Evidence map›Paper›PMID 41975511›Full record

ArticleAdvances in simulation (London, England)2026

On simulation, artificial intelligence, and the spirit of the Shokunin.

Ben Symon

Abstract readLetter
In one paragraph

Article in Advances in simulation (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Ben SymonMater Misericordiae Limited, Mater Health Simulation Service, Mater Hospitals, Level 4, Duncombe Building, South Brisbane, QLD, 4101, Australia. ben.symon@mater.org.au.ORCID http://orcid.org/0000-0003-4437-7478

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe healthcare simulation community has rapidly embraced artificial intelligence (AI) and large language models (LLMs) for scenario design, delivery, and debriefing. While discussions have largely centred on efficiency and academic integrity, less attention has been paid to the philosophical and humanistic costs of this integration. This commentary explores the potential erosion of identity, expertise, and craftsmanship within simulation as cognitive labour is increasingly outsourced to machines. MAIN BODY: Drawing on the Japanese concept of the Shokunin-the devoted artisan in lifelong pursuit of mastery-the commentary contrasts the Western drive for efficiency with the intrinsic value of patient diligence and deliberate practice. Using the life and reflections of artist Katsushika Hokusai as a metaphor for the simulationist's path, the author argues that expertise is cultivated through repetition, reflection and time-qualities at risk when AI automates creative and cognitive processes. The concept of cognitive debt is introduced to describe the deferred mental cost of repeated reliance on AI, including diminished critical inquiry and weakened creative ownership. To preserve the spirit of the Shokunin, three guiding principles are proposed: (1) Know the grain of your wood before you carve-protect formative manual and reflective work early in one's career; (2) Paint first with your own brush-prioritise original human creation before seeking AI feedback; and (3) Strive for personal growth-maintain curiosity and continuous growth as enduring antidotes to automation's complacency. These principles urge simulationists to use AI as a supportive partner, not a surrogate for expertise.

conclusionAI will undoubtedly enhance simulation's technical capabilities, yet it also challenges our professional identity. To sustain meaning and mastery, simulation educators must intentionally preserve spaces for imperfection, repetition, and human creativity. The spirit of the Shokunin-humble, diligent, and ever-striving-offers a moral compass for navigating the evolving partnership between simulation and artificial intelligence.

Indexed as

Artificial IntelligenceCognitive debtCraftsmanshipDeliberate practiceHealthcare educationLarge Language ModelsProfessional identityReflectionShokuninSimulation-based education

Identifiers

PMID41975511
PMCPMC13072569

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.