As part of the NSF I-Corps™ regional programming at UW–Madison, the Technology Entrepreneurship Office has been expanding participation from campuses around the state. Nearly 60 teams have participated throughout the UW System since 2023, including Dean Seon Yoon Chung and Teaching, Learning, Technology Specialist Becca McLagan from the School of Nursing, Health Professions, and STEM at UW–Oshkosh.
They have created the De-escalation AI Client Avatar, an interactive, video-based simulation designed to provide nurses with realistic, low-risk opportunities to practice communication skills. It was designed to help nurse educators train nurses to handle high-stress, emotionally charged interactions—the kind that happen when a patient or family member is frightened, angry, or in crisis, or when a nurse needs to communicate urgent concerns to a provider in a high-pressure environment. The avatar can provide feedback on each learner’s performance, offering real-time personalization at a scale that has previously been difficult to achieve.
A Critical Problem
Through her professional connections with local and regional healthcare organizations, Chung learned that nurse educators and mental healthcare providers were facing a growing number of escalated interactions and were seeking more de-escalation training. Communications training was noted as essential, but in-person trainings were not always available when nurses needed to practice, required specialized human expertise, and were expensive—some reported costs were as high as $60,000 per new nurse.
“Passive” learning methods like reading or listening to a lecture also do not help nurses use communication strategy effectively during a stressful, dynamic interaction. When existing trainings went from passive, asynchronous delivery to active, in-person classes, one hospital saw an increase in pass rate from 58% to 100%. But even live role play, which can help nurses practice in real time, is resource-intense and difficult to provide to large or geographically dispersed groups. Traditional de-escalation training methods, typically offered to five students for around 30 minutes, were simply not scalable.
Chung and McLagan’s avatar bridges many of these gaps by allowing nurses to build confidence and skill through practice when it is most needed. Using the web app, nurse learners engage with an AI avatar that looks, sounds, and acts like a real patient exhibiting escalated behavior. The avatar responds naturally, creating an interactive experience in which the learner must adapt to the avatar’s responses and employ de-escalation techniques. The goal is for the learner to successfully calm the avatar. The team aims for nurses to successfully communicate 80% of the time and for organizations to see a 5% decrease in conflict after using the program 30 times.
“Our question was whether an AI avatar could make realistic practice more repeatable and accessible while still preserving the reflection, feedback, and facilitation that make simulation educationally meaningful,” said McLagan.
Importantly, the avatar can be accessed remotely, delivered asynchronously, repeated as needed, and made available to more learners. It is built to be responsive, interactive, and easy to deploy while still customizable.
“Some of the top pains we heard were lack of time to create and deliver training, lack of experienced educator capacity, and the cost of training,” said Chung. “We saw an opportunity to give overextended nurse educators a scalable, always-available way to deliver the interactive, realistic practice that current methods can’t consistently provide.”
Building Connections & Shifting Perspectives through I-Corps
During the I-Corps program, Chung (Entrepreneurial Lead) brought expertise in nursing education and simulation along with relationships to healthcare individuals and providers throughout the region, while McLagan (Technical Lead) brought a background in instructional design, emerging technology, and developing AI-avatar learning experiences.
Along with industry mentor Ronald Kelley and guidance from TEO Director Bonnie Bachman, the team refined their value proposition through six customer discovery sessions and 30 interviews with healthcare educators, leaders, and other stakeholders. Kelley pushed the team to make their hypotheses quantifiable, relevant, specific, and testable, and to treat every interview as a chance to disprove what they believed—not just validate it.
“As researchers, it’s easy to fall in love with a solution before confirming the problem is shared by the people who would actually use or pay for it. Customer discovery forces you to test your assumptions against real, observable evidence instead of your own intuition,” said Chung.
Participating in the I-Corps program shifted the team’s perspective on both customer and content. Initially, Chung and McLagan thought nurses themselves were the end user. After mapping the entire healthcare ecosystem from nurses and nurse educators to HR, IT, and even external agencies, they gleaned tested proof of who their real customer was, and what was really needed: nurse educators seeking a complete, ready-to-use learning experience rather than just a standalone avatar, with scope including de-escalation and interprofessional communication.
“Those different connections were essential. We were bringing together clinical expertise, learning design, emerging technology, and direct feedback from the people responsible for educating and supporting healthcare professionals,” said McLagan.
The discovery process also delivered hard truths within a chaotic healthcare system. For example, although many responses from nursing leaders were AI-optimistic, some stakeholders emphasized a priority for human-to-human contact rather than AI-driven tools. The team realized positioning the avatar as a complement to human connection and bedside presence, not a replacement for it, would be essential for real-world adoption.
What’s Next?
Although de-escalation for hospital nurses was the team’s starting use case, their platform is flexible enough to create and deliver a wide range of communications training. Ultimately, the team wants to offer evidence-informed ways to integrate AI-supported experiential learning into professional education for customers throughout the health system. Senior living communities and nursing homes, psychiatric facilities, and public health organizations are top potentials. Decision makers for these applications—especially those with high turnover and complex behavioral health needs—are ready to invest in training with a clear return on investment.
“With our team’s expertise, the technology platform and our proprietary educational assets create a scalable approach with the potential to extend simulation learning to an unlimited number of learners and organizations,” said McLagan.
The team has a robust plan to move the De-escalation AI Client Avatar toward standardization and ensure its effectiveness at scale. They are applying to the National I-Corps program via the Great Lakes Hub, which requires around 100 additional interviews over an intensive seven-week program.
Chung and McLagan especially recommend I-Corps for researchers like them, who are interested in building technology for real-world settings. Early discovery helped them discover they had the wrong end user, the wrong single-avatar concept, and an incomplete picture of the stakeholder ecosystem before they spent any time or money. Early course-correction through programs like I-Corps could be the difference between a solution that gets adopted and one that never leaves the lab.
For any UW System teams hoping to learn more about the regional I-Corps program, TEO at UW–Madison is always here to help. Reach out to TEO Director Bonnie Bachman with questions.
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Written by: Bri Meyer