Web-Based AI-Driven Virtual Patient Simulator Versus Actor-Based Simulation for Teaching Consultation Skills: Multicenter Randomized Crossover Study
Bibliographic record
Abstract
Background: There is a need to increase health care professional training capacity to meet global needs by 2030. Effective communication is essential for delivering safe and effective patient care. Artificial intelligence (AI) technologies may provide a solution. However, evidence for high-fidelity virtual patient simulators using unrestricted 2-way verbal conversation for communication skills training is lacking. Objective: This study aims to compare a fully automated AI-driven voice recognition-based virtual patient simulator with traditional actor-based consultation skills simulated training in undergraduate medical students for differences in developing self-rated communication skills, student satisfaction scores, and direct cost comparison. Methods: Using an open-label randomized crossover design, a single web-based AI-driven communication skills training session (AI-CST) was compared with a single face-to-face actor-based consultation skills training session (AB-CST) in undergraduates at 2 UK medical schools. Offline total cohort recruitment was used, with an opt-out option. Pre-post intervention surveys using 10-point linear scales were used to derive outcomes. The primary outcome was the difference in self-reported attainment of communication skills between interventions. Secondary outcomes were differences in student satisfaction and the cost comparison of delivering both interventions. Results: Of 396 students, 378 (95%) completed at least 1 survey. Both modalities significantly increased self-reported communication skills attainment (AI-CST: mean difference 1.14, 95% CI 0.97-1.32 points; AB-CST: mean difference 1.50, 95% CI 1.35-1.66 points; both P<.001). Attainment increase was lower for AI-CST than AB-CST (by mean difference 0.36, 95% CI -0.60 to -0.13 points; P=.04). Overall satisfaction was lower for AI-CST than AB-CST (8.09 vs 9.21; mean difference -1.13, 95% CI -1.33 to -0.92 for AI-CST vs AB-CST; P<.001). The estimated costs of AI-CST and AB-CST were £33.48 (US $42.22) and £61.75 (US $77.87) per student, respectively. Conclusions: AI-CST and AB-CST were both effective at improving self-reported communication skills attainment, but AI-CST was slightly inferior to AB-CST. Student satisfaction was significantly greater for AB-CST. Costs of AI-CST were substantially lower than AB-CST. AI-CST may provide a cost-effective opportunity to build training capacity for health care professionals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".