Pub Date : 2026-02-02DOI: 10.1016/j.nedt.2026.107016
Mingming Yu , Chenming Guo , Wenhai Fan , Shuyu Han
Background
In recent years, escape rooms have emerged as a novel pedagogical approach and are increasingly being integrated into nursing education to enhance active learning and engagement.
Objectives
To comprehensively identify and synthesize qualitative evidence regarding nursing students' experiences and perceptions of escape room-based learning, thereby generating collective insights into its educational impact and implementation.
Methods
A comprehensive literature search was conducted across six electronic databases including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, and PsycINFO from their inception to January 19, 2026. Thematic synthesis was employed to analyze and synthesize data from the included studies. The methodological quality of these studies was assessed using the Critical Appraisal Skills Programme qualitative studies checklist.
Results
A total of 13 studies were included in this meta-synthesis. From these, four overarching themes emerged with each encompassing a set of underlying sub-themes resulting in eight distinct themes overall. The overarching themes were: the enabling environment-core pedagogical mechanisms, internal gains-foundational learning outcomes, external competencies-observable skills and readiness, and recommendations for improvement-the learner's voice.
Conclusion
This review enables nursing educators to gain comprehensive insights into students' experiences with escape rooms and their expectations for such educational activities. To maximize the effectiveness of escape rooms in nursing education, future game design may systematically address authenticity, logistical optimization, curricular integration, and feedback mechanisms.
近年来，密室逃生已经成为一种新的教学方法，并越来越多地融入护理教育中，以增强主动学习和参与。目的全面识别和综合有关护生逃生室学习体验和感知的定性证据，从而对其教育影响和实施产生集体见解。方法对PubMed、Embase、Scopus、Web of Science、CINAHL Plus、PsycINFO等6个电子数据库自成立以来至2026年1月19日的文献进行综合检索。采用主题综合法对纳入研究的数据进行分析和综合。这些研究的方法学质量使用关键评估技能计划定性研究核对表进行评估。结果本meta-synthesis共纳入13项研究。从这些主题中，出现了四个总体主题，每个主题都包含一系列潜在的子主题，从而产生了八个不同的主题。总体主题是：有利环境-核心教学机制，内部收益-基础学习成果，外部能力-可观察的技能和准备，以及改进建议-学习者的声音。结论本综述使护理工作者能够全面了解学生密室逃生的经历以及他们对密室逃生教育活动的期望。为了使密室逃生在护理教育中的效果最大化，未来的游戏设计可以系统地解决真实性、后勤优化、课程整合和反馈机制等问题。
{"title":"Experiences and perceptions of escape room-based learning among nursing students: A systematic review and meta-synthesis","authors":"Mingming Yu , Chenming Guo , Wenhai Fan , Shuyu Han","doi":"10.1016/j.nedt.2026.107016","DOIUrl":"10.1016/j.nedt.2026.107016","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, escape rooms have emerged as a novel pedagogical approach and are increasingly being integrated into nursing education to enhance active learning and engagement.</div></div><div><h3>Objectives</h3><div>To comprehensively identify and synthesize qualitative evidence regarding nursing students' experiences and perceptions of escape room-based learning, thereby generating collective insights into its educational impact and implementation.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across six electronic databases including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, and PsycINFO from their inception to January 19, 2026. Thematic synthesis was employed to analyze and synthesize data from the included studies. The methodological quality of these studies was assessed using the Critical Appraisal Skills Programme qualitative studies checklist.</div></div><div><h3>Results</h3><div>A total of 13 studies were included in this meta-synthesis. From these, four overarching themes emerged with each encompassing a set of underlying sub-themes resulting in eight distinct themes overall. The overarching themes were: the enabling environment-core pedagogical mechanisms, internal gains-foundational learning outcomes, external competencies-observable skills and readiness, and recommendations for improvement-the learner's voice.</div></div><div><h3>Conclusion</h3><div>This review enables nursing educators to gain comprehensive insights into students' experiences with escape rooms and their expectations for such educational activities. To maximize the effectiveness of escape rooms in nursing education, future game design may systematically address authenticity, logistical optimization, curricular integration, and feedback mechanisms.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"161 ","pages":"Article 107016"},"PeriodicalIF":4.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to \"workplace trust and moral resilience in nurses: The parallel mediating roles of moral courage, ethical climate and social support\" [Nurse Educ. Today volume 158, March 2026, 106949].","authors":"Zhe Shen, Yubei Chen, Shiyi Li, Ting Du, Xia Li, Zhihui Zheng","doi":"10.1016/j.nedt.2026.107005","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107005","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":" ","pages":"107005"},"PeriodicalIF":4.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.nedt.2026.107015
Tracy Levett-Jones, Tessa Maguire, Maicee Young
Background: The Clinical Reasoning Cycle, first developed more than 15 years ago, has been internationally used as an educational model in nursing programs. Given the changing nature of healthcare and higher education, it is timely to review whether the Cycle remains clinically current and pedagogically sound.
