Medical EducationRSTM-VPNCT07615621
Adaptive Real-Time Voice Virtual Patients for Clinical Communication Training
A study testing Adaptive Real-Time Voice Virtual Patient Training, Non-Adaptive Real-Time Voice Virtual Patient Training and Standardized Patient Training in people with Medical Education and Clinical Communication, run by Wang Shalong at 1 site in China.
Trial summary
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… Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Medical Education, Clinical Communication, Breaking Bad News Skills
- What is being tested?
- Adaptive Real-Time Voice Virtual Patient Training, Non-Adaptive Real-Time Voice Virtual Patient Training and Standardized Patient Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 195 participants
- Where
- 1 siteChina
- Study dates
- 1 Dec 2025to 20 Mar 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
China1 site
The Second Xiangya Hospital of Central South University
Changsha, Hunan, 410011
About this study
Official title: 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.
Read more
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.
- Being tested
- Adaptive Real-Time Voice Virtual Patient Training, Non-Adaptive Real-Time Voice Virtual Patient Training, Standardized Patient Training
- Keywords
- Virtual Patient, Real-Time Voice Interaction, Clinical Communication, Resident Physicians, Medical Education, Generative Artificial Intelligence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Adaptive Real-Time Voice Virtual Patient TrainingBehavioural
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.
Non-Adaptive Real-Time Voice Virtual Patient TrainingBehavioural
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.
Standardized Patient TrainingBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| Adaptive Virtual Patient Training | Experimental | 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. Receives: Behavioral: Adaptive Real-Time Voice Virtual Patient Training |
| Non-Adaptive Virtual Patient Training | Active comparator | 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. Receives: Behavioral: Non-Adaptive Real-Time Voice Virtual Patient Training |
| Standardized Patient Training | Active comparator | 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. Receives: Behavioral: Standardized Patient Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Four-Week Mini-OSCE Total Communication Score
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.
Measured: 4 weeks after completion of training
Secondary outcomes (3)
Four-Week Mini-OSCE Domain Scores
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.
Measured: 4 weeks after completion of training
Learner-Reported Perceived Response Contingency and Patient Realism
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.
Measured: Immediately after training session 2 (each session was 45 minutes)
Expert-Rated Behavioral Consistency and Clinical Credibility of Virtual Patient Interactions
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.
Measured: Training session 2(each session was 45 minutes)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 May 2026
- Study start1 Dec 2025
- Primary completion20 Mar 2026
- Study completion20 Mar 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Medical EducationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants were randomized in a 1:1:1 ratio to one of three parallel groups: emotionally and interactionally adaptive real-time voice virtual patient training, non-adaptive real-time voice virtual patient training, or standardized patient training. All groups completed two structurally matched breaking-bad-news communication training sessions, followed by a four-week delayed mini-OSCE assessment using a human standardized patient.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 195 participants (actual)
Sponsor and investigators
- Lead sponsor
- Wang Shalong
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Wang Shalong, Central South University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07615621
- Sponsor's protocol ID
- XY-Z0379-01
- Other IDs
- 2026JJ50060
- Acronym
- RSTM-VP
- Status last verified
- May 2026
- First submitted
- 16 May 2026
- Last updated
- 29 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: 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.
Study at a glance
From the registry record, last updated by the sponsor on 29 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Emotionally and Interactionally Adaptive Real-Time Voice Virtual Patients on Clinical Communication Training in Resident Physicians: A Three-Arm Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07615621
- Acronym / sponsor ID
- RSTM-VP / XY-Z0379-01
- Keywords
- Virtual Patient, Real-Time Voice Interaction, Clinical Communication, Resident Physicians, Medical Education, Generative Artificial Intelligence
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 195 participants (actual)
- Lead sponsor
- Wang ShalongUniversity, hospital or other
- Study start
- 1 Dec 2025 (actual)
- Primary completion
- 20 Mar 2026 (actual)
- Study completion
- 20 Mar 2026 (actual)
- First posted
- 29 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Participants were randomized in a 1:1:1 ratio to one of three parallel groups: emotionally and interactionally adaptive real-time voice virtual patient training, non-adaptive real-time voice virtual patient training, or standardized patient training. All groups completed two structurally matched breaking-bad-news communication training sessions, followed by a four-week delayed mini-OSCE assessment using a human standardized patient.
| Arm | Type | Receives |
|---|---|---|
| Adaptive Virtual Patient Training | Experimental | Behavioral: Adaptive Real-Time Voice Virtual Patient TrainingParticipants 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. |
| Non-Adaptive Virtual Patient Training | Active comparator | Behavioral: Non-Adaptive Real-Time Voice Virtual Patient TrainingParticipants 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. |
| Standardized Patient Training | Active comparator | Behavioral: Standardized Patient TrainingParticipants 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. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- 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.
Key exclusion criteria (6 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Adaptive Real-Time Voice Virtual Patient TrainingParticipants 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. | Behavioural | Adaptive Virtual Patient Training |
| Non-Adaptive Real-Time Voice Virtual Patient TrainingParticipants 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. | Behavioural | Non-Adaptive Virtual Patient Training |
| Standardized Patient TrainingParticipants 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. | Behavioural | Standardized Patient Training |
Primary outcome
Four-Week Mini-OSCE Total Communication Score
Time frame: 4 weeks after completion of training
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.
3 secondary outcomes
Four-Week Mini-OSCE Domain Scores
Time frame: 4 weeks after completion of training
Learner-Reported Perceived Response Contingency and Patient Realism
Time frame: Immediately after training session 2 (each session was 45 minutes)
Expert-Rated Behavioral Consistency and Clinical Credibility of Virtual Patient Interactions
Time frame: Training session 2(each session was 45 minutes)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 May 2026.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: No. 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Adaptive Real-Time Voice Virtual Patient Training, Non-Adaptive Real-Time Voice Virtual Patient Training and Standardized Patient Training in people with Medical Education and Clinical Communication, run by Wang Shalong at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Four-Week Mini-OSCE Total Communication Score (time frame: 4 weeks after completion of training). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 May 2026.