Effective virtual patient simulators for medical communication training: A systematic review
Open accessAbstract
Context: Despite the growing use of virtual patients (VPs) in medical education, few studies have explored the features and effectiveness of VP‐based medical communication skills training. We undertook a systematic review to summarise the design and evaluation of VP‐based medical communication skills training systems in order to identify features of successful cases. Methods: Following PRISMA guidelines, we searched four databases for studies published between 2006 and 2018. Using a refined classification scheme, we extracted data on instructional design (scenario and instructional intervention), technological design (modality and interaction), and evaluation (user experience, learning effectiveness and evaluator). We assessed the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and the QualSyst standard assessment criteria. Results: A total of 14 studies were included for review. Of these, 85.7% (n = 12) were quantitative and 71.4% (n = 10) involved undergraduate students. The most common VP training scenario was history taking followed by the delivery of bad news. Diverse instructional interventions, including tutorials, learning activities, and feedback, were embedded in the VPs. The first‐person perspective animated within‐screen size VP was a popular technological feature. Most evaluations concerned the reality of simulation (for user experience) and skill in expressing empathy (as a learning outcome). Of the eight comparative studies, half reported significant attitude or skill improvements in the VP group. The distinct features of VPs shown to be effective were well‐designed instructional interventions (eg, a pre‐activity with a protocol‐informed tutorial), and post‐activity (eg, debrief or reflection), scaffolding and human feedback, but not system feedback. Conclusions: Evidence‐based VP training can enable students to gain communication skills in a safe and affordable learning environment. Elaborate technology alone cannot guarantee effective learning, but evidence‐based instructional interventions can facilitate its optimal use and bring about better learning outcomes.
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Traditional face-to-face history-taking training is resource-intensive, costly, and difficult to standardize on a large scale.
“While traditional face-to-face history-taking training has proven effective, it is often resource-intensive, costly, and difficult to standardize on a large scale.”
From Feasibility study of using GPT for history-taking training in medical education: a randomized clinical trial (2025) · cites this paper as [1]
The Introduction (page unavailable) says interactions with standardised patients provide realistic communication practice but pose resource and logistical challenges. It also says patient stories can be difficult to keep consistent across actors and scenarios. The paper does not specifically establish that face-to-face history-taking training is costly, difficult to standardize at large scale, or proven effective. (LLM, conf=0.86)
Experimental — accuracy not yet measuredClinical reasoning and communication are areas that are often challenging for medical students.
“A key contribution of this study is the measurable improvement in clinical reasoning and communication—areas that are often challenging for medical students [1, 2].”
From Feasibility study of using GPT for history-taking training in medical education: a randomized clinical trial (2025) · cites this paper as [1]
The Introduction (page not available in our copy) describes medical communication as involving complex situations and explains why students receive communication training. It does not say that clinical reasoning is often challenging for medical students; a search for clinical reasoning found only a reference title, not a finding on that point. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Lee, J., Kim, H., Kim, K. H., Jung, D., Jowsey, T., & Webster, C. S.
- Affiliations
- Seoul National University (KR)
- Smart Experience Design Graduate School of Techno Design Kookmin University Seoul South Korea
- Florida State University (US)
- University of Auckland (NZ)
- Corresponding author
- Kim, Kwan Hoon
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2020-05-22
- Volume
- 54
- Issue
- 9
- Pages
- 786-795
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W3012349076
- Cited by
- 210
- References
- 53
- Citations by year
- 2026: 44 · 2025: 46 · 2024: 45 · 2023: 17 · 2022: 31 · 2021: 21 · 2020: 6
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation of Korea (NRF‐2017R1C1B2010469)
- Topics
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- virtual patients, medical communication skills, communication skills training, instructional design, medical history, breaking bad news, empathy, debriefing, human feedback, simulation-based training, undergraduate medical students, user experience
- MeSH terms
- Clinical Competence, Communication, Education, Medical, Empathy, Humans, Learning
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