Effect of GenAI Patient Simulation on Clinical Preparedness and Clinical Competence in Nursing Students

NCT07811245 — Not applicable, Not yet recruiting, 44 participants, The University of Hong Kong

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Effectiveness of Generative Artificial Intelligence (GenAI) Patient Simulation on Preparedness for Clinical Practicum and Clinical Competence Among Undergraduate Nursing Students: A Waitlist Randomized Controlled Trial and Mixed-methods Study

Registry	NCT07811245
Status	Not yet recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: none, other
Enrollment	44 (Estimated)
Sponsor	The University of Hong Kong (Other)
Conditions	Undergraduate Nursing Students
Interventions	GenAI Patient Simulation Platform (Behavioral)
Dates	start 2026-09-28 (estimated), primary completion 2027-08-31 (estimated), completion 2028-03-31 (estimated), first posted 2026-09-10, last updated 2026-09-21

-Summary

The transition from theoretical knowledge to clinical practice is a critical and challenging phase for nursing students. Limited opportunities for scenario-based learning before an clinical practicum impacts students' preparedness for practice and clinical competence. Consequently, this lack of preparation directly fuels stress, creating a a negative feedback loop where this stress inhibits cognitive processing and effective learning. Generative artificial intelligence (GenAI) has emerged as a novel educational technology capable of providing interactive, flexible, and learner-centred simulation experiences.

This waitlist randomised controlled trial aims to examine the effectiveness of incorporating the GenAI patient simulation in preparing the undergraduate nursing students for clinical practicum and enhancing the clinical competence compared to the current practice. Hypotheses of this study include:

1. Participants using the GenAI patient simulation will report higher preparedness for the first acute clinical practicum (CP) and higher clinical competence scores compared to the usual practice group at all time points.
2. The frequency of using the GenAI patient simulation will be positively correlated with preparedness for the CP and clinical competence.
3. Participants using the GenAI patient simulation will report lower perceived stress before and during the CP compared to the usual practice group.
4. The frequency of using of the GenAI patient simulation will negatively correlate with the levels of perceived stress before and during the CP.

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+Detailed description

Clinical practicum represents a critical transition point in undergraduate nursing education. Although pre-practicum workshops are commonly provided, students continue to experience difficulties in applying theoretical knowledge during the clinical practicum in acute care settings. A substantial gap often exists between the workshop and the start of clinical practicum, during which opportunities for ongoing learning, reinforcement of knowledge, and practice through virtual clinical scenarios are limited. GenAI patient simulation provide additional opportunities for experiential learning, deliberate practice, and self-directed preparation before clinical exposure.

The intervention of this study is a GenAI Patient Simulation Platform.

Participants in the intervention group will receive the pre-practicum workshop as usual followed by a two-phase GenAI patient simulation intervention:

Phase 1 - a 2-hour facilitated face-to-face simulation exercise session using the scenarios in the GenAI platform.

Phase 2 - a self-initiated, wall-free GenAI patient simulation scenario package. Participants is allowed to access the platform and do the exercises before and during clinical practicum.

Participants in the waitlist control group will receive the same intervention after completion of the study.

A total of forty-four undergraduate nursing students will be recruited and randomly assigned to intervention group and waitlist control group with 1:1 allocation ratio. Participants will be fully informed about the interventions, benefits and risks of the study. Participation is entirely voluntary, and individuals may withdraw at any time without penalty.

Baseline data will be collected before randomisation (T0). All participants will complete the questionnaires immediately after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3). Participants in the intervention group will be invited to join a semi-structured interview by the end of the study.

+Arms and interventions

Arm	Type	Interventions	Description
Arm 1	Experimental	Behavioral: GenAI Patient Simulation Platform
Arm 2	Other	Behavioral: GenAI Patient Simulation Platform	Waitlist control

GenAI Patient Simulation Platform (Behavioral): The intervention is a two-phase GenAI patient simulation platform. Phase 1 - a 2-hour facilitated face-to-face simulation exercise session using the scenarios in the GenAI platform. Phase 2 - a self-initiated, wall-free GenAI patient simulation scenario package. Participants is allowed to access the platform and do the exercises before and during clinical practicum.
GenAI Patient Simulation Platform (Behavioral): Same intervention after completion of the study.

+Outcome measures

Primary outcomes

Preparedness for Clinical Practicum [Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)]: Preparedness for clinical practicum will be measured using the Casey-Fink Readiness for Practice Survey, consists of 15 items in three domains: clinical problem solving (6 items), learning activities (5 items), and practice readiness (4 items). The minimum and maximum mean scores for each subscale are 1 and 4, respectively. A higher mean score indicates a higher level of agreement with each subscale.
Clinical Competence [Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)]: Measured by the Clinical Competency Questionnaire, consists of 47 items divided into four domains: nursing professional behaviour, general performance, core nursing skills and advanced nursing skills. Total scores range from 47 to 235, with a higher score indicating a higher level of competence.

Secondary outcomes

Perceived Stress [Baseline (T0), immediate after Phase 1 (T1), 2 weeks prior to the clinical practicum (T2), and within 1 week after completion of the clinical practicum (T3)]: Measured by the Perceived Stress Scale-10. Total scores range from 0 to 40. The higher total scores indicate higher perceived stress level.

+Eligibility

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

Year 3 nursing students of a 5-year full-time Bachelor in Nursing programme,

* of any nationality including non-local and non-Chinese students, and
* able to read and understand English, and
* completed the introduction of clinical nursing practicum in year 2, and
* scheduled to undertake their first acute clinical practicum within the same academic year.

Exclusion Criteria:

Year 3 nursing students of a 5-year full-time Bachelor in Nursing programme, who will not have their first acute clinical practicum within that academic year.