# When Avatars Have Personality: Effects on Engagement and Communication in Immersive Medical Training

arXiv: https://arxiv.org/abs/2509.14132 · HTML: https://mlsanity.com/paper/2509.14132/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 50 references that are in the map.
- First posted on arXiv 17 Sep 2025.

## Builds on (most cited first, 13 of 13)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [LLMs-as-Judges: A Comprehensive Survey on LLM-based Evaluation Methods](https://mlsanity.com/paper/2412.05579/) (2024)
- [PersonaLLM: Investigating the Ability of Large Language Models to Express Personality Traits](https://mlsanity.com/paper/2305.02547/) (2023)
- [Can LLM be a Personalized Judge?](https://mlsanity.com/paper/2406.11657/) (2024)
- [PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions](https://mlsanity.com/paper/2505.17818/) (2025)
- [The Effects of Embodiment and Personality Expression on Learning in LLM-based Educational Agents](https://mlsanity.com/paper/2407.10993/) (2024)
- [Adaptive-VP: A Framework for LLM-Based Virtual Patients that Adapts to Trainees' Dialogue to Facilitate Nurse Communication Training](https://mlsanity.com/paper/2506.00386/) (2025)
- [Modeling Challenging Patient Interactions: LLMs for Medical Communication Training](https://mlsanity.com/paper/2503.22250/) (2025)
- [nuReality: A VR environment for research of pedestrian and autonomous vehicle interactions](https://mlsanity.com/paper/2201.04742/) (2022)
- [Integrating Personality into Digital Humans: A Review of LLM-Driven Approaches for Virtual Reality](https://mlsanity.com/paper/2503.16457/) (2025)
- [Fine-Tuning LLMs on Small Medical Datasets: Text Classification and Normalization Effectiveness on Cardiology reports and Discharge records](https://mlsanity.com/paper/2503.21349/) (2025)
- [SAMPAI: A VR Framework for Industrial Safety Training Inspired by Cultural Heritage Education](https://mlsanity.com/paper/2412.13725/) (2024)

## Abstract (arXiv)

While virtual reality (VR) excels at simulating physical environments, its effectiveness for training complex interpersonal skills is limited by a lack of psychologically plausible virtual humans. This gap is particularly critical in medical education, where communication is a core clinical competency. This paper introduces a framework that integrates large language models (LLMs) into immersive VR to create medically coherent virtual patients with distinct, consistent personalities, based on a modular architecture that decouples personality from clinical data. We evaluated the system in a mixed-methods, within-subjects study with licensed physicians conducting simulated consultations. Results suggest that the approach is feasible and perceived as a rewarding and effective training enhancement. Our analysis highlights key design principles, including a "realism-verbosity paradox" and the importance of challenges being perceived as clinically authentic to support learning.