Abstract: Virtual standardized patient (VSP), which result from the advanced integration of artificial intelligence with simulation-based medical education, are catalyzing a shift in medical education towards a data-driven paradigm. This paper provides a systematic analysis of the technological advancements in VSP, highlighting their fundamental distinctions from traditional standardized patients. It further examines the divergent developmental trajectories in technical architecture and functional orientation between China and other countries. Domestically, there is an emphasis on intelligent scoring systems for assessment and evaluation, whereas internationally, the focus is on process-oriented multimodal immersive interaction. VSP presents notable benefits in terms of cost-effectiveness, uniformity in instruction, and adaptability in various scenarios. However, they also encounter practical challenges, such as limitations in replicating non-verbal communication, potential for content distortion, and the lack of standardized evaluation criteria. Future advancements in VSP development should focus on technological integration, progressing from multimodal interactions to physiological closed-loop systems. Additionally, there is a need for standardization to move from disparate practices to a cohesive assessment framework, and for security governance to transition from passive protection measures to proactive management strategies. This study seeks to serve as a foundational reference for the localized development and implementation of VSP, as well as for the advancement of intelligent methodologies in medical education.

Key words: Patient simulation, Virtual standardized patients, Medical simulation education, Virtual reality, Technological paradigms, Research progress