The effectiveness of virtual reality simulated scenarios at improving medical students’ confidence and engagement in clinical communication: an observational cohort study

BACKGROUND: Effective communication is a core component of medical training, yet opportunities to practise emotionally challenging conversations such as those involving distressed families are often limited in clinical placements. Virtual reality (VR) offers a scalable, immersive teaching tool that may enhance student confidence and engagement in communication skills training. METHODS: A prospective observational study was conducted with fifth-year medical students in their penultimate year of study at Imperial College School of Medicine. Participants engaged in a VR session simulating an emotionally charged conversation with an upset family. Pre- and post-session questionnaires assessed self-reported confidence using a 5-point Likert scale. Student engagement was measured objectively using the validated Behavioural Engagement Related to Instruction (BERI) tool. Statistical analysis was performed using the Wilcoxon Signed-Rank test. As there was no comparator group, findings should be interpretated as exploratory. RESULTS: Of the 109 students, 62 completed both pre- and post-session questionnaires (57%). A significant median increase of one point in self-reported confidence was observed (p < 0.001). Engagement was high, with minimal distraction events which were attributed solely to technical issues. CONCLUSION: VR-based clinical communication training resulted in increased self-reported confidence and was well received. This modality shows promise as a scalable, engaging complement to traditional teaching methods in medical education.