MedSimAI: Simulation and Formative Feedback Generation to Enhance Deliberate Practice in Medical Education

Medical education faces challenges in scalability, accessibility, and consistency, particularly in clinical skills training for physician-patient communication. Traditional simulation-based learning, while effective, is resource-intensive, difficult to schedule, and often highly variable in feedback quality. Through a collaboration between AI, learning science, and medical education experts, we co-developed MedSimAI, an AI-powered simulation platform that enables deliberate practice, self-regulated learning (SRL), and automated assessment through interactive patient encounters. Leveraging large language models (LLMs), MedSimAI generates realistic clinical interactions and provides immediate, structured feedback using established medical evaluation frameworks such as the Master Interview Rating Scale (MIRS). In a pilot study with 104 first-year medical students, we examined engagement, conversation patterns, and user perceptions. Students found MedSimAI beneficial for repeated, realistic patient-history practice. Conversation analysis revealed that certain higher-order skills were often overlooked, though students generally performed systematic histories and empathic listening. By integrating unlimited practice opportunities, real-time AI assessment, and SRL principles, MedSimAI addresses key limitations of traditional simulation-based training, making high-quality clinical education more accessible and scalable.