Immersive Virtual Reality and AI (Generative Pretrained Transformer) to Enhance Student Preparedness for Objective Structured Clinical Examinations: Mixed Methods Study.

backgroundImmersive virtual reality (VR) and artificial intelligence have been used to determine whether a simulated clinical exam setting can reduce anxiety in first-year occupational therapy students preparing for objective structured clinical examinations (OSCEs). Test anxiety is common among postsecondary students, leading to negative outcomes such as increased dropout risk, lower grades, and limited employment opportunities. Students unfamiliar with specific testing environments are particularly prone to anxiety. VR simulations of OSCEs may allow students to become familiar with the exam setting and reduce anxiety.

objectiveThis study aimed to assess the efficacy of a VR simulation depicting clinical settings to reduce student anxiety about a clinical exam while gathering perspectives on their first-year coursework experiences to better understand their learning environment.

methodsAn experimental, nonrandomized controlled trial compared state anxiety, trait test anxiety, and OSCE grades in 2 groups of first-year occupational therapy students analyzed using independent t tests (2-tailed). Group 1 (NoVR) was not exposed to the VR simulation and acted as a control group for group 2 (YesVR), who were exposed to the VR simulation. The VR used artificial intelligence in the form of a generative pretrained transformer to generate responses from virtual patients as students interacted with them in natural language. Self-reported psychometric scales measured anxiety levels 3 days before the OSCE. YesVR students completed perceived preparation surveys at 2 time points-3 weeks and 3 days before the OSCE-analyzed using dependent t tests. Semistructured interviews and focus groups were conducted within 1 week after the OSCE. Student perspectives on their classes and VR experiences were summarized using interpretative thematic analysis.

resultsIn total, 60 students-32 (53%) in the NoVR group and 28 (47%) in the YesVR group-participated in the study, and the YesVR group showed a significant reduction in state anxiety (t

conclusionsIntolerance of uncertainty may lead students to interpret ambiguous exam situations as overly precarious. Findings suggest that VR simulation was associated with reduced state anxiety, although results from this small, nonrandomized sample should be interpreted cautiously. Qualitative data indicated that VR helped students gain familiarity with clinical exam settings, potentially decreasing uncertainty-based anxiety. Future research with larger or randomized samples is needed to confirm these findings and explore advanced VR tools offering feedback to enhance learning.