A Voice-Enabled Virtual Patient System for Interactive Training in Standardized Clinical Assessment

Abstract: Training mental health clinicians to conduct standardized clinical assessments is challenging due to a lack of scalable, realistic practice opportunities, which can impact data quality in clinical trials. To address this gap, we introduce a voice-enabled virtual patient simulation system powered by a LLM. This study describes the system's development and validates its ability to generate virtual patients who accurately adhere to pre-defined clinical profiles, maintain coherent narratives, and produce realistic dialogue. We implemented a system using a LLM to simulate patients with specified symptom profiles, demographics, and communication styles. The system was evaluated by 5 experienced clinical raters who conducted 20 simulated structured MADRS interviews across 4 virtual patient personas. The virtual patients demonstrated strong adherence to their clinical profiles, with a mean item difference between rater-assigned MADRS scores and configured scores of 0.52 (SD=0.75). Inter-rater reliability across items was 0.90 (95% CI=0.68-0.99). Expert raters consistently rated the qualitative realism and cohesiveness of the virtual patients favorably, giving average ratings between "Agree" and "Strongly Agree." Our findings suggest that LLM-powered virtual patient simulations are a viable and scalable tool for training clinicians, capable of producing high-fidelity, clinically relevant practice scenarios.