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2.18.2025

New Tactics: Becoming AI Curious

By Christine Kueter
Originally published on the School of Nursing website

Clinical simulation educator James Nisley claims he’s not creative.

It used to take him weeks to develop a new simulation — its learning outcomes and structure, as well as the infinite details that bring a simulation story to life, like setting, plot and action, patient medical and psychological profiles, and backstories. 

In December 2023, though, after the Virginia Board of Nursing mandated that the School offer specific clinical experiences in a long-term care setting, Nisley — who’d just devoured a feature article on the use of AI in simulation in the Society for Simulation in Healthcare Journal — dipped into ChatGPT for the first time. He came away intrigued.

The tool created eight standardized patient profiles in seconds — patients with complex diagnoses, medications, labs, and varied backstories. Across 127 pages and 28,000 words, it dreamed up the “Harmony Haven” nursing home and helped Nisley develop and refine the simulation’s objectives, bringing immediate color and depth to a process that otherwise would have taken him weeks.  

“The literature shows that it takes about 56 hours to develop a one-patient simulation from scratch,” Nisley explained, “but within seconds of logging in, I was getting information and data and ideas, and was like, ‘I’ve got this.’ It took my stress level down because I had to do everything by the end of winter break. I was amazed.” 

In the end, Nisley developed the entire eight-patient "Harmony Haven" simulation and all its characters, medical records, test results, and formatting, in about 75 hours using AI: less than one-quarter of what it might have taken, on average, to create it without using AI for help.

Not that Nisley didn’t notice a few hiccoughs — “hallucinations” in AI parlance.  

“There were medications prescribed for one simulated patient that, based on her diagnosis, were totally inappropriate,” Nisley recalled. AI also generated bad lab values, strange imaging results, and inaccurate CT scans, errors he found as he combed through the ideas it generated. 

Across 2024, simulation faculty members developed/deployed three new simulations, including one involving practice for end-of-life care at a nursing facility called "Harmony Haven" . . .
Across 2024, simulation faculty members developed/deployed three new simulations, including one involving practice for end-of-life care at a nursing facility called "Harmony Haven" ...
. . . in which standardized patients acted out roles in which they were argumentative, depressed, confused, and suffering while bedridden at the end-of life ...
... in which standardized patients acted out roles in which they were argumentative, depressed, confused, and suffering while bedridden at the end-of life ...
. . . and students sought to comfort, care for, feed, assess, and monitor them. They used AI to develop the sims, including, in particular, patients' backstories and health histories.
... and students sought to comfort, care for, feed, assess, and monitor them. They used AI to develop the sims, including, in particular, patients' backstories and health histories.
Another new simulation focused on interpersonal skills that included standardized patients with whom students practiced having difficult, uncomfortable conversations . . .
Another new simulation focused on interpersonal skills that included standardized patients with whom students practiced having difficult, uncomfortable conversations ...
James Isley
... including with people who were rude, combative, depressed, hysterical, patient scenarios and profiles that faculty member James Nisley, here in the control room, birthed with the help of AI.
After every simulation, students debrief with one another and their faculty, and review the tape of the interaction, a sometimes fun, revealing, often unnerving experience.
After every simulation, students debrief with one another and their faculty, and review the tape of the interaction, a sometimes fun, revealing, often unnerving experience.
Nisley's growing comfort with AI to develop rich simulations has prompted him to share what he's learned with fellow faculty members around the world, including at events in Florida and Switzerland.
Nisley's growing comfort with AI to develop rich simulations has prompted him to share what he's learned with fellow faculty members around the world, including at events in Florida and Switzerland.
Other faculty members, including assistant professor Dawn Bourne, have worked to consolidate and reorient course curricula to group in-person labs and determine how best to deploy online content.
Other faculty members, including assistant professor Dawn Bourne, have worked to consolidate and reorient course curricula to group in-person labs and determine how best to deploy online content.
As a result, the BSN to DNP pathway program requires students to be on Grounds roughly monthly, down from three times each week . . .
As a result, the BSN to DNP pathway program requires students to be on Grounds roughly monthly, down from three times each week ...
. . . making in-person learning for DNP students - most of whom are working nurses - less cumbersome, more focused, and convenient, and improving how online content and community is curated, too.
... making in-person learning for DNP students - most of whom are working nurses - less cumbersome, more focused, and convenient, and improving how online content and community is curated, too.
Simulation faculty members like Ryne Ackard, Sam Hudgins, Cindi Dellett, and others, along with Nisley, keep abreast of new tech and broadly share their own successes and lessons learned as well.
Simulation faculty members like Ryne Ackard, Sam Hudgins, Cindi Dellett, and others, along with Nisley, keep abreast of new tech and broadly share their own successes and lessons learned as well.

But he was intrigued. In the 15 months since, he’s presented the “Harmony Haven” simulation at two international simulation conferences, both to a standing-room only crowd, work that tethers him to goal 1, transforming educational offerings, and enthusiasm for a new way to work. 

These days, ChatGPT is Nisley’s regular companion: to craft multiple choice questions for quizzes, develop learning outcomes, and refine presentation proposals. 

“I’m not afraid, but curious,” Nisley said. “I want to tackle it, understand it, and champion it.” 

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