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Published on: December 23, 2025
AI-based virtual patient interactions improve professional language proficiency in international nurses
Sebastian Ullrich1, Jan-Marcus Haus2, Sandra Lamb3
1Städtisches Krankenhaus Kiel, Department of Internal Medicine III, Kiel, Germany.
Objectives:
International healthcare personnel face significant challenges in language acquisition. We investigated whether virtual patient interaction (VI) training can support professional integration and clinical language proficiency.
Methods:
In an explorative controlled study, 25 international nursing staff undergoing professional qualification measures in Germany were included. The intervention group (n=13) received access to casuu, a digital simulation tool providing interactive communication scenarios with virtual patients and colleagues. The control group (n=12) followed standard language training without VI. Both groups received 600 hours of training for the B2 for Nursing exam, as required for professional licensure in several German states, at the same language school using the same textbook. The primary outcome was the fail rate at the first attempt, with effects on different skill dimensions assessed in addition. The clinical supervisors were interviewed 12-14 months after the arrival.
Results:
The fail rate in the B2 for Nursing exam was reduced from 66.7% in the control group to 25.0% in the intervention group (relative reduction 62.5%). Competence increased primarily in the skill dimension "active speaking". Attrition rates did not increase (1/13 vs. 2/12). Clinical superiors reported increased confidence and competence in team and patient interactions in the intervention group.
Conclusion:
Virtual interaction-based training improves the acquisition of professional language and clinical communication skills of international nurses. It integrates with conventional teaching and does not increase dropout rates.
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