From AI agents and holographic patients, to immersive spaces and smart technology, health care education is evolving rapidly and the University of Miami’s School of Nursing and Health Studies is keeping up to support the demand. Frank Guido-Sanz, associate dean for simulation and research at the University of Miami School of Nursing and Health Studies, leads a team of simulation nurse specialists and technologists at the school’s 41,000-square-foot simulation hospital—Simulation Hospital Advancing Research and Education® (S.H.A.R.E.)—and remains focused on preparing University of Miami students, future practitioners, with the latest technology to enhance their training.
As the demand for nurses continues to grow, simulation-based learning has taken on an even more critical role. According to the U.S. Bureau of Labor Statistics, nurses with advanced degrees will have a 35 percent increase in employment from 2024 to 2034. Employment for registered nurses is expected to rise to five percent, compared to a three percent projected increase in all other occupations, during the same time period.
“The workforce shortage drives us to design high-yield, scalable simulations that accelerate clinical readiness and ensure consistent competency development, especially when clinical placements are limited,” Guido-Sanz said. “Simulation enables us to expose students to a broader range of competencies earlier—clinical judgment, teamwork, informatics, and systems thinking—while ensuring consistency and quality across cohorts. In this way, simulation functions not just as training, but as workforce preparedness infrastructure.”
Charged with developing simulation-based learning models for nursing students, Guido-Sanz and his team worked closely with the school’s IT experts to develop two recently unveiled AI agents: L.A.I.L.A. (Learning AI Liaison Assistant); and A.I.D.A. (Automated Intelligence for Dynamic Assistance).
“These AI agents and video tools support adaptive learning through real-time feedback, and they enable rapid development of instructional and orientation content tailored to clinical procedures and learning objectives,” Guido-Sanz said.
For example, “A.I.D.A. grew out of preparing for our Society for Simulation in Healthcare reaccreditation which we earned without deficiencies.”
L.A.I.L.A., a troubleshooter with a user-friendly communication style, was designed to help simulation staff members quickly access standard operating procedures, manuals, and other curated resources.
A.I.D.A., the behind-the-scenes agent, can create avatars, write simulation instructions, role-play, produce debriefing analytics, and drive customizations for multi-user simulations and remote sessions.
The scenarios students are exposed to through simulation “would be rare, unpredictable, or unsafe for novice learners to manage in real clinical settings.”
“Simulation allows students to experience high-acuity, low-frequency events—such as rapid clinical deterioration, sepsis escalation, cardiac arrest, mass casualty incidents, end-of-life conversations, and ethical conflicts—well before they are likely to encounter them in practice,” Guido-Sanz said. “We can also recreate complex interprofessional and systems-level challenges, including communication breakdowns, health inequities, technology failures, and workflow disruptions.”
Guido-Sanz has been on the cutting-edge of innovation for years, and prior to joining the University of Miami, gained experience in AI-driven technologies while working on U.S. Department of Defense-funded grants.
He was the co-creator of a now-patented multisensory dynamic wound simulator that blends tactile and digital realities, allowing first responders to learn the appropriate amount of pressure to apply to a bleeding wound.
So, what’s next for AI integration in nursing education? Guido-Sanz remains enthusiastic about adopting holographic technology where holograms have integrated capabilities like LLMs and voice agents for real-time conversations and interactions.
But his next mission is to develop a completely immersive space driven by artificial intelligence, colloquially called “phygital space,” a hybrid of physical and digital environments.
“Imagine an iMax theatre where you project a movie around you, but it also has sounds, smells, and floors that vibrate. You can recreate intense environments, such as rescue task force scenarios, where you are embedded in the simulation,” Guido-Sanz said.
These simulations virtually replicate a variety of high-stress, real-life situations that completely immerse and allow participants to practice decision-making in a low-risk environment, optimizing their reaction time.
“Your five senses must be completely stimulated. The more realistic the simulation, the better prepared the learners are,” Guido-Sanz said.
Immersive learning environments also help bridge the gap between theory and practice.
“Textbooks deliver knowledge; immersive simulation builds clinical judgment, situational awareness, and adaptive expertise,” Guido-Sanz said. “Simulation places learners in environments where they must synthesize data, prioritize actions, communicate effectively, and reflect on outcomes—skills that cannot be developed through static learning alone. Advanced technologies, including extended reality and AI-enabled simulations, further enhance realism by adapting scenarios in real time and providing actionable feedback.”
As AI continues to advance, University faculty and staff members are diligent in developing groundbreaking methods of integrating the technology into the classroom.
“We’re increasing the realism and putting in our students’ hands the technology they may see in the workforce very soon,” Guido-Sanz said. “We’re all engaged in creating and bringing new technology to this space, positioning ourselves at the forefront of technology adoption.”
