Effect of AI-Supported Virtual Patient Chatbot Training on Nursing Students' Self-Perceived Clinical Decision-Making and Gynecological Cancer Knowledge

September 20, 2026 updated by: Ahsen Demirhan, Sakarya University

Effect of AI-Supported Virtual Patient Chatbot Training on Nursing Students' Self-Perceived Clinical Decision-Making and Gynecological Cancer Knowledge: A Randomized Controlled Trial

This randomized controlled trial evaluated the effects of structured case-based training delivered through an artificial intelligence-supported educational virtual patient chatbot platform on nursing students' gynecological cancer knowledge and self-perceived clinical decision-making. Third-year undergraduate nursing students who had completed the Obstetrics and Gynecology Nursing course were randomly assigned in a 1:1 ratio to an intervention group or an assessment-only wait-list control group. The intervention group completed five AI-supported virtual patient training scenarios during a two-week access period, followed by a common virtual patient assessment. The control group completed the same virtual patient assessment without access to the training scenarios during the study assessment period. Knowledge and self-perceived clinical decision-making were assessed at baseline and immediately after the assigned study procedures. Virtual patient performance was assessed once at the final assessment.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
110

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Turkey
      • Sakarya, Turkey, Turkey (Türkiye), 54050
        • Sakarya University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Enrolled as a third-year undergraduate nursing student.
  • Successfully completed the Obstetrics and Gynecology Nursing (Women's Health and Diseases Nursing) course.
  • Volunteered to participate and provided digital informed consent.

Exclusion Criteria:

- No additional exclusion criteria.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: AI-Supported Virtual Patient Chatbot Training Group

Participants received access to five sequential AI-supported educational virtual patient scenarios addressing cervical, endometrial, ovarian, vulvar, and vaginal cancers. The scenarios were completed during a two-week access period. Participants responded in free text, received immediate individualized formative feedback, and were allowed up to three response attempts per scenario. After completing all five training scenarios, participants completed the common virtual patient assessment and the immediate post-intervention outcome assessments.
Other: AI-Supported Educational Virtual Patient Chatbot Platform

A web-based educational platform integrating structured gynecological oncology scenarios, AI-supported virtual patient interaction, predefined performance criteria, sequential progression, and immediate individualized formative feedback. Participants completed five training scenarios during a two-week access period. The platform used the Claude Sonnet 4 model, API identifier claude-sonnet-4-20250514, throughout the study.
No Intervention: Assessment-Only Wait-List Control Group

Participants did not receive access to the AI-supported training scenarios during the outcome assessment period. They completed the baseline assessments, the same common virtual patient assessment as the intervention group, and the immediate post-assessment knowledge and clinical decision-making measures. After completing all study outcome assessments, they were granted access to the AI-supported educational scenarios.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Clinical Decision Making in Nursing Scale-Turkish Version (CDMNS-Tr) Score
Time Frame: Baseline, before access to any group-specific study procedure, and immediately after completion of the assigned study procedures.

The CDMNS-Tr is a 40-item scale assessing self-reported clinical decision-making. Items are rated on a 5-point Likert scale ranging from 1 (never) to 5 (always), with eighteen negatively worded items being reverse-scored. Total scores range from 40 to 200, with higher scores indicating a higher self-perception of clinical decision-making abilities.
Baseline, before access to any group-specific study procedure, and immediately after completion of the assigned study procedures.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in Gynecological Oncology Knowledge Test Total Score
Time Frame: Baseline, before access to any group-specific study procedure, and immediately after completion of the assigned study procedures, within approximately two weeks after baseline.

The researcher-developed test consists of 15 multiple-choice items assessing the pathophysiology, clinical manifestations, diagnosis, treatment, complications, and nursing care of gynecological cancers. Correct answers are scored as 1 and incorrect or unanswered items as 0. Total scores range from 0 to 15, with higher scores indicating greater knowledge. Change was evaluated by comparing baseline and immediate post-intervention total scores.
Baseline, before access to any group-specific study procedure, and immediately after completion of the assigned study procedures, within approximately two weeks after baseline.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Sakarya University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 29, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 2, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 2, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 4, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 8, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 23, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 20, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 02.09.2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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