The digital standardized patient: An artificial intelligence coach for cultural dexterity in surgical care

Document Type

Article

Department

Surgery; General Surgery

Abstract

Background: Cultural dexterity, defined as the ability to effectively respond to diverse patient backgrounds, is crucial for equitable surgical care. Standardized patient (SP) encounters are proven tools for cultivating these skills but are resource-intensive and limited in scope. Large language models (LLMs) offer a scalable solution. This study evaluates the feasibility and perceived effectiveness of an LLM-based SP platform (SP-LLM) for cultural dexterity training among general surgery residents.
Study design: In this two-week pilot cohort study, 16 general surgery residents at a single academic center interacted with a novel SP-LLM platform simulating two scenarios from the Provider Awareness and Cultural Dexterity Toolkit for Surgeons (PACTS) curriculum. Residents engaged with the SP-LLM via both text and voice to navigate complex, culturally sensitive patient encounters. Post-interaction surveys assessed perceptions of realism, emotional depth, cultural relevance, and educational utility using Likert scales and qualitative responses.
Results: Residents found the SP-LLM clinically accurate (mean score 4.27) and its portrayals realistic (4.00). The platform supported culturally sensitive communication (3.87) and helped residents address patient emotions (3.87). Text-based interactions were valued for encouraging reflection (4.00), while voice interactions received more mixed feedback (3.13). Participants reported strong utility for discussing pain management (4.40) and some effectiveness in addressing medical mistrust (3.40). Qualitative feedback emphasized a need for more nuanced patient histories and improved voice realism.
Conclusion: This pilot study demonstrates the promise of SP-LLMs as scalable tools for advancing cultural dexterity training in surgical education and beyond. Residents found the platform clinically relevant and effective for practicing culturally sensitive communication. With continued development, SP-LLMs have the potential to broaden access to high-quality, scenario-based training across medical specialties and institutions.

Comments

Volume, issue and pagination are not provided by the author/publisher.

Publication (Name of Journal)

Journal of the American College of Surgeons

DOI

10.1097/XCS.0000000000001505

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