Pub Date : 2026-01-21DOI: 10.1016/j.nepr.2026.104736
Sarah Oerther, Daniel B Oerther
{"title":"Triangulating primary sources, professional judgement, and LLM-generated summaries: Educating nurses in an AI-first world.","authors":"Sarah Oerther, Daniel B Oerther","doi":"10.1016/j.nepr.2026.104736","DOIUrl":"https://doi.org/10.1016/j.nepr.2026.104736","url":null,"abstract":"","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":" ","pages":"104736"},"PeriodicalIF":4.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.nepr.2026.104737
Jerome Visperas Cleofas
Aim
This paper proposes a human rights-based framework to guide nursing academia’s stakeholdership in the healthcare artificial intelligence governance ecosystem.
Background
As artificial intelligence transforms healthcare, nursing academia must engage as an activated stakeholder in its governance ecosystem to ensure high-quality, equitable, safe and ethical artificial intelligence-enabled healthcare goods and services.
Design
Discussion paper
Methods
This discussion paper employs abductive reasoning and the ethical and emancipatory conventions of nursing knowing to propose a multifaceted framework of nurse academia’s stakeholdership in the context of artificial intelligence-driven healthcare by appealing to three perspectives, namely: the AI governance ecosystem, the tripartite functions of academia and the human rights-based approach.
Results
The proposed framework integrates three axes— domains, modalities and human rights considerations—positioning nursing academia as both a capacity-builder for duty bearers and an empowerment advocate for rights claimants. This normative framework can be used to guide the actions of nursing academic institutions as stakeholders in healthcare artificial intelligence governance.
Conclusions
By leveraging its instructional, research and service functions, nursing academia can be a transformative stakeholder that can shape artificial intelligence governance to uphold health-related human rights.
{"title":"Towards a framework for human rights-based stakeholdership of nursing academia in the healthcare artificial intelligence governance ecosystem: A discussion paper","authors":"Jerome Visperas Cleofas","doi":"10.1016/j.nepr.2026.104737","DOIUrl":"10.1016/j.nepr.2026.104737","url":null,"abstract":"<div><h3>Aim</h3><div>This paper proposes a human rights-based framework to guide nursing academia’s stakeholdership in the healthcare artificial intelligence governance ecosystem.</div></div><div><h3>Background</h3><div>As artificial intelligence transforms healthcare, nursing academia must engage as an activated stakeholder in its governance ecosystem to ensure high-quality, equitable, safe and ethical artificial intelligence-enabled healthcare goods and services.</div></div><div><h3>Design</h3><div>Discussion paper</div></div><div><h3>Methods</h3><div>This discussion paper employs abductive reasoning and the ethical and emancipatory conventions of nursing knowing to propose a multifaceted framework of nurse academia’s stakeholdership in the context of artificial intelligence-driven healthcare by appealing to three perspectives, namely: the AI governance ecosystem, the tripartite functions of academia and the human rights-based approach.</div></div><div><h3>Results</h3><div>The proposed framework integrates three axes— domains, modalities and human rights considerations—positioning nursing academia as both a capacity-builder for duty bearers and an empowerment advocate for rights claimants. This normative framework can be used to guide the actions of nursing academic institutions as stakeholders in healthcare artificial intelligence governance.</div></div><div><h3>Conclusions</h3><div>By leveraging its instructional, research and service functions, nursing academia can be a transformative stakeholder that can shape artificial intelligence governance to uphold health-related human rights.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"92 ","pages":"Article 104737"},"PeriodicalIF":4.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/j.nepr.2026.104731
Jinfang Wang , Jie Sun , Jie Song , Na Li , Kaili Lv , Kexin Pu
Aim
This review aims to evaluate the effectiveness of high-fidelity simulation (HFS) training for teaching emergency and critical care nursing to undergraduate students, assessing outcomes in terms of knowledge scores, skill performance and critical thinking competency.
Background
HFS training is a significant teaching method to enhance the emergency response capabilities of nursing students. However, a comprehensive conclusion regarding its application in emergency and critical care nursing education is lacking.
Design
A systematic review and meta-analysis.
Method
We searched PubMed, Web of Science, CINAHL, Embase, CNKI, VIP, WanFang Data and SinoMed for eligible articles published in English or Chinese from inception until December 31, 2024. Two researchers independently screened the literature, extracted data and assessed the quality of the included studies using Cochrane RoB 1 and JBI tools. A systematic review and meta-analysis were then performed using Review Manager 5.4.
