Effect of GenAI Patient Simulation on Clinical Preparedness and Clinical Competence in Nursing Students

September 3, 2026 updated by: The University of Hong Kong

Effectiveness of Generative Artificial Intelligence (GenAI) Patient Simulation on Preparedness for Clinical Practicum and Clinical Competence Among Undergraduate Nursing Students: A Waitlist Randomized Controlled Trial and Mixed-methods Study

The transition from theoretical knowledge to clinical practice is a critical and challenging phase for nursing students. Limited opportunities for scenario-based learning before an clinical practicum impacts students' preparedness for practice and clinical competence. Consequently, this lack of preparation directly fuels stress, creating a a negative feedback loop where this stress inhibits cognitive processing and effective learning. Generative artificial intelligence (GenAI) has emerged as a novel educational technology capable of providing interactive, flexible, and learner-centred simulation experiences.

This waitlist randomised controlled trial aims to examine the effectiveness of incorporating the GenAI patient simulation in preparing the undergraduate nursing students for clinical practicum and enhancing the clinical competence compared to the current practice. Hypotheses of this study include:

  1. Participants using the GenAI patient simulation will report higher preparedness for the first acute clinical practicum (CP) and higher clinical competence scores compared to the usual practice group at all time points.
  2. The frequency of using the GenAI patient simulation will be positively correlated with preparedness for the CP and clinical competence.
  3. Participants using the GenAI patient simulation will report lower perceived stress before and during the CP compared to the usual practice group.
  4. The frequency of using of the GenAI patient simulation will negatively correlate with the levels of perceived stress before and during the CP.

Study Overview

Detailed Description

Clinical practicum represents a critical transition point in undergraduate nursing education. Although pre-practicum workshops are commonly provided, students continue to experience difficulties in applying theoretical knowledge during the clinical practicum in acute care settings. A substantial gap often exists between the workshop and the start of clinical practicum, during which opportunities for ongoing learning, reinforcement of knowledge, and practice through virtual clinical scenarios are limited. GenAI patient simulation provide additional opportunities for experiential learning, deliberate practice, and self-directed preparation before clinical exposure.

The intervention of this study is a GenAI Patient Simulation Platform.

Participants in the intervention group will receive the pre-practicum workshop as usual followed by a two-phase GenAI patient simulation intervention:

Phase 1 - a 2-hour facilitated face-to-face simulation exercise session using the scenarios in the GenAI platform.

Phase 2 - a self-initiated, wall-free GenAI patient simulation scenario package. Participants is allowed to access the platform and do the exercises before and during clinical practicum.

Participants in the waitlist control group will receive the same intervention after completion of the study.

A total of forty-four undergraduate nursing students will be recruited and randomly assigned to intervention group and waitlist control group with 1:1 allocation ratio. Participants will be fully informed about the interventions, benefits and risks of the study. Participation is entirely voluntary, and individuals may withdraw at any time without penalty.

Baseline data will be collected before randomisation (T0). All participants will complete the questionnaires immediately after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3). Participants in the intervention group will be invited to join a semi-structured interview by the end of the study.

Study Type

Interventional

Enrollment (Estimated)

44

Phase

  • 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 Contact

  • Name: Choi Fung Mabel LAM
  • Phone Number: 39176694
  • Email: lamcfm@hku.hk

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

Year 3 nursing students of a 5-year full-time Bachelor in Nursing programme,

  • of any nationality including non-local and non-Chinese students, and
  • able to read and understand English, and
  • completed the introduction of clinical nursing practicum in year 2, and
  • scheduled to undertake their first acute clinical practicum within the same academic year.

Exclusion Criteria:

Year 3 nursing students of a 5-year full-time Bachelor in Nursing programme, who will not have their first acute clinical practicum within that academic year.

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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm 1

The intervention is a two-phase GenAI patient simulation platform.

Phase 1 - a 2-hour facilitated face-to-face simulation exercise session using the scenarios in the GenAI platform.

Phase 2 - a self-initiated, wall-free GenAI patient simulation scenario package. Participants is allowed to access the platform and do the exercises before and during clinical practicum.

Same intervention after completion of the study.
Other: Arm 2
Waitlist control

The intervention is a two-phase GenAI patient simulation platform.

Phase 1 - a 2-hour facilitated face-to-face simulation exercise session using the scenarios in the GenAI platform.

Phase 2 - a self-initiated, wall-free GenAI patient simulation scenario package. Participants is allowed to access the platform and do the exercises before and during clinical practicum.

Same intervention after completion of the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Preparedness for Clinical Practicum
Time Frame: Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)
Preparedness for clinical practicum will be measured using the Casey-Fink Readiness for Practice Survey (CF-RPS), consists of 15 items in three domains: clinical problem solving (6 items), learning activities (5 items), and practice readiness (4 items).
Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)
Clinical Competence
Time Frame: Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)
Measured by the Clinical Competency Questionnaire (CCQ), consists of 47 items divided into four domains: nursing professional behaviour, general performance, core nursing skills and advanced nursing skills.
Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Stress
Time Frame: Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)
Measured by the Perceived Stress Scale (PSS-10).
Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)

Collaborators and Investigators

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

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 (Estimated)

September 28, 2026

Primary Completion (Estimated)

August 31, 2027

Study Completion (Estimated)

March 31, 2028

Study Registration Dates

First Submitted

September 3, 2026

First Submitted That Met QC Criteria

September 3, 2026

First Posted (Actual)

September 10, 2026

Study Record Updates

Last Update Posted (Actual)

September 10, 2026

Last Update Submitted That Met QC Criteria

September 3, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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