Nurse Education in Practice最新文献

{"title":"Artificial intelligence-enhanced clinical reasoning in nurse practitioners: A systematic review","authors":"Su-Ying Yu ,&nbsp;Hui-Ping Lin ,&nbsp;Ying-Mai Kung ,&nbsp;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}

{"title":"Construction of a competency evaluation index system for geriatric nursing positions in the context of new medical science: A Delphi study","authors":"Shuyue Mu,&nbsp;Rongrong Wang,&nbsp;Xiangnan Wang,&nbsp;Yaqi Zhuang,&nbsp;Wenling Qiu,&nbsp;Guiyu Qu","doi":"10.1016/j.nepr.2026.104714","DOIUrl":"10.1016/j.nepr.2026.104714","url":null,"abstract":"<div><h3>Aim</h3><div>To construct a competency evaluation index system for geriatric nursing positions in the context of new medical science.</div></div><div><h3>Background</h3><div>The new medical discipline is centered on the concept of population health, aiming to establish a comprehensive health service system that incorporates preventive measures, treatment and wellness strategies. It deeply integrates advanced technologies such as artificial intelligence and data science to achieve the digital and intelligent transformation of healthcare services. This places greater demands on the professional competence of nurses working in geriatric care positions. However, the precise competencies that nurses in China's geriatric care settings currently possess to meet the demands of high-quality elderly care remain unclear.</div></div><div><h3>Design</h3><div>A Delphi study.</div></div><div><h3>Methods</h3><div>Based on the onion model as a theoretical foundation, this study has preliminarily constructed a draft competency framework through evidence-based integration and behavioral event interviews. Two rounds of Delphi expert consultations were conducted with 19 specialists to revise and refine the indicator system.</div></div><div><h3>Results</h3><div>The evaluation indicator system comprises four primary indicators, 14 secondary indicators and 51 tertiary indicators, which include professionalism, theoretical knowledge, skills and personal characteristics. The response rates for the two rounds of expert questionnaires were 95 % and 89 %, respectively. The expert authority coefficients for the two rounds were 0.93 and 0.89, respectively.</div></div><div><h3>Conclusion</h3><div>The indicator system is scientifically sound and reliable, closely aligned with core characteristics such as digital intelligence and interdisciplinary integration. This provides a practical reference point for future development of geriatric care curricula and optimization of talent cultivation programs.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104714"},"PeriodicalIF":4.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978369","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}

{"title":"Enhancing student nurses’ cultural competence in the care of transgender individuals: An integrative review of educational approaches","authors":"Jane Mary Hager","doi":"10.1016/j.nepr.2026.104720","DOIUrl":"10.1016/j.nepr.2026.104720","url":null,"abstract":"<div><h3>Objective</h3><div>This integrative review aimed to synthesise and critically examine educational strategies in improving cultural competence among pre-registration student nurses when caring for transgender patients. It also sought to inform future educational development and identify gaps for further research.</div></div><div><h3>Background</h3><div>The 2021 UK Census identified at least 262,000 individuals (0.5 % of the population) as transgender, though this is likely underestimated due to stigma and underreporting. Despite evolving public attitudes, 16 % of respondents in a 2019 survey admitted prejudice towards transgender people. The Nursing and Midwifery Council (NMC, 2018) emphasises dignified, non-discriminatory care for all, yet many LGBTQ+ individuals report negative healthcare experiences. Research consistently highlights gaps in education for healthcare professionals, affecting their confidence and ability to provide competent care for transgender individuals.</div></div><div><h3>Design</h3><div>An integrative review design was adopted, enabling the synthesis of diverse evidence sources to explore educational strategies that enhance cultural competence in pre-registration nursing curricula.</div></div><div><h3>Methods</h3><div>Using Whittemore and Knafl’s (2005) integrative review framework and Joanna Briggs Institute (2024) mixed-methods guidance, nine studies were synthesised. A constant comparison approach enabled integration of qualitative and quantitative findings.</div></div><div><h3>Results</h3><div>No single educational strategy emerged as most effective. However, multi-method approaches, especially those involving active learning were consistently linked to improvements in knowledge, attitudes and skills</div></div><div><h3>Conclusion</h3><div>Findings highlight the need for a standardised, comprehensive approach to cultural competence education in nursing curricula. Integrating such content has the potential to improve care quality, reducing health disparities and ensuring equitable, person-centred care for transgender individuals.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104720"},"PeriodicalIF":4.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978371","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}