Results
Following PRISMA guidelines, 11 studies were included after rigorous screening. The meta-analysis showed that HFS training significantly improved undergraduate nursing students' theoretical knowledge scores [SMD = 1.76, 95 % CI (1.03, 2.49), P < 0.001] and retention, as well as operational skill scores [SMD = 1.51, 95 % CI (1.22, 1.80), P < 0.001] and retention. However, the effect of HFS on improving students' critical thinking ability and its retention remains inconclusive.
Conclusions
HFS training can significantly improve undergraduate nursing students' knowledge, skills and their retention in the context of emergency and critical care nursing. Its impact on critical thinking requires further verification. Future studies should include more rigorous randomized controlled trials.
目的评价高保真模拟(high-fidelity simulation, HFS)训练在本科急危护理教学中的效果,从知识得分、技能表现和批判性思维能力三个方面评估效果。背景dhfs培训是提高护生应急能力的重要教学手段。然而,对其在急危护理教育中的应用还缺乏全面的结论。设计系统回顾和荟萃分析。方法检索PubMed、Web of Science、CINAHL、Embase、CNKI、VIP、万方数据和中国医学信息网,检索自开刊至2024年12月31日期间发表的符合条件的中英文文章。两名研究人员独立筛选文献,提取数据,并使用Cochrane RoB 1和JBI工具评估纳入研究的质量。然后使用review Manager 5.4进行系统评价和荟萃分析。结果遵循PRISMA指南,经过严格筛选,纳入了11项研究。meta分析显示,HFS培训显著提高了本科护生的理论知识得分[SMD = 1.76,95 % CI (1.03, 2.49), P <; 0.001]和操作技能得分[SMD = 1.51,95 % CI (1.22, 1.80), P <; 0.001]和保留率。然而,HFS对学生批判性思维能力的提高和保持的效果还没有定论。结论shfs培训能显著提高本科护生在急危重症护理情境下的知识、技能和记忆力。它对批判性思维的影响需要进一步验证。未来的研究应包括更严格的随机对照试验。
{"title":"The effectiveness of high-fidelity simulation training in emergency and critical care nursing education for undergraduate nursing students: A systematic review and meta-analysis","authors":"Jinfang Wang , Jie Sun , Jie Song , Na Li , Kaili Lv , Kexin Pu","doi":"10.1016/j.nepr.2026.104731","DOIUrl":"10.1016/j.nepr.2026.104731","url":null,"abstract":"<div><h3>Aim</h3><div>This review aims to evaluate the effectiveness of high-fidelity simulation (HFS) training for teaching emergency and critical care nursing to undergraduate students, assessing outcomes in terms of knowledge scores, skill performance and critical thinking competency.</div></div><div><h3>Background</h3><div>HFS training is a significant teaching method to enhance the emergency response capabilities of nursing students. However, a comprehensive conclusion regarding its application in emergency and critical care nursing education is lacking.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Method</h3><div>We searched PubMed, Web of Science, CINAHL, Embase, CNKI, VIP, WanFang Data and SinoMed for eligible articles published in English or Chinese from inception until December 31, 2024. Two researchers independently screened the literature, extracted data and assessed the quality of the included studies using Cochrane RoB 1 and JBI tools. A systematic review and meta-analysis were then performed using Review Manager 5.4.</div></div><div><h3>Results</h3><div>Following PRISMA guidelines, 11 studies were included after rigorous screening. The meta-analysis showed that HFS training significantly improved undergraduate nursing students' theoretical knowledge scores [SMD = 1.76, 95 % CI (1.03, 2.49), P < 0.001] and retention, as well as operational skill scores [SMD = 1.51, 95 % CI (1.22, 1.80), P < 0.001] and retention. However, the effect of HFS on improving students' critical thinking ability and its retention remains inconclusive.</div></div><div><h3>Conclusions</h3><div>HFS training can significantly improve undergraduate nursing students' knowledge, skills and their retention in the context of emergency and critical care nursing. Its impact on critical thinking requires further verification. Future studies should include more rigorous randomized controlled trials.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"92 ","pages":"Article 104731"},"PeriodicalIF":4.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-17DOI: 10.1016/j.nepr.2026.104713
Monica Motta Lino , Jamille Costa Engler , Joice Cristina Guesser , Luiza Sheyla Evenni Porfirio Will Castro , Janaina da Silva Flôr , Felipa Rafaela Amadigi , Mônica Oliveira Batista Oriá , Amina Regina Silva , Desiree A. Díaz
Aim
To map and characterize, systematically, the volume, scope and distribution of systematic review evidence on virtual clinical simulation in healthcare education, describing the educational outcomes assessed, the contexts and modalities where virtual simulations have been implemented and the main evidence gaps identified.
Background
Virtual clinical simulations are increasingly used to support healthcare education and training. However, existing evidence on their effectiveness remains fragmented, with variations in methodological quality and scope.
