Objective Digital transformation in higher education has presented medical students with new challenges, which has increased the difficulty of organising their own studies. The main objective of this study is to evaluate the effectiveness of a chatbot in assessing the stress levels of medical students in everyday conversations and to identify the main condition for accepting a chatbot as a conversational partner based on validated stress instruments, such as the Perceived Stress Questionnaire (PSQ20). Methods In this mixed-methods research design, medical-student stress level was assessed using a quantitative (digital- and paper-based versions of PSQ20) and qualitative (chatbot conversation) study design. PSQ20 items were also shortened to investigate whether medical students’ stress levels can be measured in everyday conversations. Therefore, items were integrated into the chat between medical students and a chatbot named Melinda. Results PSQ20 revealed increased stress levels in 43.4% of medical students who participated ( N  =  136). The integrated PSQ20 items in the conversations with Melinda obtained similar subjective stress degree results in the statistical analysis of both PSQ20 versions. Qualitative analysis revealed that certain functional and technical requirements have a significant impact on the expected use and success of the chatbot. Conclusion The results suggest that chatbots are promising as personal digital assistants for medical students; they can detect students’ stress factors during the conversation. Increasing the chatbot's technical and social capabilities could have a positive impact on user acceptance.

IntroductionFace-to-face medical and psychotherapeutic treatments during the Corona pandemic often involve patients and health care providers wearing face masks. We performed a pilot survey assessing the subjective experience of wearing face masks during psychotherapy sessions regarding (i) feasibility, (ii) psychotherapeutic treatment and (iii) communication, emotion and working alliance in patients and healthcare professionals.MethodsA total of n = 62 inpatients (RR = 95.4%) and n = 33 healthcare professionals (RR = 86.8%) at an academic department of Psychosomatic Medicine and Psychotherapy participated in this survey anonymously. The items of the questionnaire were created by the interprofessional expert team and were based on existing instruments: (i) the Therapeutic Relationship Questionnaire and (ii) the German translation of Yalom’s Questionnaire on Experiencing in Group Psychotherapy.ResultsThe majority of patients rate their psychotherapy as highly profitable despite the mask. In individual therapy, face masks seem to have a rather low impact on subjective experience of psychotherapy and the relationship to the psychotherapist. Most patients reported using alternative facial expressions and expressions. In the interactional group therapy, masks were rather hindering. On the healthcare professional side, there were more frequent negative associations of face masks in relation to (i) experiencing connectedness with colleagues, (ii) forming relationships, and (iii) therapeutic treatment.DiscussionInformation should be given to patients about the possible effects of face masks on the recognition of emotions, possible misinterpretations and compensation possibilities through alternative stimuli (e.g., eye area) and they should be encouraged to ask for further information. Especially in group therapy, with patients from other cultural backgrounds and in cases of need for help (e.g., hearing impairment) or complex disorders, appropriate non-verbal gestures and body language should be used to match the intended emotional expression.