{"title":"Entrepreneurship education for nurses and healthcare professionals: A scoping review and future research agenda","authors":"Andrew Rixon ,&nbsp;Anya Phelan ,&nbsp;Sara Ekberg ,&nbsp;Julienne Senyard ,&nbsp;Arash Mashahady ,&nbsp;Amie Shaw ,&nbsp;Naomi Birdthistle","doi":"10.1016/j.nepr.2026.104716","DOIUrl":"10.1016/j.nepr.2026.104716","url":null,"abstract":"<div><h3>Aim</h3><div>To map and synthesise global evidence on entrepreneurship education for nurses and healthcare professionals.</div></div><div><h3>Background</h3><div>As healthcare systems face increasing complexity, entrepreneurial skills—including innovation, value creation and resourcefulness in addressing service gaps—are recognised as vital for transforming healthcare delivery. While entrepreneurship training has expanded in medical education, its integration into nursing and allied health education remains limited and under-researched.</div></div><div><h3>Design</h3><div>Scoping review guided by the Joanna Briggs Institute methodology and reported in accordance with PRISMA-ScR guidelines.</div></div><div><h3>Methods</h3><div>A systematic search of five databases (Embase, Scopus, Web of Science, CINAHL and Medline) identified 18 eligible studies. Data were thematically analysed and mapped using the Quintuple Aim framework alongside a consolidated set of ten entrepreneurial competencies derived from established entrepreneurship literature, enabling integrated analysis of program content and outcomes.</div></div><div><h3>Results</h3><div>Programs were predominantly concentrated in urban academic centres and primarily targeted physicians. Nursing-focused initiatives were fewer and demonstrated narrower competency coverage, with key gaps in risk management and financial literacy. Most programs employed experiential, team-based pedagogies. Evidence of impact was strongest for improving the work life of healthcare providers, while empirical evidence for patient outcomes, cost reduction and health equity remained limited.</div></div><div><h3>Conclusions</h3><div>Entrepreneurship education shows promise for strengthening the leadership, innovation and system-change capacity of nurses and healthcare professionals. However, current offerings are fragmented and physician centric. This review highlights the need for more robust, nursing-specific entrepreneurship education grounded in comprehensive competency frameworks and evaluated through rigorous, longitudinal approaches, providing a foundation for curriculum development, faculty capacity-building and future research.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104716"},"PeriodicalIF":4.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978370","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}

{"title":"The Urostomy Care Skills Evaluation Tool: A scale development study","authors":"Hatice Merve ALPTEKİN ,&nbsp;Öykü KARA ,&nbsp;Kübra ŞENGÖR ,&nbsp;Rabia GÖRÜCÜ ,&nbsp;Ayfer ÖZBAŞ","doi":"10.1016/j.nepr.2026.104722","DOIUrl":"10.1016/j.nepr.2026.104722","url":null,"abstract":"<div><h3>Aim</h3><div>This study was designed and implemented to develop a tool for evaluating the steps involved in urostomy care.</div></div><div><h3>Background</h3><div>Providing effective urostomy care requires the acquisition of specific clinical skills. However, nursing education lacks standardized tools to assess these skills.</div></div><div><h3>Design</h3><div>Methodological study.</div></div><div><h3>Method</h3><div>This research was conducted at a nursing faculty in Istanbul from May–June 2023. The sample consisted of 140 nursing student enrolled in a surgical nursing course who met the inclusion criteria. Data for the study were collected via the “Personal Information Form,” which consists of 10 questions about individual characteristics such as age, gender, academic performance and perspectives on the nursing profession and the “Urostomy Care Skills Evaluation Tool,” a 28-step tool developed on the basis of the literature.</div></div><div><h3>Results</h3><div>After the items for the evaluation tool were created, feedback was obtained from 10 experts and the content validity index was found to be sufficient (CVI: 0.978). The consistency among independent observers evaluating the tool’s items was statistically significant and high (ICC: 0.995; p &lt; 0.001). The test<img>retest reliability of the tool also showed high consistency.</div></div><div><h3>Conclusion</h3><div>The Urostomy Care Skills Evaluation Tool provides initial evidence of content validity and reliability for assessing urostomy care performance among nursing students in a simulation-based educational setting. The tool appears useful for evaluating training outcomes in undergraduate nursing education. However, further validation studies conducted in clinical settings and involving practicing nurses and caregivers are needed before broader applicability can be established.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104722"},"PeriodicalIF":4.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978360","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}

