Background: Artificial intelligence (AI) and virtual/extended reality technologies are reshaping nursing education by providing standardized, interactive, and low-stress learning environments. This study developed a clinical skill assessment and feedback system integrating computer vision, GPT-4o analysis, and a Unity-based metaverse Avatar.
Objective: To design and validate a prototype system that automatically evaluates nursing students’ clinical skills based on OSCE checklists, generates individualized feedback, and delivers real-time commentary through a digital Avatar.
Methods: A total of 82 nursing students were recruited and randomly assigned to an experimental group (AI+Avatar feedback) or a control group (traditional teacher feedback). Standard operating procedure (SOP) videos were used as benchmarks, and students’ performance videos were analyzed using computer vision and GPT-4o to produce scores and narrative feedback. Evaluation measures included pre- and post-test OSCE scores and a learning satisfaction scale.
Results: Students in the experimental group demonstrated an average 15% improvement in OSCE scores (p < .05) and reported significantly higher learning satisfaction compared with the control group (4.5 vs. 3.8/5). AI-generated feedback accurately identified strengths and weaknesses, while Avatar-based real-time delivery enhanced motivation and reduced performance anxiety. Conclusion: This system provides a standardized, immersive, and learner-centered approach to clinical skill training. Quantitative results indicate that AI+Avatar not only improved skill performance but also increased learning motivation, demonstrating strong potential for advancing digital innovations in nursing education.

Authors:
Wei-Kai Liou, HungKuo Delin University of Technology, Taiwan

About the Presenter(s)
Dr. Wei-Kai Liou graduated from the National Taiwan University of Science and Technology. His academic interests are the application of augmented reality(AR), virtual reality(VR), and mixed reality(MR) in education. In recent years, he has been comm

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