However, insufficient radiation protection education poses serious risks to patients and healthcare professionals. Nursing students often have limited formal training, and traditional lecture-based methods foster passive learning, which may not promote deep understanding. Augmented reality (AR) technology offers a novel approach by overlaying digital models onto real-world images, enabling students to intuitively visualize abstract concepts such as time, distance, and shielding. This study was conducted to evaluate an AR-based radiation protection application integrated with conventional lectures to enhance the knowledge of nursing students and calibrate their perceptions of radiation safety.Materials and Methods: A cross-sectional, pre–post-intervention study was conducted at Tokyo Metropolitan University among 80 second-year nursing students (95% female) without prior radiation safety training. The intervention comprised two phases: a standardized 90-minute lecture covering the nature and biological effects of ionizing radiation and the principles of time, distance, and shielding; and a hands-on AR session using an Android-based application that overlays a three-dimensional model of scattered radiation dose onto a live camera view, demonstrating exposure effects. Radiation knowledge was assessed using a 50-item questionnaire, and risk perception was measured using a 30-item, seven-point Likert scale. Data in this study were analyzed using nonparametric tests and compared with reference data.Results and Discussion: Post-intervention knowledge scores were significantly higher than pre-intervention and reference scores (p<0.05). Additionally, risk perception ratings for ‘nuclear power’ and ‘X-ray’ decreased by one rank, suggesting a more balanced and realistic evaluation of risks.Conclusion: Integrating AR with traditional lectures significantly improves radiation protection knowledge and risk assessment among nursing students, supporting the promising role of AR in healthcare education. Future research should include longitudinal follow-up and explore AR features, such as dose simulation.