{"title":"Hearing the deaf nursing student: Navigating inclusive nurse education in ableist learning environments","authors":"Rachel Birch ,&nbsp;Christopher Seymour ,&nbsp;Samuel Beckett ,&nbsp;Gayatri Nambiar-Greenwood","doi":"10.1016/j.nepr.2026.104719","DOIUrl":"10.1016/j.nepr.2026.104719","url":null,"abstract":"<div><h3>Aim</h3><div>This aim of this discussion paper is to explore and reflect those biases and limiting discriminatory practices of those of us entrusted to support the educational journey of a deaf Mental Health student nurse, through his lens, to reconsider and re-examine what it means to be genuinely inclusive.</div></div><div><h3>Background</h3><div>Adopting an ethos of social justice, this discussion connects the narrative of this student to those who supported him through his 3-year degree learning experience in university and clinical placements. Our reflections as educators are based on deconstructing and connecting concepts around ableist, stigmatizing discrimination alongside the student narrative.</div></div><div><h3>Design</h3><div>A critical discussion paper.</div></div><div><h3>Methods</h3><div>Adopting the principles of a qualitative case study approach as a reflective evaluation to interrogate our pre-judgments, thought processes and habitual responses, to understand our complex roles in relation to enabling successful student journeys.</div></div><div><h3>Results</h3><div>The inclusion of a deaf student in a ‘hearing’ cohort required pre-planning and great thought, for it to be truly inclusive. Although practical solutions to the physicality of communication was resolvable, the greater challenge and constant advocative negotiations from his Personal Tutor came from pre-conceived ideas and attitudes more in adult placement settings, whose apprehensions of this students’ learning fixated around safety, responding to emergency bells and fast communication.</div></div><div><h3>Conclusions</h3><div>The approach to a person with disabilities needs to begin with the assumption that everyone has a right to contribute to and benefit from higher education and an equal chance to be what they perceive as their contribution to society.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104719"},"PeriodicalIF":4.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979070","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}

