Aim <p>This study examined the effects of brief immersive virtual reality (IVR) exposure (10–15&#xa0;min) using commercially available applications (Beat Saber, TRIPP) on nursing students’ clinical anxiety, stress, and adaptation, compared with usual clinical preparation in the control group.</p> Background <p>The success of students who experience anxiety during clinical experiences is negatively affected by the process, which may be attributed to several factors.</p> Design <p>The research was designed as a prospective, randomized controlled trial.</p> Methods <p>The present study was conducted with 195 students enrolled in the Department of Surgical Nursing at the Faculty of Nursing of an academic institution. Following the randomized controlled research design, the students were divided into two groups using a simple randomization method. Students in the intervention group were allowed to practice using IVR goggles in the clinical setting. The students were subjected to various gaming interventions involving breathing and aerobics. The Demographics Questionnaire Form, State-Trait Anxiety Inventory, Clinical Success Evaluation Form, and Stress, Adaptation, and Satisfaction Scale were administered to the students and correlated with clinical success.</p> Results <p>This study found that the IVR application can facilitate the management of clinical anxiety and stress among students by fostering alternative perceptions of the environment. The assessment of the participant’s knowledge and abilities demonstrated that they were receptive and actively engaged in IVR, exhibiting a high level of immersion in the virtual environment. Although within-group changes in state anxiety were not statistically significant in the intervention group, between-group ANCOVA revealed significantly lower post-intervention anxiety scores in the IVR group compared with the control group (<i>p</i> = 0.02).</p> Conclusion <p>Brief IVR exposure was associated with lower self-reported stress and improved adaptation compared with usual clinical preparation, while effects on standardized anxiety scores and objective clinical success were limited. The type of VR experience may influence outcomes.</p> Trial registration <p>Retrospectively registered. Registration number NCT07617415 on March 18, 2026 (<a href="https://ClinicalTrials.gov">ClinicalTrials.gov</a>).</p>