Artificial Intelligence Virtual Patient: A proof of concept study

Background Artificial Intelligence(AI) is advancing, but its role in simulating detailed patient-doctor interactions in the style of Objective Structured Clinical Examinations(OSCEs) is emerging. This study's goal was to create and validate an AI virtual patient(AIVP) that could interact with medical students, mimic a patient with a medical issue, and provide students feedback on their performance. Methods Six AIVP were developed to simulate OSCE scenarios for common emergency department presentations. The simulations were created using the Unity game engine, featuring a conversation loop that includes speech-to-text conversion (OpenAI Whisper), response generation(Open AI ChatGPT 4o), and speech generation (OpenAI TTS). A tutor AI(ChatGPT 4o) then generates feedback after the conversation to help students improve their responses. Final-year medical students were given the opportunity to interact with the AIVPs and participated in pre- and post-AIVP OSCE assessments to evaluate the AIVP's effect on performance, with Wilcoxon paired t-tests used for analysis. Students completed Likert Scales and surveys on the AIVP's educational value and technical issues. Results Twenty-one students participated over two weeks for a total of 21.7 hours, averaging 1.1 hour per user. The median OSCE scores improved from 63/100 (IQR: 53.5–70) to 70/100 (IQR: 63-73.5) (p = 0.29). On a Likert scale of 0 (strongly disagree) to 5 (strongly agree) there was strong agreement that the AIVP was a valuable learning experience(mean 4.62, SD 0.65). Students valued the feedback provided by the AIVP at the end of their interaction on their performance(mean 4.38, SD 0.84), Technical issues like voice recognition problems, latency in AIVP interaction, and occasional role reversals were reported. Conclusion This is a novel tool for developing history-taking skills and OSCE performance. Students found their interactions with the AIVP, and the feedback it provided on their performance, to be a valuable learning experience. However, technical factors and AIVP realism need further development.