{"title":"Operationalizing joy in nursing education: Simulation and interprofessional learning as catalysts for resilience and renewal","authors":"Mohammed Al-Hassan","doi":"10.1016/j.nepr.2026.104718","DOIUrl":"10.1016/j.nepr.2026.104718","url":null,"abstract":"<div><h3>Aim</h3><div>To propose a conceptual framework that repositions joy as a pedagogical imperative in nursing education and demonstrates how Simulation-Based Learning (SBL) and Interprofessional Education (IPE) can serve as catalysts for cultivating resilience, connection and renewal.</div></div><div><h3>Background</h3><div>Burnout, moral distress and disengagement among students and educators have revealed the emotional fragility of current educational systems. The Institute for Healthcare Improvement’s Framework for Joy in Work and Bernard’s values alignment theory suggest that joy is not an emotional byproduct but a strategic condition for engagement and well-being.</div></div><div><h3>Design</h3><div>This paper presents a conceptual synthesis integrating insights from positive psychology, learning science and organizational theory to advance The Joyful Learning Cycle (JLC), a new model for embedding joy as a design principle in nursing education.</div></div><div><h3>Methods</h3><div>The JLC model was developed through theoretical integration of existing frameworks and reflective analysis of SBL and IPE pedagogies. The five interrelated phases, Inquiry, Connection, Reflection, Celebration and Renewal, operationalize joy as a regenerative, teachable process.</div></div><div><h3>Results</h3><div>SBL and IPE are identified as high-impact educational modalities that naturally support the cultivation of joy through psychological safety, collective efficacy and shared purpose. The JLC demonstrates how joy can be intentionally designed, measured and sustained within faculty development and curriculum design.</div></div><div><h3>Conclusions</h3><div>Joy is a pedagogical vital sign, an indicator of learning health and educator well-being. Embedding joy alongside competence as a core metric can transform nursing education into a system that not only trains skilled professionals but sustains the humanity of those who teach and learn.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104718"},"PeriodicalIF":4.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927385","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}

{"title":"A large language model-powered reflective AI agent for evidence-based nursing education: Design and evaluation","authors":"Shuqi Yang ,&nbsp;Manfei Shi ,&nbsp;Yuhang Qian ,&nbsp;Tiantian Hu ,&nbsp;Zongan Huang ,&nbsp;Shuai Wang ,&nbsp;Zheng Zhu","doi":"10.1016/j.nepr.2026.104710","DOIUrl":"10.1016/j.nepr.2026.104710","url":null,"abstract":"<div><h3>Aim</h3><div>To develop and evaluate the <em>Evidence-Based Nursing Expert (EBN-Expert),</em> a domain-specific intelligent agent designed to support reflective learning in evidence-based nursing education.</div></div><div><h3>Background</h3><div>Evidence-based practice (EBP) is a core competency in nursing education yet remains challenging for students to master due to its emphasis on critical thinking and decision-making. Traditional teaching methods often fall short in fostering these higher-order skills. While large language models (LLMs) are increasingly used in education, general-purpose systems offer limited support for the specific demands of EBP.</div></div><div><h3>Design</h3><div>A comparative evaluation study using standardized exam questions aligned with a widely used evidence-based nursing curriculum.</div></div><div><h3>Methods</h3><div>The <em>EBN-Expert</em> was constructed with content from the textbook <em>Evidence-Based Nursing</em> and designed around a closed-loop workflow incorporating Retrieval, Reflection and Decision-making modules. The system was evaluated using 124 standardized test items and compared with three leading general-purpose LLMs: ChatGPT-o1, DeepSeek-R1 and Kimi.</div></div><div><h3>Results</h3><div>The <em>EBN-Expert</em> significantly outperformed three general-purpose models (<em>P</em> &lt; 0.001), achieving the highest overall score (1035.00 ± 17.32). It led in most of the 12 textbook chapters, especially in those requiring methodological or interpretive reasoning. It maintained perfect accuracy in true/false questions and excelled in multiple-choice formats. A mixed effects model further confirmed its superior accuracy and response consistency, especially at intermediate difficulty levels (Level 2 and Level 4).</div></div><div><h3>Conclusion</h3><div>The <em>EBN-Expert</em> illustrates the promise of domain-specific generative AI tools in nursing education. Its alignment with curriculum structure, high accuracy and reflective reasoning capabilities position it as a scalable and trustworthy approach for advancing EBP training.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104710"},"PeriodicalIF":4.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927389","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}

