Table 5. Themes from Qualitative Analysis (n=25).

Values represent the number of participants (n) who contributed to each theme. Some participants expressed more than one theme, so totals exceed n = 25.

Theme No.	Theme Title	Description	Representative Quote	Participants n (%)
1	Perceived Realism	Virtual patients felt lifelike and presented realistic emotional and clinical responses.	“The virtual patient’s expressions and language felt real.”	18 (72%)
2	Safe Learning Environment	Learners appreciated being able to practice without fear of harming real patients.	“I could make mistakes and learn without stress.”	16 (64%)
3	Usability Challenges	Technical or navigation issues occasionally disrupted the experience.	“Sometimes the interface was slow or confusing.”	10 (40%)
4	Enhanced Reflective Learning	Feedback and performance tracking promoted reflection on communication style.	“The feedback made me think about how I explain things.”	14 (56%)
5	Increased Engagement	Interactive nature kept learners attentive and interested throughout the module.	“It was much more engaging than traditional lectures.”	20 (80%)