Generative AI-Integrated Virtual Agents and Simulations in Health Professions Education: A Systematic Review

The rapid development of generative artificial intelligence (GenAI) is transforming both the health sector and health profession education, although AI-based systems have existed in these sectors for decades. GenAI-integrated virtual agents and simulations now play novel and critical roles in simulation-based education and are potential solutions to enhance the adaptability of health profession education. This systematic review was conducted using the PRISMA guidelines and explores how GenAI-integrated virtual agents and simulations are being applied in health profession education, with a particular focus on their educational impact, technical features and functionalities, and current limitations. This review aims to synthesize the pedagogical value and technological design of GenAI-integrated simulations and to inform health professionals and educators about the effective use, impact, and challenges of GenAI in health education simulations. A total of 16 papers were reviewed. Results show that GenAI-integrated virtual agents and simulations have potential to enhance clinical communication, diagnostic accuracy, multilingual interactions, and learner confidence for health profession education. Related theoretical, technological, and educational implications of generative AI-integrated virtual agents and simulations are discussed to inform future design and application. Limitations include insufficient educational effectiveness, response accuracy issues, and unresolved ethical and privacy concerns. Future studies should focus on long-term efficacy, ethical considerations, and optimizing AI–human collaboration in various health profession education contexts.