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. 2019 Oct 29;21(10):e14658.
doi: 10.2196/14658.

A Virtual Counseling Application Using Artificial Intelligence for Communication Skills Training in Nursing Education: Development Study

Shefaly Shorey  1 , Emily Ang  1 , John Yap  2 , Esperanza Debby Ng  1 , Siew Tiang Lau  1 , Chee Kong Chui  3
Affiliations

A Virtual Counseling Application Using Artificial Intelligence for Communication Skills Training in Nursing Education: Development Study

Shefaly Shorey et al. J Med Internet Res. .

Erratum in

Abstract

Background: The ability of nursing undergraduates to communicate effectively with health care providers, patients, and their family members is crucial to their nursing professions as these can affect patient outcomes. However, the traditional use of didactic lectures for communication skills training is ineffective, and the use of standardized patients is not time- or cost-effective. Given the abilities of virtual patients (VPs) to simulate interactive and authentic clinical scenarios in secured environments with unlimited training attempts, a virtual counseling application is an ideal platform for nursing students to hone their communication skills before their clinical postings.

Objective: The aim of this study was to develop and test the use of VPs to better prepare nursing undergraduates for communicating with real-life patients, their family members, and other health care professionals during their clinical postings.

Methods: The stages of the creation of VPs included preparation, design, and development, followed by a testing phase before the official implementation. An initial voice chatbot was trained using a natural language processing engine, Google Cloud's Dialogflow, and was later visualized into a three-dimensional (3D) avatar form using Unity 3D.

Results: The VPs included four case scenarios that were congruent with the nursing undergraduates' semesters' learning objectives: (1) assessing the pain experienced by a pregnant woman, (2) taking the history of a depressed patient, (3) escalating a bleeding episode of a postoperative patient to a physician, and (4) showing empathy to a stressed-out fellow final-year nursing student. Challenges arose in terms of content development, technological limitations, and expectations management, which can be resolved by contingency planning, open communication, constant program updates, refinement, and training.

Conclusions: The creation of VPs to assist in nursing students' communication skills training may provide authentic learning environments that enhance students' perceived self-efficacy and confidence in effective communication skills. However, given the infancy stage of this project, further refinement and constant enhancements are needed to train the VPs to simulate real-life conversations before the official implementation.

Keywords: artificial intelligence; communication; learning; nursing education; patients; technology; virtual reality.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Theoretical framework for virtual counseling application using artificial intelligence.
Figure 2
Figure 2
Case scenario selection menu for the virtual counseling application using artificial intelligence.
Figure 3
Figure 3
Technical voice input instructions on how to initiate a conversation with the virtual patient.
Figure 4
Figure 4
Assessment instructions and objectives for students.
Figure 5
Figure 5
List of case scenario–specific keywords provided for voice recognition training.
Figure 6
Figure 6
Case scenario of a depressed patient.
Figure 7
Figure 7
Performance checklist at the end of the assessment.
See this image and copyright information in PMC

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