Objective: The objective of this study was to review and revise the Clinical Reasoning Cycle to ensure its contemporary relevance to nursing education using a consensus driven approach.
Design: A Nominal Group Technique was used to elicit opinions of registered nurses who had subject matter expertise related to clinical reasoning and experience teaching the Clinical Reasoning Cycle to nursing students.
Setting and participants: This study was conducted online using Zoom. Participants (n = 12) were from seven universities, six Australian and one Singaporean. They held a range of academic/education roles.
Results: Three key themes emerged from the analysis and informed the changes to the Clinical Reasoning Cycle Version 2. They included: 1) The world that graduates are entering; 2) The power of language; and 3) Who we position as the expert. Consensus was reached with greater than 90% agreement achieved for each of the changes made to Clinical Reasoning Cycle Version 2.
Conclusions: This study highlights the utility of the Clinical Reasoning Cycle as a pedagogical model and attests to its potential for improving the quality of patient care. Revisions to the Cycle were made using a consensus-based approach designed to strengthen its contemporary relevance. The Clinical Reasoning Cycle Version 2 encourages a person-centred approach to nursing care, incorporates inclusive language and includes the person, their family and other members of the healthcare team in the decision-making process.
{"title":"Using the Nominal Group Technique to explore the contemporary relevance of the Clinical Reasoning Cycle as a pedagogical model for nursing education.","authors":"Tracy Levett-Jones, Tessa Maguire, Maicee Young","doi":"10.1016/j.nedt.2026.107015","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107015","url":null,"abstract":"<p><strong>Background: </strong>The Clinical Reasoning Cycle, first developed more than 15 years ago, has been internationally used as an educational model in nursing programs. Given the changing nature of healthcare and higher education, it is timely to review whether the Cycle remains clinically current and pedagogically sound.</p><p><strong>Objective: </strong>The objective of this study was to review and revise the Clinical Reasoning Cycle to ensure its contemporary relevance to nursing education using a consensus driven approach.</p><p><strong>Design: </strong>A Nominal Group Technique was used to elicit opinions of registered nurses who had subject matter expertise related to clinical reasoning and experience teaching the Clinical Reasoning Cycle to nursing students.</p><p><strong>Setting and participants: </strong>This study was conducted online using Zoom. Participants (n = 12) were from seven universities, six Australian and one Singaporean. They held a range of academic/education roles.</p><p><strong>Results: </strong>Three key themes emerged from the analysis and informed the changes to the Clinical Reasoning Cycle Version 2. They included: 1) The world that graduates are entering; 2) The power of language; and 3) Who we position as the expert. Consensus was reached with greater than 90% agreement achieved for each of the changes made to Clinical Reasoning Cycle Version 2.</p><p><strong>Conclusions: </strong>This study highlights the utility of the Clinical Reasoning Cycle as a pedagogical model and attests to its potential for improving the quality of patient care. Revisions to the Cycle were made using a consensus-based approach designed to strengthen its contemporary relevance. The Clinical Reasoning Cycle Version 2 encourages a person-centred approach to nursing care, incorporates inclusive language and includes the person, their family and other members of the healthcare team in the decision-making process.</p>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"161 ","pages":"107015"},"PeriodicalIF":4.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Contemporary nursing practice requires the integration of perceptual and psychological competencies alongside technical skills to ensure safe and effective care. Although situational awareness and confidence have been linked to clinical judgments, how these internal competencies are jointly associated with clinical competence remains insufficiently understood.
Aim
This study examined the relationships among social acuity, self-efficacy, and clinical competence in nursing students, and tested whether self-efficacy mediates the association between social acuity and clinical competence.
