Virtual patient simulation strengthens confidence in clinical conversations among undergraduated nursing students: a randomized controlled trial

Intimate partner violence (IPV) is a major public health concern, and healthcare staff must be competent in identifying and responding to IPV. However, training opportunities to handle such cases remain limited. This study examined whether integrating a virtual patient (VP) simulation into nursing education improves confidence, self-efficacy, and knowledge in addressing IPV. In this randomized controlled trial (RCT), fifty-four nursing students (87% female) were randomly assigned to an intervention group (n = 29) receiving a VP module in addition to standard training, or a control group (n = 25) receiving standard training only. Students were assessed at baseline and after each educational activity: (1) a web-based module (both groups) (2), VP training for the intervention group while the control group had no corresponding module, and (3) a teacher-led seminar (both groups). Primary outcomes were confidence in asking about IPV, general self-efficacy, self-assessed knowledge, and objective knowledge. Linear mixed-effects models were used to analyse changes over time. The VP group showed a significantly greater improvement in confidence in asking about IPV (between-group difference + 1.26, 95% CI 0.40–2.15; p = 0.010). Objective knowledge scores were consistently higher in the VP group, although the group × time interaction was not significant. General self-efficacy and self-assessed knowledge improved similarly in both groups. Integrating an interactive VP simulation into a nursing curriculum enhances learners’ confidence in addressing IPV and is associated with higher levels of factual knowledge. VP simulations may represent a scalable complement to conventional teaching for complex and sensitive clinical topics. ClinicalTrials.gov ID: NCT06706011.