The next frontier in healthcare simulation is human-AI teaming

Abstract Background Across health professions, AI agents are moving out of the background and into clinical teams as collaborative entities. Yet healthcare simulation continues to conceptualise AI as a tool that serves the scenario rather than one that inhabits it. This framing is no longer adequate. The clinical environments we are preparing practitioners for demand that professionals learn to team with AI and not merely use it. Main body We contend that human-AI teaming (HAIT) is the next frontier for healthcare simulation education and research. The addition of AI agents to human teams fundamentally alters how teams communicate, work together, and accomplish goals and therefore, by extension, how we must design simulation systems for education and research. We identify five dimensions of teamwork that AI is reshaping and discuss what each means for simulation practice: communication and information exchange, shared mental models, trust calibration, team reflexivity, and team performance. We then present five imperatives that healthcare simulation must address to meet the challenges and opportunities HAIT introduces: fidelity, assessment, ethics, governance, and medico-legal framing, curriculum and faculty development, and transfer of learning. Together, these ten domains constitute a research and education agenda for a field built on the science and art of preparation. Conclusion HAIT is an emerging clinical reality and the next frontier for healthcare simulation. We call on the simulation community to treat it as a first-order priority and to focus on developing fidelity standards for AI agents in simulation, validating human-AI teaming assessment tools, establishing ethical frameworks for AI-inclusive scenario design, investing in curriculum and faculty development, and committing to the research needed to establish whether HAIT-based simulation training translates into improved performance in AI-augmented clinical practice.