Assessing virtual patients for empathy training in healthcare: A scoping review

A growing body of virtual patients (VPs) generated by computers has been incorporated into medical education that includes empathy training. We sought to uncover the validity and effectiveness of VPs in empathy training.

The authors carried out a comprehensive search of all articles published between 1991 and 2023 in the seven databases of literature in the areas of health science and education. In total, 2170 abstracts were reviewed, and ultimately, the final corpus consisted of 44 articles.

Guided by the Computer-as-social-actor framework, this study identified four types of primary social cues presented in current literature to arouse trainees' social responses. Overall, the social cues used across the included studies were similar. However, the efficacy and effectiveness of VPs varied, and we identified four factors that may influence these outcomes. First, technology matters. VPs for VR systems were found to be effective in clinical empathy training, but limited empirical evidence supported web-or-mobile-based VPs. Second, improvement was only observed in the cognitive empathy dimension. Third, studies that have longer interaction duration (over 30 minutes). Last, using self-report measurements were more likely to observe significant improvements. Qualitative findings revealed that VPs for VR systems can create an immersive experience that allows users to understand the needs of patients and put themselves in patients' shoes, while web-or-mobile-based VPs are more convenient for trainees.

This review displays evidence supporting the efficacy and effectiveness of VPs in future medical empathy training. Mechanisms and future research agendas were discussed.

VPs are promising tools for future empathy training.