Artificial intelligence and virtual reality-based communication skills training in nursing education: a systematic review with implications for palliative care
The need for communication is common to all nurses during patient interaction in different medical scenarios, such as palliative care and end of life care. It is important to note that many nurses and nursing students perceive their level of training as inadequate to deal with difficult conversations. The two tools – virtual reality and artificial intelligence – provide practical help in achieving this. To synthesize empirical evidence on artificial intelligence (AI)- and virtual reality (VR)-based communication skills training among nurses and nursing students and examine its implications for palliative care education. Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Original studies written in English and published from database inception until March 2026 were identified. Studies that used AI- and/or VR-based communication training for nurses or nursing students using randomized controlled, quasi-experimental, mixed-methods, cross-sectional, or qualitative study designs were eligible for inclusion in this review. Thirteen studies were included in this review. Quality of the methodology was appraised using the Mixed Methods Appraisal Tool (MMAT). Communication training through VR led to increased confidence in end-of-life communication, improved postmortem care knowledge, increased motivation and high acceptability. A 360 VR communication workshop was found to be feasible and scalable. Multiuser VR simulation reached the same communication outcome as live simulation, and VR-based communication training was more effective than video-based training for basic nurse-patient communication. AI- and VR-based communication training represents an innovative tool for nursing education, specifically in the field of palliative and end-of-life care. However, further randomized controlled trials with objective performance measurements and long-term follow-ups are needed due to the heavy reliance on subjective self-reports in the existing literature.