The incidence of medical-surgical patients with a secondary anxiety diagnosis is increasing, and nurses' feelings of inadequacy in communicating with anxious patients have hindered the therapeutic nurse-patient relationship, negatively impacting patient outcomes. Simulation methods such as high fidelity simulation and standardized patients have decreased nursing students' anxiety levels in caring for anxious patients. However, they face maintenance costs, availability, and consistency barriers. Full immersion virtual reality simulation has demonstrated success in nonhealthcare and medical education but is limited in nursing education. Nursing students from an associate and bachelor's degree nursing program participated in a full immersion virtual reality simulation anxious patient scenario twice. Their anxiety levels were assessed at three points in time: before the simulation experience (week 3), after session I (weeks 4-7), and after session II (weeks 8-11). In addition, participants' communication skills were evaluated during each session using the simulation's analytics dashboard, which issued a numeric score based on their communication performance. Study results found a statistically significant decrease in students' anxiety levels over time, from the pretest to posttest II. However, participants' communication scores did not display a statistically significant increase from session I to session II. Implications of these findings are discussed relative to increasing research of full immersion virtual reality simulation in nursing education and the use of an analytics dashboard to objectively evaluate communication skills. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]