{"title":"End-of-life care preparedness program for senior nursing students in Türkiye: Effects on attitudes and self-efficacy in a randomized controlled trial","authors":"Sinem Öcalan ,&nbsp;Aylin Bilgin ,&nbsp;Hilal Altundal Duru ,&nbsp;Mustafa Sabri Kovancı","doi":"10.1016/j.nepr.2026.104717","DOIUrl":"10.1016/j.nepr.2026.104717","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the effectiveness of an online End-of-Life Care Preparedness Program on senior nursing students’ attitudes toward caring for dying patients and their self-efficacy in end-of-life care.</div></div><div><h3>Background</h3><div>Senior nursing students often experience fear and uncertainty when facing death due to insufficient preparation and limited clinical exposure, which may hinder the provision of quality end-of-life care. Structured, culturally adapted educational interventions are therefore needed to enhance readiness and competence.</div></div><div><h3>Design</h3><div>Randomized controlled trial with pre-test, post-test and one-month follow-up assessments.</div></div><div><h3>Methods</h3><div>Sixty senior nursing students from two universities were randomized to either an intervention group receiving the End-of-Life Care Preparedness Program (four weekly 90-minute online sessions via Microsoft Teams) or a control group continuing routine education. Data were collected between April and June 2025 (pre-test in April, post-test in May, follow-up in June). Outcomes were measured using the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) and the End-of-Life and Postmortem Self-Efficacy Scale (ELPSES). Data were analyzed using repeated-measures GLM with Bonferroni-adjusted comparisons.</div></div><div><h3>Results</h3><div>The intervention group showed a significant increase in attitudes and self-efficacy from pre-test to post-test, sustained at one-month follow-up (p &lt; 00.001). The control group demonstrated a decline. Time × group interactions were significant for attitudes (F = 31.854, p &lt; 00.001, ηp² =.359) and self-efficacy (F = 14.224, p &lt; 00.001, ηp² =.200).</div></div><div><h3>Conclusion</h3><div>The program significantly improved students’ attitudes and self-efficacy with sustained effects, underscoring the need to integrate culturally sensitive, digitally delivered death education into nursing curricula.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104717"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927388","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}

{"title":"Interpreting free-text cardiac catheterisation reports: A machine learning approach informed by focused ethnography","authors":"Lu-Yen Anny Chen ,&nbsp;En-Hau Yeh ,&nbsp;Phone Lin ,&nbsp;Mu-Yang Hsieh ,&nbsp;Cheng-Pei Lin ,&nbsp;Zih-Yong Liao","doi":"10.1016/j.nepr.2026.104715","DOIUrl":"10.1016/j.nepr.2026.104715","url":null,"abstract":"<div><h3>Aim</h3><div>To examine how focused ethnographic insights can inform the development of a machine learning pipeline to improve the extraction of clinically relevant information from percutaneous coronary intervention (PCI) documentation and support nursing education and practice.</div></div><div><h3>Background</h3><div>Cardiac catheterisation procedures produce detailed documentation, often embedded in free-text fields in electronic health records. For nurses delivering post-procedural care, extracting this information is time-consuming and prone to error. While machine learning (ML) offers automation potential, many models struggle to handle contextual and structural inconsistencies in real-world documentation.</div></div><div><h3>Design</h3><div>A qualitative-informed machine learning study using focused ethnography and rule-based model development.</div></div><div><h3>Methods</h3><div>The study was conducted at a tertiary medical centre in Taiwan and included 200 h of non-participant ethnographic observation to explore documentation practices in PCI reporting. Ethnographic data were thematically analysed to identify structural patterns, linguistic variability and workflow behaviours. These insights informed the iterative development of a rule-based ML pipeline, which was tested on 4128 de-identified PCI reports to evaluate extraction accuracy.</div></div><div><h3>Results</h3><div>Three key patterns were identified: structured use of templates, formatting inconsistencies and free-form narrative variability. These informed the application of four extraction strategies: (1) rule-based and ontology-driven methods; (2) statistical topic modelling; (3) deep learning models and (4) large language models. A rule-based approach was selected for its adaptability and interpretability. Extraction accuracy exceeded 99 % in structured fields and approximately 50 % in narrative-rich sections.</div></div><div><h3>Conclusion</h3><div>Combining ethnography with machine learning enhances automated clinical documentation interpretation and supports AI-informed nursing education through improved digital literacy and contextual awareness.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"91 ","pages":"Article 104715"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978368","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}