From high-fidelity patient simulators to robotics and artificial intelligence: A discussion paper on new challenges to enhance learning in nursing education.

High-fidelity simulation (HFS) is an educational method based on technological mannequins which faithfully reproduces both physiological or physiopathological human body responses to specific clinical conditions and nursing care. When the traditional education is integrated with HFS, improvements in nursing students’ knowledge, performance, self-efficacy, self-confidence, problem solving ability, and critical thinking were reported, as well as relational and empathic skills. The level of realism reached in HFS sessions, defined as the ‘degree to which a simulated experience approaches reality’ demonstrated a positive association with students’ learning outcomes. Most of high-fidelity patient simulators are computer-driven static mannequins which resemble adult or child human body dimensions. However, they show limits that should be overcome to provide a more realistic full-body experience in nursing education. In this regard, robotics and artificial intelligence have a key role for the technological evolution of nursing educational systems and their introduction in the simulation field is opening new perspectives that will produce unavoidably the redefinition of educational standards with beneficial implications for future nursing care. In this perspective, new challenges for nursing education has been discussed in this paper.