Evaluation of a Virtual Counseling Application for Communication Skills Training in Nursing Education

The Alice Lee Centre for Nursing Studies under the National University of Singapore offers a three-years (four years for honors students), full-time Bachelor of Science (Nursing) program that is accredited by the Singapore Nursing Board. The course covers core modules such as, anatomy, physiology and physical assessment, pathophysiology, pharmacology and nursing practice, communication and cultural diversity, and includes clinical practicums at tertiary hospitals that range from two weeks to three months.

This project will be carried out with nursing undergraduates of National University of Singapore who had completed the core module NUR1110 (Effective Communication for Health Professionals) in their year 1 of nursing courses. The 2-year study will follow these students in year 2 and year 3 consecutively by introducing Virtual Patients (VP) depicting real-life case scenarios at gradual difficulty levels before their end-of-semester clinical posting. Four VP case scenarios were developed for each semester on the following topics: 1) interview a pregnant woman with pain to solicit holistic history taking (year 2 semester 1); 2) history taking from a depressed patient (year 2 semester 2); 3) use of a standardized approach such as Situation, Background, Assessment, and Recommendation (SBAR) to hand off interdisciplinary communications (year 3 semester 1); and 4) showing empathy to the fellow nursing student (year 3 semester 2).

Overall, the aim of this project is to develop and evaluate the use of VPs in better preparing nursing undergraduates in communicating with real-life patients, family members, and other healthcare professionals during their clinical posting. The specific research questions the investigators plan to answer in this project are as follows:

1. What is the effect of using VPs in enhancing nursing undergraduates' self-efficacy and attitude toward learning communication skills?
2. Do the students receiving additional training using VPs perform better in their communication skills during the clinical posting compared with students receiving standard training?
3. What are the levels of outcomes of students' self-efficacy and attitude toward learning communication skills at pretest (semester 1, year 2 before receiving the VP training), posttest 1 (last day of clinical posting year 2 semester 1), posttest 2 (last day of clinical posting year 2 semester 2), posttest 3 (last day of clinical posting year 3 semester 1), and posttest 4 (last day of clinical posting year 3 semester 2)?
4. What are the changes in self-efficacy and attitude toward communication skills scores over time (pretest, posttests 1-4)?
5. What are the students' experiences in receiving additional training using VPs before their clinical posting? The aim of this paper is therefore to provide a detailed breakdown on the development process of the Virtual Counseling Application using Artificial Intelligence (VCAAI) for communication skills training in nursing education and to highlight challenges faced and recommended resolutions to inform future research.


Eligibility Criteria:
Inclusion Criteria:

* Year two nursing undergraduates
* Enrolled for Bachelor of Science (Nursing) course for Academic years 2017/2018 at Alice Lee Center for Nursing Studies, NUS.
* Completed the core module "Effective Communication for Health Professionals" in Year 1
* Able to read and speak English fluently

Exclusion Criteria:

* Medical or mental illness that may hinder the use of Virtual Patients