Student-staff co-developed immersive virtual reality and engineered AI prompts to enhance therapeutic communication

Abstract

Although students frequently use generative AI for various purposes, their limited understanding of effective usage and critical evaluation often reduces its educational value. This study examines the impact of AI-assisted prompt engineering and explicit instruction in therapeutic communication on nursing students’ clinical communication skills during immersive virtual reality (IVR) simulations. Analysis of thirty-seven student scripts across three stages—initial, AI-refined, and therapeutically enhanced—revealed that initial responses were factual and impersonal, reflecting limited AI literacy. Without explicit guidance, students struggled to optimise AI outputs for therapeutic communication. However, prompt engineering led to more structured, empathetic, and patientcentred responses. Thematic analysis of student reflections indicated increased confidence and self-awareness. These findings underscore the essential role of prompt engineering in empowering students to maximise AI’s educational benefits and develop advanced communication skills, highlighting the need for targeted instruction to fully realise AI’s potential in nursing education.