From AI agents and holographic patients, to immersive “caves” and smart technology, health care education is evolving rapidly, says Professor of Clinical Frank Guido-Sanz, who joined the University of Miami School of Nursing and Health Studies in January 2025.
As associate dean for simulation and research, he leads a veteran team of nurse specialists in simulation and simulation technologists at the school’s S.H.A.R.E. Simulation Hospital Advancing Research & Education® (S.H.A.R.E.), a 41,000-square-foot hub for health care innovation, exploration, and education. There they do everything from teach introductory nursing skills to new students to lead full-scale multi-agency disaster response trainings.
With artificial intelligence (AI) advancing at warp speed, Guido-Sanz and his team have been hard at work envisioning and building S.H.A.R.E. 2.0 through AI integration.
“Part of our strategic plan is to continue innovating and bringing in new technology, renovating the S.H.A.R.E. space in equipment and focus,” he said. “Our vision for excellence is positioning S.H.A.R.E. as a leader in AI and multimedia adoption and innovation for health care education. A strong foundation of innovation will enable us to evolve quickly and stay at the forefront, even as new technologies emerge rapidly.“
To this end, he and his team recently rolled out two new custom AI agents developed in-house, and they are now exploring the incorporation of AI-driven digital twin, hologram, and immersive technology.
“We’re increasing the realism and putting in our students’ hands the technology they may see in the workforce very soon,” said Guido-Sanz, an acute care nurse practitioner and a Certified Healthcare Simulation Educator. “The whole team is very engaged in creating and bringing new technology here. We’re all vested in this project of positioning ourselves at the forefront technology adoption.”
Agents of change
Not long after coming to the school, Guido-Sanz began brainstorming with his team. They soon enlisted the technical assistance of Roberto Padron, the school’s senior help desk technician. Padron had never built an AI agent before. University-licensed version of Microsoft Copilot, he taught himself. “I like to sink my teeth into anything that’s new and is going to make all our lives easier,” Padron said.
After six months of revising, testing, and debugging, custom agents L.A.I.L.A. (Learning AI Liaison Assistant) and A.I.D.A. (Automated Intelligence for Dynamic Assistance) were born.
L.A.I.L.A. —a troubleshooter with a “transparent, user-friendly communication style” —helps S.H.A.R.E. simulation technicians, support staff, and administrators gain access to standard operating procedures, manuals, and other curated resources.
In an initiative led by simulation technician Robert Brau, L.A.l.L.A. created an avatar to introduce learners to all features of the simulation space and scenario in preparation for their human instructor. “This is definitely a tool—not a replacement for staff,” said Padron. “All this does is put more time in our hands.”
A.I.D.A. is more a behind-the-scenes agent, explained Guido-Sanz, standardizing simulations used by a wide range of classes and faculty. “We all disseminate information in very different ways. Technology can solve this problem,” said Guido-Sanz.
Adaptive learning
A.I.D.A. is being used to create avatars, write simulation instructions, role-play, produce debriefing analytics, and advance customization for multi-user simulations and remote sessions.
“These AI agents and video tools support adaptive learning through real-time feedback and guidance, and they enable rapid development of instructional and orientation content tailored to clinical procedures and learning objectives,” said Guido-Sanz.
Pairing AI-driven video platform d-id.com with graphic design platform Canva has allowed the team to build interactive video modules with animations, infographics, and other visually appealing elements. Although AI is being used to enhance simulation fidelity and streamline support for educators and technicians, strict parameters prevent AI “hallucinations” Padron assured.
“We are turning all this curricular mapping into competency-based education,” added Guido-Sanz. “These are like baby steps we’re taking to integrate S.H.A.R.E. into our bigger strategic picture.”
A.I.D.A. does this by creating dynamic health care simulation scenarios that are standardized to the National League for Nursing (NLN) Simulation Scenario Template and aligned with the core competencies of the American Association of Colleges of Nursing (AACN), known as Essentials.
“A.I.D.A. grew out of preparing for our Society for Simulation in Healthcare (SSH) reaccreditation,” said Guido-Sanz. “We are pleased and the accreditors were too. We had 100 percent passing for SSH reaccreditation.”
Prepared to lead
Guido-Sanz first gained experience in AI-driven technologies while working on U.S. Department of Defense-funded grants at the University of Central Florida (UCF) College of Nursing.
There he co-created a now-patented multisensory dynamic wound simulator to teach first responders the correct amount of pressure to apply to bleeding wounds and worked on digital twin and hologram initiatives for nurse practitioner programs.
“We were the first university in this country to adopt hologram technology from a company called Dr. Hologram,” he said, noting that he is excited to add hologram technology to the learning environment at S.H.A.R.E.
“AI-powered holograms have integrated capabilities like large language models and a voice agent,” he said. “I can record you, and the viewer sees you in three dimensions in the hologram system, and it’s interactive because that persona you’re creating is powered with AI.”
Guido-Sanz is also involved in a multisite “Human Digital Twin” preceptor study begun with UCF colleagues, where digital replicas of humans represent, model, and simulate how health care professionals with varying levels of expertise, knowledge, and skill behave, operate, and reason across various contexts.
“Clinicians can augment or accelerate their clinical decision-making skills and knowledge development by designing, modeling, and testing Human Digital Twin supports while caring for actual or simulated patients,” he explained.
Another AI technology Guido-Sanz wants S.H.A.R.E. learners to experience is immersive simulation. “We need a completely immersive space, driven by artificial intelligence,” he said. “The concept is called the ‘cave’ or ‘igloo.’ Imagine an iMax theatre, where you project a movie around you, but it also has sounds, smells, whatever you want. You are embedded in the simulation. You could put floors that vibrate. You could re-create, for example, in a mass shooting scenario, screaming and people running, the smell of blood. All of this is reproducible.”
Guido-Sanz saw the promise of using the igloo to enhance educational engagement and innovation during a DOD study he was involved with at UCF on how communication can deteriorate and affect patient transfer outcomes in noisy environments. At UCF, they simulated a battlefield exchange. “We had not only the victim, but also everything else projected—gunfire, explosions, the helicopter landing, the sound of the wind, everything,” he said. “Your five senses are completely stimulated. The more realistic the simulation, the better prepared the learners are.”
