One Does Not Simply Walk Into Artificial Intelligence: A Distributed Leadership Framework for Healthcare Simulation

Area of Science:

• Healthcare Simulation
• Artificial Intelligence Integration
• Educational Technology

Background:

• Healthcare simulation is increasingly incorporating artificial intelligence (AI).
• Current AI implementation in simulation is fragmented, lacking unified governance.
• A need exists for a structured approach to integrate AI effectively and sustainably.

Purpose of the Study:

• To propose an ecosystem-level framework for sustainable AI integration in healthcare simulation.
• To introduce a Fellowship model for distributed leadership in AI implementation.
• To provide practical recommendations for aligning AI with simulation practices.

Main Methods:

• Conceptual framework development using a literary metaphor (Tolkien's Fellowship).
• Analysis of AI integration challenges in simulation centers.
• Translation of principles into actionable recommendations for stakeholders.

Main Results:

• A Fellowship model illustrates distributed leadership, trust-building, and situational emergence of leadership.
• Simulation centers are identified as ideal environments for AI testing and implementation.
• Key recommendations include problem-anchoring, psychological safety, multidimensional evaluation, and continuous ethical governance.

Conclusions:

• Sustainable AI integration in healthcare simulation requires an ecosystem approach beyond tool-centricity.
• The Fellowship model provides a structure for aligning diverse stakeholder perspectives and fostering trust.
• Practical implementation strategies are essential for effective and ethical AI adoption in simulation.