ArticleBMC nursing2026
Effects of ChatGPT-generated immediate feedback integrated into VR-based OSCEs on nursing students' performance: a randomized crossover study.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Objective Structured Clinical Examination (OSCE) is a gold-standard assessment in nursing education, yet traditional and virtual reality (VR) formats often lack timely, individualized feedback, potentially limiting gains in higher-order competencies such as communication and decision-making. Advances in artificial intelligence (AI), particularly ChatGPT, offer opportunities to address this gap. To evaluate the impact of ChatGPT-generated immediate feedback integrated into VR-based OSCE stations on nursing students’ communication performance, clinical decision-making accuracy, and related learning outcomes.
methodsA randomized, two-period crossover trial was conducted among 65 final-year nursing students at a tertiary teaching hospital in China between March and May 2025. Participants completed two matched OSCE stations under VR-only and VR + ChatGPT conditions, with a one-week washout period between the two study phases. Primary outcomes included OSCE communication scores, clinical decision-making accuracy, and task completion time. Secondary outcomes comprised learning satisfaction, acceptance of AI-assisted feedback, academic and communication self-efficacy, reflection quality, and cognitive workload. Data were analyzed using paired statistical comparisons and linear mixed-effects models adjusting for sequence and period effects.
resultsCompared with VR-only, VR + ChatGPT significantly improved communication scores (mean difference [MD] = 3.38, 95% CI: 2.12–4.64, P < 0.001, Cohen’s d = 0.63) and decision accuracy (MD = 3.91%, 95% CI: 2.09–5.72, P < 0.001, Cohen’s d = 0.49), while reducing completion time (MD = − 0.78 min, 95% CI: − 1.12 to − 0.44, P < 0.001, Cohen’s d = − 0.62). VR + ChatGPT also yielded higher learning satisfaction (MD = 0.31, P < 0.001), greater reflection quality (MD = 0.62, P < 0.001), lower cognitive workload (MD = − 5.7, P = 0.001), and significant gains in academic and communication self-efficacy (both P < 0.001). No severe adverse events occurred. Effects were consistent across subgroups defined by prior VR experience and digital literacy.
conclusionsIntegrating ChatGPT-generated immediate feedback into VR OSCE scenarios significantly enhances nursing students’ communication and decision-making performance, accelerates skill acquisition, and reduces cognitive strain, without compromising safety. CLINICAL TRIAL NUMBER: Not applicable.
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