Teaching clinical communication skills through virtual patient-based learning: an umbrella review of systematic reviews

Abstract Background Effective clinical communication is a core component of patient-centered care. Immersive learning technologies, including virtual patients, virtual reality, and augmented reality, are increasingly used to train clinical communication skills in undergraduate health professions education. However, the existing evidence is fragmented and methodologically heterogeneous. This umbrella review synthesizes review-level evidence on immersive technologies and virtual patients for developing clinical communication skills in undergraduate health professions education and explores barriers to curricular integration and key research gaps. Methods An umbrella review of systematic reviews (with or without meta-analysis) was conducted following PRISMA guidelines. Searches were performed in PubMed, ScienceDirect, CINAHL, and Cochrane Library. Eligible reviews examined immersive technologies (e.g., VR, AR, MR, XR, virtual patients) targeting clinical communication skills in undergraduate learners. Methodological quality was assessed using AMSTAR-2. No pooled meta-analysis was feasible because of substantial heterogeneity in interventions, comparison conditions, and outcome measures. Results Nine systematic reviews were included. All were rated as critically low in methodological quality, which limits confidence in the conclusions that can be drawn. Across reviews, immersive technologies were reported as potentially beneficial for short-term communication performance, learner engagement, and perceived confidence, particularly in comparison with no intervention or some traditional teaching formats. However, evidence regarding long-term retention, empathy development, non-verbal communication, and transfer to clinical practice remained inconsistent. Substantial heterogeneity in intervention design, outcome measures, and feedback structures limited comparability across reviews.