Design
Evidence and Gap Map (EGM) following Campbell Collaboration Guidance.
Methods
A systematic search was conducted across nine databases and two gray literature sources. Eligible studies included systematic reviews examining healthcare professionals or students using virtual simulations. Data were extracted using the PICOS framework and reviewed independently by two researchers. Methodological quality was assessed using AMSTAR-2 and confidence in findings was appraised using CERQual.
Results
A total of 118 reviews met inclusion criteria: 91 systematic, 25 scoping and 2 umbrella reviews. Most were published within the past four years and originated from high-income countries. We identified seven categories across the results: (1) Learning and Knowledge Acquisition; (2) User Perception; (3) Development of Technical Skills; (4) Simulation Performance; (5) Development of Practical Skills; (6) Transfer to Real Clinical Practice; and (7) Program Effectiveness. More than half of the systematic reviews were rated as low or critically low quality, with only 10 % achieving high methodological rigour.
Conclusions
Virtual clinical simulations demonstrate potential to enhance learning outcomes in healthcare education. However, evidence is limited by uneven methodological quality, concentration in high-income settings and a lack of research on emerging technologies and long-term educational impacts. Future high-quality, comparative studies are needed to strengthen the evidence base.
{"title":"Virtual clinical simulation as a pedagogical strategy in healthcare learning: Evidence and gap map","authors":"Monica Motta Lino , Jamille Costa Engler , Joice Cristina Guesser , Luiza Sheyla Evenni Porfirio Will Castro , Janaina da Silva Flôr , Felipa Rafaela Amadigi , Mônica Oliveira Batista Oriá , Amina Regina Silva , Desiree A. Díaz","doi":"10.1016/j.nepr.2026.104713","DOIUrl":"10.1016/j.nepr.2026.104713","url":null,"abstract":"<div><h3>Aim</h3><div>To map and characterize, systematically, the volume, scope and distribution of systematic review evidence on virtual clinical simulation in healthcare education, describing the educational outcomes assessed, the contexts and modalities where virtual simulations have been implemented and the main evidence gaps identified.</div></div><div><h3>Background</h3><div>Virtual clinical simulations are increasingly used to support healthcare education and training. However, existing evidence on their effectiveness remains fragmented, with variations in methodological quality and scope.</div></div><div><h3>Design</h3><div>Evidence and Gap Map (EGM) following Campbell Collaboration Guidance.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across nine databases and two gray literature sources. Eligible studies included systematic reviews examining healthcare professionals or students using virtual simulations. Data were extracted using the PICOS framework and reviewed independently by two researchers. Methodological quality was assessed using AMSTAR-2 and confidence in findings was appraised using CERQual.</div></div><div><h3>Results</h3><div>A total of 118 reviews met inclusion criteria: 91 systematic, 25 scoping and 2 umbrella reviews. Most were published within the past four years and originated from high-income countries. We identified seven categories across the results: (1) Learning and Knowledge Acquisition; (2) User Perception; (3) Development of Technical Skills; (4) Simulation Performance; (5) Development of Practical Skills; (6) Transfer to Real Clinical Practice; and (7) Program Effectiveness. More than half of the systematic reviews were rated as low or critically low quality, with only 10 % achieving high methodological rigour.</div></div><div><h3>Conclusions</h3><div>Virtual clinical simulations demonstrate potential to enhance learning outcomes in healthcare education. However, evidence is limited by uneven methodological quality, concentration in high-income settings and a lack of research on emerging technologies and long-term educational impacts. Future high-quality, comparative studies are needed to strengthen the evidence base.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104713"},"PeriodicalIF":4.0,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Explore the experiences of pre-registration midwifery students undertaking midwifery practice experience within a university facilitated student-led midwifery clinic and compare their experiences with students within traditional placement models.
Background
Availability of midwifery placements and current student attrition limits the ability to increase midwifery graduates. To retain and prepare students for their future role as midwives, students require high quality and positive midwifery practice experiences.
Design
Mixed method descriptive design including a cross-sectional survey and focus group.
Methods
Midwifery students (n = 146) attending one South East Queensland University in Australia were invited to participate and complete the Clinical Practice Environment scale of the Midwifery Students' Experience of Practice tool (MidSTEP). Results were compared between students who completed placement in a traditional model and those who experienced placement in a student-led clinic. In addition, a focus group was held with seven of the 14 students that experienced placement in the student-led midwifery clinic.
Results
Students rated 15 of the 16 items in the Clinical Practice Environment scale of MidSTEP statistically significantly higher when placed with the student-led midwifery clinic (n = 14) compared with students in traditional placement models (n = 68). Thematic analysis using Braun and Clarke’s six stages revealed four themes: 1) Enhanced continuity relationships; 2) A safe space; 3) Alignment with midwifery philosophy; 4) Taking the lead.
