The use of conversational technologies to create conversational virtual patients (CVPs) holds great promise for improving the communication skills and medical knowledge of future physicians. This design science study aims to establish effective design principles for the implementation of CVPs. Based on existing literature and insights gained through semi-structured interviews with physicians, this study identifies design requirements and synthesizes them into four design principles: authentic representation, user adaptability, performance feedback, and user friendliness. The prototypical instantiation and first round of positive evaluation of a CVP for the symptom of stomach pain provides support for the validity of these principles. The study contributes actionable guidance for the development of future CVPs, ensuring that future medical education meets the evolving needs of digital-native learners.

The use of clinical decision support systems (CDSS) transforms physicians' decision-making process and therewith their competency. Some physicians have concerns about using such systems, while others using them experience improved outcomes such as increased efficiency. Physicians’ competency, particularly in the domains of medical science and clinical practice, serves as a bridge between the use of CDSS and the anticipated outcomes. This connection is relatively unexplored. As physicians’ competency fields are an important puzzle piece within the transformation of the decision-making process, our aim is to identify how CDSS change physicians’ tasks and affect their competency. After deriving a competency framework for physicians, our contribution is to explain the effect of the use of CDSS on physicians' competency. Our findings indicate personal, sociotechnical, and medical factors moderating physicians’ use of CDSS.