Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Aug 26, 2026)
Date Submitted: May 18, 2026
Open Peer Review Period: May 19, 2026 - Jul 14, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Artificial Intelligence in Simulation-based Healthcare Education: A Systematic Literature Review
ABSTRACT
Background:
Simulation-based learning (SBL) is widely used in healthcare education to develop both clinical competence and essential soft skills such as communication and teamwork. Although digital and simulation technologies have expanded rapidly, the specific role of artificial intelligence (AI) in enhancing and transforming these environments remains fragmented and insufficiently understood. Current knowledge is limited by small-scale implementations, narrow disciplinary focus, and weak connections between technological innovation and educational theory, underscoring the need for a comprehensive synthesis of evidence.
Objective:
This study aimed to systematically review and map the landscape of AI-supported SBL in healthcare education, identifying trends, approaches, theoretical foundations, and ethical considerations.
Methods:
We conducted a systematic literature review of published studies on AI-supported SBL across healthcare contexts. Articles were analysed for geographic and disciplinary distribution, learner populations, simulation technologies, AI techniques, educational frameworks, and reporting of ethical practices. A structured approach was used to compare technological, pedagogical, and methodological characteristics across studies.
Results:
AI-supported SBL research is concentrated in developed countries and primarily targets undergraduate medical and nursing education, with limited attention to other professions, interprofessional learning, or continuing development. Most initiatives are small-scale and experimental, relying heavily on computer-based platforms and large language model-driven conversational agents, while immersive and multimodal simulations remain underexplored. Weak theoretical grounding, limited attention to learner experience, and insufficient engagement with ethical issues such as bias and data governance persist.
Conclusions:
Further investigation of theory-informed, ethically robust AI-supported SBL across diverse healthcare settings may strengthen educational effectiveness and broader competency development.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.