Conclusions
Student-led midwifery clinics can optimise student learning, increase placements opportunities and increase student confidence in midwifery practice. In addition, being supervised by an Endorsed midwife facilitates students to experience the full scope of midwifery practice.
{"title":"Student-led midwifery clinics as an innovative practice placement model: A mixed method evaluation","authors":"Amanda Gaye Carter , Marnie Icim , Nikki Tickle , Hannah McCallum , Valerie Slavin","doi":"10.1016/j.nepr.2026.104727","DOIUrl":"10.1016/j.nepr.2026.104727","url":null,"abstract":"<div><h3>Aim</h3><div>Explore the experiences of pre-registration midwifery students undertaking midwifery practice experience within a university facilitated student-led midwifery clinic and compare their experiences with students within traditional placement models.</div></div><div><h3>Background</h3><div>Availability of midwifery placements and current student attrition limits the ability to increase midwifery graduates. To retain and prepare students for their future role as midwives, students require high quality and positive midwifery practice experiences.</div></div><div><h3>Design</h3><div>Mixed method descriptive design including a cross-sectional survey and focus group.</div></div><div><h3>Methods</h3><div>Midwifery students (n = 146) attending one South East Queensland University in Australia were invited to participate and complete the Clinical Practice Environment scale of the Midwifery Students' Experience of Practice tool (MidSTEP). Results were compared between students who completed placement in a traditional model and those who experienced placement in a student-led clinic. In addition, a focus group was held with seven of the 14 students that experienced placement in the student-led midwifery clinic.</div></div><div><h3>Results</h3><div>Students rated 15 of the 16 items in the Clinical Practice Environment scale of MidSTEP statistically significantly higher when placed with the student-led midwifery clinic (n = 14) compared with students in traditional placement models (n = 68). Thematic analysis using Braun and Clarke’s six stages revealed four themes: 1) Enhanced continuity relationships; 2) A safe space; 3) Alignment with midwifery philosophy; 4) Taking the lead.</div></div><div><h3>Conclusions</h3><div>Student-led midwifery clinics can optimise student learning, increase placements opportunities and increase student confidence in midwifery practice. In addition, being supervised by an Endorsed midwife facilitates students to experience the full scope of midwifery practice.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104727"},"PeriodicalIF":4.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 10.1016/j.nepr.2026.104723
Susana Miguel , Helga Martins , José Moreira
Aim
This rapid review was to inform the innovative strategies for teaching oncology to undergraduate nursing students.
Background
Oncology nursing education has become a priority owing to the increasing demand for specialized, person-centered care. Oncology care is recognized as a complex and challenging area in clinical practice and in education, requiring students to possess not only technical knowledge but also communication skills, empathy and decision-making abilities in delicate situations.
Design
A rapid systematic review was conducted in April 2025.
Methods
Four databases were searched: PubMed, Web of Science, the Cumulative Index to Nursing and Allied Health Literature and SCOPUS. The included studies focused on innovative teaching strategies, in undergraduate oncology nursing education, were primary research and were written in English or Portuguese. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Study quality assessed using JBI guidelines.
Results
Twenty-eight studies published between 1992 and 2025 were included in this review. The identified strategies comprised technological innovations (n = 15), such as clinical simulations, online educational programs and virtual reality; and non-technological approaches (n = 13), including case study analysis, concept mapping and multidisciplinary educational programs.
Conclusions
The integration of technological and non-technological strategies has shown itself is beneficial. A combined approach enables students to develop a broad and diverse set of competencies in oncology, promoting a more complete and effective educational experience.