Design
A cross-sectional survey design was employed.
Settings
The study was conducted across 15 nursing departments in South Korea.
Participants
A total of 128 third- and fourth-year nursing students with clinical practice experience participated (88.3% female; 60.2% third-year and 39.8% fourth-year students).
Methods
Validated instruments measured social acuity, self-efficacy, and clinical competence. Data were analyzed using IBM SPSS Statistics 26.0 and Hayes' PROCESS macro (Model 4). Covariates identified through univariate analyses were included in regression and bootstrapped mediation analyses (5000 resamples, 95% CI).
Results
Students reported moderate-to-high levels of social acuity (Mean = 4.07), self-efficacy (Mean = 3.32), and clinical competence (Mean = 3.90). Correlation analyses showed positive associations among the variables. Mediation analysis indicated that self-efficacy partially mediated the relationship between social acuity and clinical competence (indirect effect = 0.064, 95% CI [0.003, 0.139]); the direct effect remained significant (β = 0.221, p = 0.006). The model explained 29.1% of the variance in clinical competence.
Conclusions
Social acuity and self-efficacy are significantly associated with clinical performance. By clarifying the relationships among cue recognition, self-efficacy, and competent action, this study advances understanding of how internal resources are related to clinical judgment. Nursing education should therefore move beyond technical training to deliberately cultivate perceptual sensitivity and confidence, preparing students to deliver safe, adaptive, patient-centered care in complex environments.
当代护理实践需要将感知和心理能力与技术技能结合起来，以确保安全有效的护理。虽然情境意识和自信与临床判断有关，但这些内部能力如何与临床能力联合起来仍然没有得到充分的理解。目的研究护生社会敏锐度、自我效能感与临床能力的关系，并检验自我效能感是否在社会敏锐度与临床能力之间起中介作用。设计采用横断面调查设计。该研究在韩国的15个护理部门进行。共有128名具有临床实践经验的三、四年级护生参与研究，其中88.3%为女性；三年级学生60.2%，四年级学生39.8%。方法采用经验证的仪器测量社会敏锐度、自我效能感和临床能力。数据分析采用IBM SPSS Statistics 26.0和Hayes’PROCESS宏（模型4）。通过单变量分析确定的协变量被纳入回归和自举中介分析（5000个样本，95% CI）。结果学生的社会敏锐度（平均4.07）、自我效能感（平均3.32）和临床能力（平均3.90）均为中高水平。相关分析显示各变量之间呈正相关。中介分析表明，自我效能感部分中介了社交敏锐度与临床能力之间的关系（间接效应= 0.064,95% CI [0.003, 0.139]）；直接效应仍然显著（β = 0.221, p = 0.006）。该模型解释了29.1%的临床能力差异。结论社会敏锐度和自我效能感与临床表现显著相关。本研究借由厘清线索识别、自我效能和胜任行为之间的关系，进一步了解内部资源如何与临床判断相关。因此，护理教育应超越技术培训，有意识地培养感知敏感性和信心，使学生能够在复杂的环境中提供安全、适应性强、以患者为中心的护理。
{"title":"The mediating role of self-efficacy between social acuity and clinical competence among nursing students: A cross-sectional study","authors":"Soojin Bong, Soyun Park, Ahyeon Lee, Haeun Lee, Hyosun Lee, Hyunji Jung, Han-Gyo Choi","doi":"10.1016/j.nedt.2026.107010","DOIUrl":"10.1016/j.nedt.2026.107010","url":null,"abstract":"<div><h3>Background</h3><div>Contemporary nursing practice requires the integration of perceptual and psychological competencies alongside technical skills to ensure safe and effective care. Although situational awareness and confidence have been linked to clinical judgments, how these internal competencies are jointly associated with clinical competence remains insufficiently understood.</div></div><div><h3>Aim</h3><div>This study examined the relationships among social acuity, self-efficacy, and clinical competence in nursing students, and tested whether self-efficacy mediates the association between social acuity and clinical competence.</div></div><div><h3>Design</h3><div>A cross-sectional survey design was employed.</div></div><div><h3>Settings</h3><div>The study was conducted across 15 nursing departments in South Korea.</div></div><div><h3>Participants</h3><div>A total of 128 third- and fourth-year nursing students with clinical practice experience participated (88.3% female; 60.2% third-year and 39.8% fourth-year students).