Voluntary use of LLM-powered virtual standardized patients and medical students' interview performance: An observational study.

Authors

Xiaoxing Gao, Jun Feng, Lian Duan, Liang Wang, Hui Xu, Xuefeng Sun, Xiaoming Huang

Published in

Medical teacher. Pages 1-8. Jun 20, 2026. Epub Jun 20, 2026.

Abstract

Large language model (LLM)-powered Virtual Standardized Patients (VSPs) offer scalable practice opportunities for clinical interviewing, but their added value within established human Standardized Patient (SP) curricula remains unclear. This study examined how self-directed VSP engagement relates to interview performance on traditional SP assessments through the lens of self-regulated learning theory.
We analyzed VSP usage logs and SP assessment data from fourth-year medical students (n = 92) enrolled in a 7-week diagnostics course with weekly human SP sessions and optional VSP access. Engagement was measured by valid sessions and total question-answer (QA) pairs. The primary outcome was the composite SP interview score (0-100). Associations were evaluated using correlation and regression analyses.
Students generated 359 valid dialogues comprising 19,380 QA pairs (hallucination rate 0.34%). Median engagement was 2 sessions (IQR 1-7) and 132 QA pairs (IQR 38-323). Session frequency correlated modestly with SP scores (ρ = 0.25, p=.016); each additional session predicted a 0.15-point increase (R²=0.070). Students with ≥7 sessions outperformed those with fewer (94.1 ± 2.0 vs 92.5 ± 2.4, p=.013). QA volume showed a stronger association (ρ = 0.28, p=.006), explaining 10.6% of variance. The high-QA group (≥132) scored higher than the low-QA group (93.3 ± 2.3 vs 92.3 ± 2.3, p=.030).
Voluntary VSP use within a human SP curriculum was associated with small but measurable differences in interview performance. Findings align with self-regulated learning and deliberate practice frameworks-students who independently sought repeated, feedback-rich practice tended to achieve higher scores. These observational data do not establish causality. VSPs may serve as scalable cognitive scaffolds for self-directed skill refinement, though their benefits likely vary with learner motivation and baseline ability.

PMID:
42322138
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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