目的对护理本科学生肿瘤学教学的创新策略进行综述。背景:由于对专业化、以人为本的护理需求的增加,口腔护理教育已成为一个优先事项。肿瘤护理在临床实践和教育中都被认为是一个复杂而具有挑战性的领域,不仅需要学生具备技术知识,还需要学生具备在微妙情况下的沟通技巧、同理心和决策能力。DesignA于2025年4月进行了快速系统审查。方法检索PubMed、Web of Science、the Cumulative Index to Nursing and Allied Health Literature、SCOPUS等数据库。纳入的研究侧重于肿瘤学本科护理教育的创新教学策略,为初级研究,以英语或葡萄牙语撰写。按照JBI指南评估的系统评价和荟萃分析研究质量的首选报告项目进行评价。结果本综述纳入了1992年至2025年间发表的28项研究。确定的策略包括技术创新(n = 15),如临床模拟、在线教育计划和虚拟现实;以及非技术方法(n = 13),包括案例研究分析、概念映射和多学科教育计划。结论技术与非技术策略的结合是有益的。综合方法使学生在肿瘤学方面发展广泛和多样化的能力,促进更完整和有效的教育体验。
{"title":"Innovative strategies in oncology education for undergraduate students: A rapid systematic review","authors":"Susana Miguel , Helga Martins , José Moreira","doi":"10.1016/j.nepr.2026.104723","DOIUrl":"10.1016/j.nepr.2026.104723","url":null,"abstract":"<div><h3>Aim</h3><div>This rapid review was to inform the innovative strategies for teaching oncology to undergraduate nursing students.</div></div><div><h3>Background</h3><div>Oncology nursing education has become a priority owing to the increasing demand for specialized, person-centered care. Oncology care is recognized as a complex and challenging area in clinical practice and in education, requiring students to possess not only technical knowledge but also communication skills, empathy and decision-making abilities in delicate situations.</div></div><div><h3>Design</h3><div>A rapid systematic review was conducted in April 2025.</div></div><div><h3>Methods</h3><div>Four databases were searched: PubMed, Web of Science, the Cumulative Index to Nursing and Allied Health Literature and SCOPUS. The included studies focused on innovative teaching strategies, in undergraduate oncology nursing education, were primary research and were written in English or Portuguese. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Study quality assessed using JBI guidelines.</div></div><div><h3>Results</h3><div>Twenty-eight studies published between 1992 and 2025 were included in this review. The identified strategies comprised technological innovations (n = 15), such as clinical simulations, online educational programs and virtual reality; and non-technological approaches (n = 13), including case study analysis, concept mapping and multidisciplinary educational programs.</div></div><div><h3>Conclusions</h3><div>The integration of technological and non-technological strategies has shown itself is beneficial. A combined approach enables students to develop a broad and diverse set of competencies in oncology, promoting a more complete and effective educational experience.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104723"},"PeriodicalIF":4.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 10.1016/j.nepr.2026.104728
Jinseon Go , Yaeji Lee
Aim
Comprehensive evaluation of randomized and non-randomized controlled trials (RCTs and NRCTs, respectively) on the effectiveness of AI-driven conversational agents in nursing education.
Background
AI-based conversational agents are innovative educational tools enhancing nursing students’ learning outcomes. However, evaluation of their educational effectiveness remains limited.
Design
Systematic review.
Methods
Three Korean database (RISS, KCI, DBpia) and three international database (PubMed, CINAHL, Web of Science) were searched from March 13, 2025 to April 25, 2025, to identify studies investigating the impact through either RCTs or NRCTs. Quality was appraised using Risk of Bias 2 for RCTs and Risk of Bias in Non-randomized Studies-I for NRCTs. Educational outcomes were analyzed based on Kirkpatrick’s evaluation model and Bloom’s taxonomy.
Results
A total of seven studies were reviewed. Four assessed Level 1 (reaction) and all seven assessed Level 2 (learning) as per Kirkpatrick’s model. Affective outcomes were confidence, self-directed learning, motivation and self-efficacy and cognitive outcomes were knowledge, clinical reasoning, critical thinking, problem-solving and learning achievement. Five studies demonstrated significant improvements in both cognitive and affective educational outcomes.
Conclusion
Conversational agents effectively enhanced cognitive and affective competencies in nursing students. Learner-initiated interactions were applied primarily in practice-oriented education, whereas system-initiated ones, in theoretical learning. Therefore, aligning interaction modes and feedback levels with educational purposes and content is essential to maximize learning outcomes. However, evaluation of long-term effects of conversational agent-based education and its impact at the organizational level is limited. Future research should adopt longitudinal and rigorously designed RCTs to provide robust evidence of educational effectiveness.
