Beyond Traditional Simulation: An Exploratory Study on the Effectiveness and Acceptability of ChatGPT‑4o Advanced Voice Mode for Communication Skills Practice Among Medical Students.

Background Effective communication skills are essential for quality medical practice and patient care, yet providing sufficient practice opportunities remains challenging in medical education. Traditional approaches using standardized patients (SPs) face limitations, including high costs and logistical constraints. This study investigates the potential of conversational artificial intelligence (AI) to supplement communication skills practice among medical students. Methodology We conducted a mixed-methods study employing a convergent parallel design with 27 medical students from three UK universities between November 2024 and March 2025. Participants engaged in communication skills roleplay sessions using freely available ChatGPT as an SP. Pre- and post-session assessments measured perceived usefulness and self-reported confidence in three communication domains: dealing with challenging patients, breaking bad news, and counselling anxious patients. The instrument was adapted from the Immersive Technology Evaluation Measure (ITEM). Quantitative data were analyzed using non-parametric tests and ordinal logistic regression, while qualitative responses underwent reflexive thematic analysis. Results Self-reported confidence increased significantly across all communication domains following the ChatGPT simulation. Confidence in dealing with challenging patients increased from a median of 3 to 4 (