AI-Enabled Virtual Clinic Impact on Pharmacist Confidence in Managing Warfarin: Implications for Experiential Education

OBJECTIVE: Despite an expanding scope of practice, uptake of advanced clinical services is hindered by pharmacists' self-efficacy in high-stakes decision-making. Traditional experiential learning builds confidence but is constrained by preceptor shortages, scheduling conflicts, and travel requirements. This study evaluates an artificial intelligence-enabled virtual clinical training program designed to replace in-person warfarin-management rotations. METHODS: This mixed-methods study assessed the impact of the Management of Oral Anticoagulation Therapy course on learners' confidence and satisfaction. The course combines online modules with a virtual clinic that simulates a full clinical rotation, including patient encounters, therapeutic decisions, documentation, and structured feedback. Surveys administered after the online modules and again after completing the virtual clinic captured confidence (5-point Likert) and program satisfaction; free-text responses underwent content analysis. RESULTS: Of 287 participants (96.9% pharmacists), mean confidence on a 5-point Likert scale increased from baseline (1.92) to post-modules (3.85) and further after the virtual clinic (4.24). Approximately 40% experienced additional gains following simulations. Virtual simulations were ranked the most valuable component (69%). Qualitative analysis yielded 4 themes: experiential consolidation of learning, virtual experience comparable to in-person training, complementary role of preparatory materials, and technical refinements needed. CONCLUSION: The artificial intelligence-enabled virtual clinic effectively replaced traditional clinical rotations and enhanced confidence in warfarin care. Graduates' patients later achieved the highest time in therapeutic range reported in Canadian general practice, supporting real-world impact. The Management of Oral Anticoagulation Therapy model may mitigate preceptor shortages and deliver standardized experiential training; broader validation across therapeutic areas and learner groups is warranted.