综合评价人工智能驱动会话代理在护理教育中的有效性的随机对照试验和非随机对照试验(分别为rct和NRCTs)。基于人工智能的会话代理是提高护理学生学习成果的创新教育工具。然而,对其教育效果的评价仍然有限。DesignSystematic审查。方法检索2025年3月13日至2025年4月25日期间的3个韩国数据库(RISS、KCI、DBpia)和3个国际数据库(PubMed、CINAHL、Web of Science),筛选通过rct或nrct调查影响的研究。随机对照试验的偏倚风险为2,非随机对照试验的偏倚风险为1。根据Kirkpatrick的评价模型和Bloom的分类法对教育成果进行了分析。结果共回顾了7项研究。根据柯克帕特里克的模型,4人评估1级(反应),7人评估2级(学习)。情感结果为自信、自主学习、动机和自我效能,认知结果为知识、临床推理、批判性思维、解决问题和学习成绩。五项研究表明,认知和情感教育成果都有显著改善。结论会话代理能有效提高护生的认知能力和情感能力。学习者发起的互动主要应用于以实践为导向的教育,而系统发起的互动则主要应用于理论学习。因此,将互动模式和反馈水平与教育目的和内容相一致,对于最大限度地提高学习效果至关重要。然而,对会话主体教育的长期效果及其在组织层面上的影响的评估是有限的。未来的研究应采用纵向和严格设计的随机对照试验,以提供有力的证据证明教育的有效性。
{"title":"The effectiveness of AI-based conversational agents in nursing education: A systematic review","authors":"Jinseon Go , Yaeji Lee","doi":"10.1016/j.nepr.2026.104728","DOIUrl":"10.1016/j.nepr.2026.104728","url":null,"abstract":"<div><h3>Aim</h3><div>Comprehensive evaluation of randomized and non-randomized controlled trials (RCTs and NRCTs, respectively) on the effectiveness of AI-driven conversational agents in nursing education.</div></div><div><h3>Background</h3><div>AI-based conversational agents are innovative educational tools enhancing nursing students’ learning outcomes. However, evaluation of their educational effectiveness remains limited.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>Three Korean database (RISS, KCI, DBpia) and three international database (PubMed, CINAHL, Web of Science) were searched from March 13, 2025 to April 25, 2025, to identify studies investigating the impact through either RCTs or NRCTs. Quality was appraised using Risk of Bias 2 for RCTs and Risk of Bias in Non-randomized Studies-I for NRCTs. Educational outcomes were analyzed based on Kirkpatrick’s evaluation model and Bloom’s taxonomy.</div></div><div><h3>Results</h3><div>A total of seven studies were reviewed. Four assessed Level 1 (reaction) and all seven assessed Level 2 (learning) as per Kirkpatrick’s model. Affective outcomes were confidence, self-directed learning, motivation and self-efficacy and cognitive outcomes were knowledge, clinical reasoning, critical thinking, problem-solving and learning achievement. Five studies demonstrated significant improvements in both cognitive and affective educational outcomes.</div></div><div><h3>Conclusion</h3><div>Conversational agents effectively enhanced cognitive and affective competencies in nursing students. Learner-initiated interactions were applied primarily in practice-oriented education, whereas system-initiated ones, in theoretical learning. Therefore, aligning interaction modes and feedback levels with educational purposes and content is essential to maximize learning outcomes. However, evaluation of long-term effects of conversational agent-based education and its impact at the organizational level is limited. Future research should adopt longitudinal and rigorously designed RCTs to provide robust evidence of educational effectiveness.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104728"},"PeriodicalIF":4.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the effect of a transformative learning program on enhancing nurses’ cultural competence in a Chinese tertiary hospital.
Background
Cultural competence underpins high-quality nursing care in diverse health care settings; however, evidence on transformative learning approaches to enhance cultural competency in China, where cultural diversity has grown substantially, remains limited.
Design
Parallel group randomized controlled trial.
Methods
One hundred and forty nurses were randomized to the experimental group (n = 70) and the control group (n = 70). The experimental group underwent a nine-week intervention grounded in Leininger’s Culture Care Theory and Mezirow’s Transformative Learning Theory, whereas the control group received standard education. Cultural competence was assessed at baseline, immediately post-intervention and 12 weeks post-intervention using the Chinese Cultural Competence Inventory for Nurses.
Results
Of 132 completers, the experimental group demonstrated significantly higher overall competence than the control group (p < 0.05), with significant improvements in the domains of knowledge, skills, respect and understanding, while no significant difference was observed for cultural awareness.
Conclusions
The program effectively enhanced overall and multiple dimensions of cultural competence, supporting transformative learning as a valuable strategy in nurse education and professional development.
