<![CDATA[Background: Hospital fires constitute one of the most catastrophic healthcare emergencies, endangeringpatients with limited mobility, healthcare personnel, and critical infrastructure. In Indonesia, conventional firesafety training for nurses has remained largely inadequate, relying on lecture-based methods that fail toreplicate high-fidelity emergency scenarios. The integration of Artificial Intelligence (AI)-based virtualsimulation offers an innovative, risk-free training modality that may substantially enhance nurses' fireemergency preparedness.Objective: To evaluate the effectiveness of AI-Based Virtual Simulation in improving fire emergencyknowledge and practical skills among hospital nurses at Mitra Sejati Hospital, Medan, Indonesia.Methods: A pre-experimental one-group pretest-posttest design was employed. Thirty active nurses frominpatient and emergency department units were selected through purposive sampling. Participants completed a60-minute individualized AI-based virtual simulation session encompassing fire evacuation, portable fireextinguisher (APAR) operation, source identification, and emergency decision-making. Data were collectedusing validated knowledge tests and structured skills observation checklists. Inferential analysis applied thePaired Samples t-test (α = 0.05).Results: Statistically significant improvements were observed in both knowledge scores (pre: 65.3 ± SD; post:84.7 ± SD; p < 0.001) and practical skills (pre: 62.0%; post: 88.0%; p < 0.001). The largest knowledge gainwas recorded in evacuation route comprehension (+20.2 points) and the highest skill improvement insimulation coordination (+27 percentage points). Effect sizes were large (Cohen's d > 0.8), indicatingsubstantial educational impact.Conclusion: AI-Based Virtual Simulation is an effective, scalable intervention for enhancing nurse fireemergency preparedness in hospital settings. These findings support the integration of immersive digitalsimulation into mandatory hospital safety training programs and nursing education curricula across Indonesia.Keywords: Artificial intelligence; Virtual]]>
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