</div></div><div><h3>Methods</h3><div>Validated instruments measured social acuity, self-efficacy, and clinical competence. Data were analyzed using IBM SPSS Statistics 26.0 and Hayes' PROCESS macro (Model 4). Covariates identified through univariate analyses were included in regression and bootstrapped mediation analyses (5000 resamples, 95% CI).</div></div><div><h3>Results</h3><div>Students reported moderate-to-high levels of social acuity (Mean = 4.07), self-efficacy (Mean = 3.32), and clinical competence (Mean = 3.90). Correlation analyses showed positive associations among the variables. Mediation analysis indicated that self-efficacy partially mediated the relationship between social acuity and clinical competence (indirect effect = 0.064, 95% CI [0.003, 0.139]); the direct effect remained significant (β = 0.221, <em>p</em> = 0.006). The model explained 29.1% of the variance in clinical competence.</div></div><div><h3>Conclusions</h3><div>Social acuity and self-efficacy are significantly associated with clinical performance. By clarifying the relationships among cue recognition, self-efficacy, and competent action, this study advances understanding of how internal resources are related to clinical judgment. Nursing education should therefore move beyond technical training to deliberately cultivate perceptual sensitivity and confidence, preparing students to deliver safe, adaptive, patient-centered care in complex environments.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"161 ","pages":"Article 107010"},"PeriodicalIF":4.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Time poverty refers to the condition where individuals struggle to secure sufficient free time due to overwhelming responsibilities. This phenomenon has significant physical and mental health implications. Clinical nursing interns are particularly susceptible to time poverty due to demanding schedules, long shifts, and irregular hours during clinical placements. Despite its relevance, limited research explores the subjective experiences of clinical nursing interns regarding time poverty and its implications for their professional development and well-being.
Aims: This study aimed to understand the experiences and coping strategies of clinical nursing interns facing time poverty, identify factors that exacerbate time poverty, and provide suggestions to mitigate its negative impact on these interns.
Methods: Interpretive phenomenological analysis (IPA) was used to capture the lived experiences of 12 clinical nursing interns. Participants were selected through purposive and snowball sampling, ensuring diverse experiences from different clinical environments. Semi-structured, in-depth interviews were conducted, focused on: perceptions and experiences of time poverty, emotional and career impacts of insufficient free time, and coping strategies among interns. All interviews were audio-recorded, transcribed verbatim, and subjected to a thematic analysis to identify recurring patterns and themes.
Results: Four primary themes emerged from the data analysis: "Life on the Treadmill"; "The Emotion of Being Chased"; "Professional Shake"; and "Adaptation and Coping Strategies".
Conclusion: The findings highlight that time poverty significantly affects clinical nursing interns' emotional well-being, professional growth, and motivation. Addressing this issue requires institutional reforms and supportive measures, including: formal training in effective time management; structured mentorship programs to guide interns through challenging schedules; enhanced emotional support systems to foster resilience. Such interventions are critical to promoting the health, academic success, and professional identity of clinical nursing interns, ultimately strengthening the future nursing workforce and overall healthcare delivery.