{"title":"Effect of a transformative learning program on cultural competence of Chinese nurses in a tertiary hospital: A randomized controlled trial study","authors":"Lingzhi Zhang , Acharaporn Sripusananpan , Cai Duanying , Patraporn Bhatarasakoon","doi":"10.1016/j.nepr.2026.104725","DOIUrl":"10.1016/j.nepr.2026.104725","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the effect of a transformative learning program on enhancing nurses’ cultural competence in a Chinese tertiary hospital.</div></div><div><h3>Background</h3><div>Cultural competence underpins high-quality nursing care in diverse health care settings; however, evidence on transformative learning approaches to enhance cultural competency in China, where cultural diversity has grown substantially, remains limited.</div></div><div><h3>Design</h3><div>Parallel group randomized controlled trial.</div></div><div><h3>Methods</h3><div>One hundred and forty nurses were randomized to the experimental group (n = 70) and the control group (n = 70). The experimental group underwent a nine-week intervention grounded in Leininger’s Culture Care Theory and Mezirow’s Transformative Learning Theory, whereas the control group received standard education. Cultural competence was assessed at baseline, immediately post-intervention and 12 weeks post-intervention using the Chinese Cultural Competence Inventory for Nurses.</div></div><div><h3>Results</h3><div>Of 132 completers, the experimental group demonstrated significantly higher overall competence than the control group (p < 0.05), with significant improvements in the domains of knowledge, skills, respect and understanding, while no significant difference was observed for cultural awareness.</div></div><div><h3>Conclusions</h3><div>The program effectively enhanced overall and multiple dimensions of cultural competence, supporting transformative learning as a valuable strategy in nurse education and professional development.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104725"},"PeriodicalIF":4.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.nepr.2026.104721
Kari A. Mastro , Nicholas A. Giordano , Rosemary Polomano , Beth A. Smith , Karyn Book , James Ballinghoff , Colleen Mattioni
Aim
This study aims to compare the experiences of newly licensed nurses who completed either in-person or virtual Vizient/AACN Nurse Residency Programs™ at a national level.
Background
Nurse residency programs are known to improve retention and intention to stay yet few studies demonstrate a comparison of comprehensive longitudinal survey outcomes with representative samples of nurse-reported outcomes between in-person and virtual formats.
Design
Observational, comparative, longitudinal study
Methods
This study analyzed Vizient/AACN Nurse Residency Program™ longitudinal data from a national United States sample (N = 3153). Linear mixed-effects models examined differences in stand ard nurse-reported outcomes (e.g., Casey-Fink Survey) over time between March 2019 pre-pand emic hires receiving in person training and March 2020 pand emic hires when virtual training occurred.
Results
No statistically significant differences in Casey-Fink Survey Composite scores were observed between nurses in the 2019 and 2020 cohorts when adjusting for time, degree, GPA and previous degree (p = 0.210). The 2020 virtual cohort reported marginally lower Dissatisfaction (p = 0.020) and Leadership scores (p < 0.001), yet slightly higher Commitment scores (p = 0.040), compared with the 2019 new hires. On average, 2020 new hires reported more favorable feedback regarding their preceptors, however, they indicated lower scores for peer interactions and support.
Conclusions
These findings suggest that virtual nurse residency programs can achieve comparable outcomes to traditional in-person formats and may provide a scalable option for rural or resource-limited settings. Future studies should explore long-term retention outcomes and strategies to improve peer engagement in virtual environments.
{"title":"A comparison of transition experiences and practice readiness of newly licensed nurses with in-person and virtual residency training: A national observational study","authors":"Kari A. Mastro , Nicholas A. Giordano , Rosemary Polomano , Beth A. Smith , Karyn Book , James Ballinghoff , Colleen Mattioni","doi":"10.1016/j.nepr.2026.104721","DOIUrl":"10.1016/j.nepr.2026.104721","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to compare the experiences of newly licensed nurses who completed either in-person or virtual Vizient/AACN Nurse Residency Programs™ at a national level.</div></div><div><h3>Background</h3><div>Nurse residency programs are known to improve retention and intention to stay yet few studies demonstrate a comparison of comprehensive longitudinal survey outcomes with representative samples of nurse-reported outcomes between in-person and virtual formats.</div></div><div><h3>Design</h3><div>Observational, comparative, longitudinal study</div></div><div><h3>Methods</h3><div>This study analyzed Vizient/AACN Nurse Residency Program™ longitudinal data from a national United States sample (N = 3153). Linear mixed-effects models examined differences in stand ard nurse-reported outcomes (e.g., Casey-Fink Survey) over time between March 2019 pre-pand emic hires receiving in person training and March 2020 pand emic hires when virtual training occurred.</div></div><div><h3>Results</h3><div>No statistically significant differences in Casey-Fink Survey Composite scores were observed between nurses in the 2019 and 2020 cohorts when adjusting for time, degree, GPA and previous degree (<em>p</em> = 0.210). The 2020 virtual cohort reported marginally lower Dissatisfaction (<em>p</em> = 0.020) and Leadership scores (<em>p</em> < 0.001), yet slightly higher Commitment scores (<em>p</em> = 0.040), compared with the 2019 new hires. On average, 2020 new hires reported more favorable feedback regarding their preceptors, however, they indicated lower scores for peer interactions and support.</div></div><div><h3>Conclusions</h3><div>These findings suggest that virtual nurse residency programs can achieve comparable outcomes to traditional in-person formats and may provide a scalable option for rural or resource-limited settings. Future studies should explore long-term retention outcomes and strategies to improve peer engagement in virtual environments.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104721"},"PeriodicalIF":4.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.nepr.2026.104724
Su-Ying Yu , Hui-Ping Lin , Ying-Mai Kung , Shu-Ching Chen
Aims
This systematic review aimed to synthesize the current evidence on artificial intelligence (AI)-enhanced clinical reasoning among nurse practitioners (NPs).
