Adaptive Real-Time Voice Virtual Patients for Clinical Communication Training (RSTM-VP)
28 maggio 2026 aggiornato da: Wang Shalong
Effects of Emotionally and Interactionally Adaptive Real-Time Voice Virtual Patients on Clinical Communication Training in Resident Physicians: A Three-Arm Randomized Controlled Trial
This study evaluated whether an emotionally and interactionally adaptive real-time voice virtual patient can improve clinical communication training for resident physicians. Communication with patients in emotionally challenging situations, such as breaking bad news, requires clinicians to deliver information clearly, recognize emotional cues, respond empathically, and maintain a coherent interaction. Standardized patient training can support these skills but is resource intensive and difficult to provide repeatedly. Real-time voice virtual patients may offer scalable practice opportunities, but simple spoken interaction alone may not provide patient responses that change meaningfully according to the learner's communication.
The adaptive virtual patient used in this study was designed to update the patient's emotional tone, openness, defensiveness, and interactional style during the conversation based on the learner's communication behavior. The study compared this adaptive virtual patient training with a non-adaptive real-time voice virtual patient and with standardized patient training.
Resident physicians were randomly assigned in a 1:1:1 ratio to one of three groups: emotionally and interactionally adaptive virtual patient training, non-adaptive virtual patient training, or standardized patient training. Participants completed two communication training sessions focused on breaking bad news. After training, participants completed learner-reported measures of perceived response contingency and patient realism. Approximately four weeks later, participants completed a mini-objective structured clinical examination using a human standardized patient to assess communication performance in a delayed near-transfer setting.
The primary outcome was the total mini-OSCE communication score at four weeks. Secondary outcomes included mini-OSCE domain scores for structured delivery, emotional responsiveness, and interactional process; learner-reported response contingency and patient realism; and expert-rated behavioral consistency and clinical credibility of virtual patient interactions.
Panoramica dello studio
Stato
Completato
Tipo di studio
Interventistico
Iscrizione (Effettivo)
195
Fase
- Non applicabile
Contatti e Sedi
Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.
Luoghi di studio
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Hunan
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Changsha, Hunan, Cina, 410011
- The Second Xiangya Hospital of Central South University
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Criteri di partecipazione
I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.
Criteri di ammissibilità
Età idonea allo studio
- Bambino
- Adulto
- Adulto più anziano
Accetta volontari sani
Sì
Descrizione
Inclusion Criteria:
- Resident physicians in postgraduate years 1-3.
- Participants who had received basic clinical communication training or related instruction.
- Participants who had not received systematic, specialized training in breaking bad news communication.
- Able to complete two training sessions and the four-week follow-up mini-OSCE assessment.
- Willing to participate and able to provide written informed consent.
Exclusion Criteria:
- Prior systematic training in breaking bad news, advanced communication skills, or similar specialized communication training.
- Prior participation in pilot testing or system testing related to this study.
- Unable to complete the required training sessions or follow-up assessment.
- Unwilling to have training or assessment sessions recorded for research scoring and analysis.
- Concurrent participation in another communication-skills intervention study that could affect communication performance.
- Any other condition judged by the investigators to make participation inappropriate.
Piano di studio
Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Altro
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: Adaptive Virtual Patient Training
Participants assigned to this arm completed two breaking-bad-news communication training sessions with an emotionally and interactionally adaptive real-time voice virtual patient.
The virtual patient updated its emotional tone, openness, defensiveness, and interactional style during the conversation based on the participant's communication behavior.
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Participants completed two breaking-bad-news communication training sessions with an emotionally and interactionally adaptive real-time voice virtual patient.
The virtual patient interacted with participants through continuous spoken dialogue and dynamically updated its emotional tone, openness, defensiveness, and interactional style based on the participant's communication behavior.
The adaptive mechanism was designed to provide behavior-contingent patient responses during the encounter.
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Comparatore attivo: Non-Adaptive Virtual Patient Training
Participants assigned to this arm completed two breaking-bad-news communication training sessions with a non-adaptive real-time voice virtual patient.
The platform, case structure, voice interaction format, and training exposure were matched to the adaptive virtual patient arm, but the patient's emotional and interactional style did not dynamically update based on participant communication behavior.
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Participants completed two breaking-bad-news communication training sessions with a non-adaptive real-time voice virtual patient.
