Multimodal Avatars and Human Simulations in Teaching Practical Skills and Training of Clinical Psychology,Psychotherapy,and Related Mental Health Specialists

Psychology students face limitations in opportunities for supervised practice, constrained by access to clients, the costs of standardized patient programs, and ethical barriers. Novel teaching instruments in the form of multimodal avatars and human simulations have been proposed as innovative solutions, yet their effectiveness remains unclear. This review aimed to answer the question: to what extent do existing systems support skill acquisition in psychology training? A structured search of nine databases (2015–2025) identified seven eligible studies. Solutions from the studies were classified into five categories: basic virtual patient simulations, chatbot-based avatars, mixed reality avatars, virtual reality avatars, and virtual world avatars. Results show that digital simulation solutions are feasible, engaging, and accepted by students. There is evidence of improved training in diagnostic reasoning, questioning strategies, and self-efficacy. However, traditional actor-based simulations are still more effective for developing interpersonal skills. Technological issues, such as limited interactivity and the Uncanny Valley effects, hurt realism and reduce training gains. In conclusion, these technologies have promise as supplements to traditional training. Yet, the field remains underdeveloped and will require further design-focused improvements to reach its full potential.