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The impact of artificial intelligence-driven simulation on the development of non-technical skills in medical education: a systematic review  
Sana Loubbairi, Yasmine El Moussaoui, Laila Lahlou, Imad Chakri, Hicham Nassik
J Educ Eval Health Prof. 2025;22:37.   Published online November 24, 2025
DOI: https://doi.org/10.3352/jeehp.2025.22.37
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AbstractAbstract PDFSupplementary Material
Purpose
Artificial intelligence (AI)-driven simulation is an emerging approach in healthcare education that enhances learning effectiveness. This review examined its impact on the development of non-technical skills among medical learners.
Methods
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted using the following databases: Web of Science, ScienceDirect, Scopus, and PubMed. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The protocol was previously registered in PROSPERO (CRD420251038024).
Results
Of the 1,442 studies identified in the initial search, 20 met the inclusion criteria, involving 2,535 participants. The simulators varied considerably, ranging from platforms built on symbolic AI methods to social robots powered by computational AI. Among the 15 AI-driven simulators, 10 used ChatGPT or its variants as virtual patients. Several studies evaluated multiple non-technical skills simultaneously. Communication and clinical reasoning were the most frequently assessed skills, appearing in 12 and 6 studies, respectively, which generally reported positive outcomes. Improvements were also noted in decision-making, empathy, self-confidence, critical thinking, and problem-solving. In contrast, emotional regulation, assessed in a single study, showed no significant difference. Notably, none of the studies examined reflection, reflective practice, teamwork, or leadership.
Conclusion
AI-driven simulation shows substantial potential for enhancing non-technical skills in medical education, particularly communication and clinical reasoning. However, its effects on several other non-technical skills remain unclear. Given heterogeneity in study designs and outcome measures, these findings should be interpreted cautiously. These considerations highlight the need for further research to support integrating this innovative approach into medical curricula.

JEEHP : Journal of Educational Evaluation for Health Professions
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