The platform, case structure, spoken interaction format, training exposure, and communication tasks were matched to the adaptive virtual patient condition.
Unlike the adaptive condition, the virtual patient did not dynamically update its emotional or interactional state based on the participant's communication behavior.
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Comparatore attivo: Standardized Patient Training
Participants assigned to this arm completed two breaking-bad-news communication training sessions with trained standardized patients.
Cases, training objectives, session duration, and communication tasks were structurally matched to the virtual patient arms.
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Participants completed two breaking-bad-news communication training sessions with trained human standardized patients.
The cases, training objectives, session duration, and communication tasks were structurally matched to the virtual patient training conditions.
Standardized patients were trained to portray the assigned clinical communication scenarios using standardized case scripts and interactional guidance.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Four-Week Mini-OSCE Total Communication Score
Lasso di tempo: 4 weeks after completion of training
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Communication performance was assessed approximately four weeks after training using a mini-objective structured clinical examination with a human standardized patient.
The total score was based on a 9-item structured communication rating scale covering structured delivery, emotional responsiveness, and interactional process.
Each item was rated from 1 to 5, yielding a total score range of 9 to 45. Higher scores indicate better clinical communication performance.
Scores from two blinded expert raters were averaged to generate participant-level total scores.
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4 weeks after completion of training
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Four-Week Mini-OSCE Domain Scores
Lasso di tempo: 4 weeks after completion of training
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Domain scores from the four-week mini-OSCE were calculated for three communication domains: structured delivery, emotional responsiveness, and interactional process.
Each domain included three items rated from 1 to 5, yielding a domain score range of 3 to 15.
Higher scores indicate better performance in the corresponding communication domain.
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4 weeks after completion of training
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Learner-Reported Perceived Response Contingency and Patient Realism
Lasso di tempo: Immediately after training session 2 (each session was 45 minutes)
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Learner-reported interaction measures were assessed after training using 7-point Likert-scale items.
Perceived response contingency was calculated as the mean of two items evaluating whether the patient's emotional or interpersonal responses changed during the conversation and whether these changes appeared to depend on how the participant communicated.
Perceived patient realism was assessed using a single item evaluating whether the patient's emotional and interpersonal responses felt realistic for a real patient in a clinical conversation.
Higher scores indicate stronger perceived response contingency and greater perceived patient realism.
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Immediately after training session 2 (each session was 45 minutes)
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Expert-Rated Behavioral Consistency and Clinical Credibility of Virtual Patient Interactions
Lasso di tempo: Training session 2(each session was 45 minutes)
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Virtual patient interactions recorded during training session 2 were later assessed by blinded expert raters using 7-point Likert-scale items.
Behavioral consistency evaluated whether the virtual patient's emotional tone, interpersonal stance, and overall behavior remained coherent with the case background and internally consistent throughout the interaction.
Clinical credibility evaluated whether the virtual patient's emotional and interactional responses were clinically believable for a real patient in the corresponding situation.
Higher scores indicate greater behavioral consistency and clinical credibility.
This outcome was assessed only for the two virtual patient groups.
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Training session 2(each session was 45 minutes)
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Collaboratori e investigatori
Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.
Sponsor
Studiare le date dei record
Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.
Studia le date principali
Inizio studio (Effettivo)
1 dicembre 2025
Completamento primario (Effettivo)
20 marzo 2026
Completamento dello studio (Effettivo)
20 marzo 2026
Date di iscrizione allo studio
Primo inviato
16 maggio 2026
Primo inviato che soddisfa i criteri di controllo qualità
28 maggio 2026
Primo Inserito (Effettivo)
29 maggio 2026
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
29 maggio 2026
Ultimo aggiornamento inviato che soddisfa i criteri QC
28 maggio 2026
Ultimo verificato
1 maggio 2026
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Altri numeri di identificazione dello studio
- XY-Z0379-01
- 2026JJ50060 (Altro numero di sovvenzione/finanziamento: Hunan Provincial Natural Science Foundation of China)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
NO
Descrizione del piano IPD
Individual participant data will not be publicly shared because participant consent and institutional ethics approval do not permit unrestricted public release of human-subject data.
Summary data and study materials sufficient to interpret the findings will be provided in the publication and supplementary materials.
Additional deidentified data may be made available from the corresponding author upon reasonable request, subject to institutional and ethics approval.
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
No
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
No
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .