Nurses need a solid understanding of anatomy knowledge to perform nursing skills, to understand how diseases affect the body, to understand treatment for the patient and help them for documentation. While past research has focused on using virtual learning environments to teach anatomical structures of the human body, there has been limited research on how to teach clinical anatomy by using cases while using Virtual Reality (VR) technology. This quantitative research study aimed to investigate the effects of VR in the application of case-based learning approach on learners' performance. The researcher compared two delivery modes (VR mode and paper-based mode) to analyze the learning gains of the participants. The participants also subjectively rated the mental load they used while studying the material. The researcher recruited twenty-nine nursing students from Midway University. No significant difference in the mean scores of both groups found while studying the anatomical structure of the mitral valve and two clinical cases. Moreover, the results indicated implementing a case study of either VR or paper-based mode was associated with significant gains in achievement which is supported by the other studies on case-based learning approach. Moreover, for both groups, there were no significant differences found in their intrinsic, extraneous and germane cognitive load while learning the material. The recommendations for further research include a larger sample, long-term retention, and opinions of faculty and students on VR-learning environment while studying clinical cases. [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://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]