AI Simulation to Reduce Stigma and Enhance Psychiatric Readiness in Nursing Students

Mental illness stigma among nursing students can undermine the quality of care that people with psychiatric conditions receive, and many students feel unprepared for psychiatric practice. This randomized controlled trial will examine whether an AI-based psychiatric simulation programme can reduce stigma and improve readiness for psychiatric nursing practice among fourth-year nursing students at the Faculty of Nursing, Alexandria University, Egypt. It will also test whether these effects are explained by students' sense of psychological safety during simulation-based learning. Two hundred students will be randomly allocated 1:1 to either the intervention or the control arm. Both arms will receive the standard psychiatric-mental health nursing curriculum. The intervention arm will additionally complete five individual AI-simulation cases (one per week over five weeks, about 15-20 minutes each), covering depression with suicide risk, mania, schizophrenia, substance use disorder, and borderline personality disorder with self-harm. Each case includes a structured interview with a simulated patient, a standardized stigma-trigger statement, automated feedback, and an opportunity to retry. Mental illness stigma, readiness for psychiatric practice, and psychological safety will be measured online at two time points: baseline and immediately after the fifth case. Intervention-arm students will also answer two open-ended questions, analyzed thematically to help explain the quantitative findings.