AI-Enabled Virtual Clinic Impact on Pharmacist Confidence in Managing Warfarin: Implications for Experiential Education.

Despite an expanding scope of practice, uptake of advanced clinical services is hindered by pharmacists' self-efficacy in high-stakes decision-making. Traditional experiential learning builds confidence but is constrained by preceptor shortages, scheduling conflicts, and travel requirements. This study evaluates an AI-enabled virtual clinical training program designed to replace in-person warfarin-management rotations. This mixed-methods study assessed the impact of the Management of Oral Anticoagulation Therapy (MOAT) course on learners' confidence and satisfaction. The course combines online modules with a virtual clinic that simulates a full clinical rotation, including patient encounters, therapeutic decisions, documentation, and structured feedback. Surveys administered after the online modules and again after completing the virtual clinic captured confidence (5-point Likert) and program satisfaction; free-text responses underwent content analysis. Of 287 participants (96.9% pharmacists), mean confidence on a 5-point Likert scale increased from baseline (1.92) to post-modules (3.85) and further after the virtual clinic (4.24). Forty percent experienced additional gains following simulations. Virtual simulations were ranked the most valuable component (69%). Qualitative analysis yielded four themes: experiential consolidation of learning, virtual experience comparable to in-person training, complementary role of preparatory materials, and technical refinements needed. The AI-enabled virtual clinic effectively replaced traditional clinical rotations and enhanced confidence in warfarin care. Graduates' patients later achieved the highest time-in-therapeutic-range reported in Canadian general practice, supporting real-world impact. The MOAT model may mitigate preceptor shortages and deliver standardized experiential training; broader validation across therapeutic areas and learner groups is warranted.