Objective:To explore the teaching reform effect of the integrated "theory virtual reality" course in Fundamentals of Nursing in vocational colleges, providing reference for related research in other courses. Methods:From January to June 2023, a convenience sampling method was used to select vocational nursing students from 11 classes of the Nursing College of Guangxi Health Vocational and Technical College in 2022 as the research objects. Through class experimental research methods, a smart simulation virtual classroom was used to carry out the integrated teaching of Fundamentals of Nursing (referred to as "theory virtual reality") in theory virtual practice. The teaching resources and pre class, in class, and post class tasks were published on the Chaoxing Learning Platform. Theory practical teaching was conducted in the simulated virtual smart classroom, and virtual training scenes were constructed using virtual simulation software. Operations evaluation, planning, implementation, and evaluation were completed by forming groups and using training related molds. In class, live broadcasting was used to display the details of student operations, and Chaoxing Learning Platform was used for teaching. The platform conducts interactive activities such as group discussions, answering questions, and testing to achieve integrated teaching of "theory virtual reality". Before and after intervention, the Chinese version of the Critical Thinking Ability Scale and Nurse Competency Scale were selected to evaluate the critical thinking ability and nursing competency of nursing students. The Simulated Teaching Design Scale (SDS) was used to evaluate student satisfaction with teaching. Results:A total of 650 nursing students were included in this study, including 89 males and 561 females, aged (18.00 ± 1.20) years old. The total score of critical thinking before intervention was (247.17 ± 33.63) points, and compared with the score after intervention (294.16 ± 33.63) points, the difference was statistically significant ( t=-10 182.33, P<0.05). The total score of nursing competence before intervention was (485.09 ± 147.68) points, and compared with the score after intervention (507.09 ± 147.68) points, the difference was statistically significant ( t=-7 154.72, P<0.05) points. The approval rate of SDS was over 87%, and the total approval rate of the five dimensions was over 95%. Conclusions:The teaching reform of the Fundamentals of Nursing course in vocational colleges based on the integration of "theory virtual reality" can help improve students′ experience and interactivity, enhance their critical thinking and nursing competence, and achieve high satisfaction. It is worth promoting.