Background
NPs require strong clinical reasoning skills and AI–based tools may support the development of these competencies; however, empirical evidence regarding their effectiveness remains limited. The strengthened literature review clearly identifies a critical gap, the absence of a prior systematic review specifically examining AI-enhanced clinical reasoning among NPs and will provid a strong rationale for the present review.
Design
Systematic review following PRISMA 2020 guidelines.
Methods
Searches were conducted in PubMed, Embase and CINAHL through July 2025. Of the 429 records retrieved, 13 met inclusion criteria. Eligible studies examined AI interventions targeting clinical reasoning among NPs. Risk of bias was assessed using the Critical Appraisal Skills Programme checklists and Joanna Briggs Institute tools. Data were extracted on study design, population, AI application domain, outcomes and quality appraisal.
Results
Thirteen studies were included: seven quantitative quasi-experimental, intervention validation, or retrospective cohort studies; three qualitative studies; and three systematic reviews. AI applications ranged from real-time monitoring and decision-support systems to simulation platforms and large language models, which supported clinical reasoning domains such as data gathering, hypothesis generation, diagnostic justification and reflective judgment. Quantitative studies showed improvements in diagnostic accuracy, consistency, efficiency and data collection, while qualitative studies found that NPs view AI as a supportive tool that enhances diagnostic reasoning and patient-centered care, while emphasizing the need for transparency, interpretability and workflow integration.
Conclusions
AI tools may strengthen NPs’ clinical reasoning by improving diagnostic accuracy, decision consistency and care efficiency, but their safe use requires rigorous validation, standardized evaluation, ethical safeguards and digital literacy training. Limitations include heterogeneous AI applications across professional groups and a predominance of simulation-based evidence over real-world clinical evaluations.
{"title":"Artificial intelligence-enhanced clinical reasoning in nurse practitioners: A systematic review","authors":"Su-Ying Yu , Hui-Ping Lin , Ying-Mai Kung , Shu-Ching Chen","doi":"10.1016/j.nepr.2026.104724","DOIUrl":"10.1016/j.nepr.2026.104724","url":null,"abstract":"<div><h3>Aims</h3><div>This systematic review aimed to synthesize the current evidence on artificial intelligence (AI)-enhanced clinical reasoning among nurse practitioners (NPs).</div></div><div><h3>Background</h3><div>NPs require strong clinical reasoning skills and AI–based tools may support the development of these competencies; however, empirical evidence regarding their effectiveness remains limited. The strengthened literature review clearly identifies a critical gap, the absence of a prior systematic review specifically examining AI-enhanced clinical reasoning among NPs and will provid a strong rationale for the present review.</div></div><div><h3>Design</h3><div>Systematic review following PRISMA 2020 guidelines.</div></div><div><h3>Methods</h3><div>Searches were conducted in PubMed, Embase and CINAHL through July 2025. Of the 429 records retrieved, 13 met inclusion criteria. Eligible studies examined AI interventions targeting clinical reasoning among NPs. Risk of bias was assessed using the Critical Appraisal Skills Programme checklists and Joanna Briggs Institute tools. Data were extracted on study design, population, AI application domain, outcomes and quality appraisal.</div></div><div><h3>Results</h3><div>Thirteen studies were included: seven quantitative quasi-experimental, intervention validation, or retrospective cohort studies; three qualitative studies; and three systematic reviews. AI applications ranged from real-time monitoring and decision-support systems to simulation platforms and large language models, which supported clinical reasoning domains such as data gathering, hypothesis generation, diagnostic justification and reflective judgment. Quantitative studies showed improvements in diagnostic accuracy, consistency, efficiency and data collection, while qualitative studies found that NPs view AI as a supportive tool that enhances diagnostic reasoning and patient-centered care, while emphasizing the need for transparency, interpretability and workflow integration.</div></div><div><h3>Conclusions</h3><div>AI tools may strengthen NPs’ clinical reasoning by improving diagnostic accuracy, decision consistency and care efficiency, but their safe use requires rigorous validation, standardized evaluation, ethical safeguards and digital literacy training. Limitations include heterogeneous AI applications across professional groups and a predominance of simulation-based evidence over real-world clinical evaluations.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104724"},"PeriodicalIF":4.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}