Telehealth Simulations with Generative Artificial Intelligence in Midwifery Education: Practice for Person-Centered and Culturally Responsive Care.

The International Confederation of Midwives Essential Competencies and the American College of Nurse-Midwives Core Competencies for Basic Midwifery Practice include essential skills needed for safe entry-level practice and provision of person-centered care to individuals from diverse backgrounds. However, opportunities for midwifery students to interact with diverse patient populations may be limited, especially in homogenous areas. Education programs struggle to recruit standardized patients from wide-ranging social, cultural, ethnic, and religious backgrounds. In addition, midwifery students may lack skills or experience in providing culturally responsive care, potentially affecting patients and exacerbating health disparities. This article reports on the pilot use of an online artificial intelligence (AI) simulation platform to prepare midwifery students for person-centered telehealth with culturally and socially diverse, underserved patients. The platform used generative technology to produce interactive avatars with detailed histories and allowed spontaneous and adaptive conversations between the virtual patient and midwife-in-training. Ease of use, avatar fidelity, ability to incorporate diverse cultural elements, student learning, time, and cost in the development were assessed. Case development requires collaboration and an iterative approach. Similar to traditional simulation, AI-based simulations require careful planning, pre- and debriefing discussions, and continuous improvement efforts for maximal student learning. Generative AI-based simulations can enable efficient, flexible preparation for patient-centered, culturally appropriate telehealth.