Effective communication training is essential to preparing nurses for high-quality patient care. While standardized patient (SP) simulations provide valuable experiential learning, they are often costly and inflexible. Virtual patient (VP) systems offer a scalable alternative, but most fail to adapt to the varying communication skills of trainees. In particular, when trainees respond ineffectively, VPs should escalate in hostility or become uncooperative—yet this level of adaptive interaction remains largely unsupported. To address this gap, we introduce Adaptive-VP, a VP dialogue generation framework that leverages large language models (LLMs) to dynamically adapt VP behavior based on trainee input. The framework features a pipeline for constructing clinically grounded yet flexible VP scenarios and a modular system for assessing trainee communication and adjusting VP responses in real time, while ensuring learner safety. We validated Adaptive-VP by simulating challenging patient conversations. Automated evaluation using a corpus from practicing nurses showed that our communication skill evaluation mechanism reflected real-world proficiency levels. Expert nurses further confirmed that Adaptive-VP produced more natural and realistic interactions than existing approaches, demonstrating its potential as a scalable and effective tool for nursing communication training.

Existing methods for simulating individual identities often oversimplify human complexity, which may lead to incomplete or flattened representations. To address this, we introduce SPeCtrum, a grounded framework for constructing authentic LLM agent personas by incorporating an individual’s multidimensional self-concept. SPeCtrum integrates three core components: Social Identity (S), Personal Identity (P), and Personal Life Context (C), each contributing distinct yet interconnected aspects of identity. To evaluate SPeCtrum’s effectiveness in identity representation, we conducted automated and human evaluations. Automated evaluations using popular drama characters showed that Personal Life Context (C)—derived from short essays on preferences and daily routines—modeled characters’ identities more effectively than Social Identity (S) and Personal Identity (P) alone and performed comparably to the full SPC combination. In contrast, human evaluations involving real-world individuals found that the full SPC combination provided a more comprehensive self-concept representation than C alone. Our findings suggest that while C alone may suffice for basic identity simulation, integrating S, P, and C enhances the authenticity and accuracy of real-world identity representation. Overall, SPeCtrum offers a structured approach for simulating individuals in LLM agents, enabling more personalized human-AI interactions and improving the realism of simulation-based behavioral studies.