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Artificial Intelligence-Based Adaptive Simulation Integrated With a Workforce Decision-Support System to Improve Simulated Nursing Leadership Performance: A Randomized Controlled Study

Background The growing integration of artificial intelligence (AI) in healthcare necessitates that nurse leaders develop advanced competencies in decision-making, communication, and data-informed clinical judgment. Traditional simulation-based education, while effective, often relies on fixed scenarios with limited adaptability and minimal real-time decision support. AI-enhanced simulation offers a potential solution by creating responsive, adaptive learning environments that support leadership development. Meth…

By the Truvace desk1 min read1 sourcePeer-reviewedTRV-2026-1262· cite & verify
Artificial Intelligence-Based Adaptive Simulation Integrated With a Workforce Decision-Support System to Improve Simulated Nursing Leadership Performance: A Randomized Controlled Study
Construction site tour of the Skilled Nursing Residence, in Edgartown, on the island of Martha's Vineyard, in Dukes County, Maryland on August 5, 2024 - 33 by USDAgov. Public domain

In brief

In a randomized controlled trial of 130 final-year nursing students, researchers compared traditional simulation to AI-adaptive simulation integrated with an AI-based workforce decision-support system. By Week 10, the AI group showed significantly larger improvements in leadership performance on the Creighton Simulation Evaluation Instrument, plus gains in team performance and self-efficacy.

The findings suggest AI-enhanced simulation can strengthen leadership competencies that are difficult to teach with fixed scenarios, but the study was limited to simulated settings with blinded preceptor ratings. Whether improved simulation scores translate into sustained performance and better clinical leadership in practice remains untested.

Main points

  1. Randomized controlled pretest-posttest trial with 130 final-year nursing students allocated 65 to intervention and 65 to control.
  2. Intervention was AI-adaptive simulation integrated with an AI-based workforce decision-support system versus traditional fixed-scenario simulation.
  3. Leadership performance measured with Creighton Simulation Evaluation Instrument; 21 clinical preceptors served as trained and blinded outcome assessors.
  4. Intervention group reported favorable AI acceptance including perceived usefulness and ease of use.

The gain

Final-year nursing students receiving AI-adaptive simulation integrated with a workforce decision-support system showed greater gains in simulated leadership performance, team performance, and self-efficacy at Week 10 compared to controls.

The rundown

The trial ran to Week 10 with pretest-posttest assessment. The intervention group received responsive, adaptive scenarios plus real-time workforce decision support, while the control received traditional simulation. Outcome assessors were 21 clinical preceptors who were trained and blinded and not part of the randomized sample.

Secondary outcomes showed large standardized effects: team performance d = 1.24 and general self-efficacy d = 1.37, alongside leadership performance d = 1.78. Students in the intervention arm also reported favorable acceptance on usefulness and ease of use, indicating feasibility for educational adoption.

Sources

  1. Peer-reviewedCureus2026-10-01

The debate