{"title":"Riding the time treadmill: An interpretive phenomenological study of clinical nursing interns' experience of time poverty.","authors":"Shuxin Zhang, Yubin Chen, Linghui Zhang, Xinyu Yang, Na Zhou, Haiqin Chen, Yang Feng, Huizhen Huang, Junhui Dong, Minle Lu, Yuqiu Zhou","doi":"10.1016/j.nedt.2026.107012","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107012","url":null,"abstract":"<p><strong>Background: </strong>Time poverty refers to the condition where individuals struggle to secure sufficient free time due to overwhelming responsibilities. This phenomenon has significant physical and mental health implications. Clinical nursing interns are particularly susceptible to time poverty due to demanding schedules, long shifts, and irregular hours during clinical placements. Despite its relevance, limited research explores the subjective experiences of clinical nursing interns regarding time poverty and its implications for their professional development and well-being.</p><p><strong>Aims: </strong>This study aimed to understand the experiences and coping strategies of clinical nursing interns facing time poverty, identify factors that exacerbate time poverty, and provide suggestions to mitigate its negative impact on these interns.</p><p><strong>Methods: </strong>Interpretive phenomenological analysis (IPA) was used to capture the lived experiences of 12 clinical nursing interns. Participants were selected through purposive and snowball sampling, ensuring diverse experiences from different clinical environments. Semi-structured, in-depth interviews were conducted, focused on: perceptions and experiences of time poverty, emotional and career impacts of insufficient free time, and coping strategies among interns. All interviews were audio-recorded, transcribed verbatim, and subjected to a thematic analysis to identify recurring patterns and themes.</p><p><strong>Results: </strong>Four primary themes emerged from the data analysis: \"Life on the Treadmill\"; \"The Emotion of Being Chased\"; \"Professional Shake\"; and \"Adaptation and Coping Strategies\".</p><p><strong>Conclusion: </strong>The findings highlight that time poverty significantly affects clinical nursing interns' emotional well-being, professional growth, and motivation. Addressing this issue requires institutional reforms and supportive measures, including: formal training in effective time management; structured mentorship programs to guide interns through challenging schedules; enhanced emotional support systems to foster resilience. Such interventions are critical to promoting the health, academic success, and professional identity of clinical nursing interns, ultimately strengthening the future nursing workforce and overall healthcare delivery.</p>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"107012"},"PeriodicalIF":4.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-28DOI: 10.1016/j.nedt.2026.107014
Züleyha Gürdap , Uğur Öner
Background
The increasing integration of artificial intelligence (AI) into healthcare has generated interest in its potential role within nursing practice, particularly in relation to clinical decision-making and care delivery processes.
Objectives
This study aimed to examine the relationship between nurses' attitudes toward AI and their clinical decision-making tendencies.
Design
This was a cross-sectional and descriptive study.
Methods
Data were collected from 323 nurses working in various clinical units of a training and research hospital in Turkey. The Artificial Intelligence Attitude Scale for Nurses and the Nursing Decision-making Instrument were used. Data were analyzed using descriptive statistics, correlation, and regression analyses.
Results
The mean score for nurses' attitudes toward AI was 107.19 ± 24.43, indicating a generally positive attitude. For clinical decision-making, the mean score was 67.17 ± 7.12, indicating an analytical decision-making tendency. A strong and significant negative correlation was found between attitudes toward AI and decision-making scores (r = −0.662, p < 0.001). Consistent with the instrument's scoring, these lower scores reflect an analytical decision-making tendency. Simple linear regression analysis demonstrated that attitudes toward AI significantly predicted decision-making scores, explaining 43.8% of the total variance. Additionally, marital status, educational level, professional experience, and clinical unit were significantly associated with both AI attitudes and decision-making tendencies (p < 0.05).
Conclusion
The findings indicate that nurses generally report positive attitudes toward AI, and that these attitudes are associated with analytical tendencies in clinical decision-making. AI technologies may function as supportive tools in clinical practice and may be associated with patient safety and care quality. Integrating AI-related competencies into nursing education may support evidence-based and systematic clinical decision-making.
人工智能（AI）日益融入医疗保健领域，引起了人们对其在护理实践中的潜在作用的兴趣，特别是在临床决策和护理交付过程中。目的探讨护士对人工智能的态度与临床决策倾向的关系。这是一项横断面描述性研究。方法对土耳其某培训研究型医院各临床科室的323名护士进行数据收集。采用护士人工智能态度量表和护理决策量表。数据分析采用描述性统计、相关分析和回归分析。结果护士对人工智能的态度平均得分（107.19±24.43），总体持积极态度。临床决策平均得分67.17±7.12，有分析性决策倾向。对人工智能的态度与决策得分之间存在强烈且显著的负相关（r = - 0.662, p < 0.001）。与仪器的得分一致，这些较低的分数反映了分析性决策倾向。简单的线性回归分析表明，对人工智能的态度显著预测了决策得分，解释了总方差的43.8%。此外，婚姻状况、文化程度、工作经验、临床单位与人工智能态度和决策倾向均有显著相关（p < 0.05）。结论护士普遍对人工智能持积极态度，这些态度与临床决策的分析倾向有关。人工智能技术可以在临床实践中发挥辅助工具的作用，并可能与患者安全和护理质量相关。将人工智能相关能力整合到护理教育中可以支持循证和系统的临床决策。
{"title":"Nurses' attitudes toward artificial intelligence applications and their clinical decision-making competence: A cross-sectional study","authors":"Züleyha Gürdap , Uğur Öner","doi":"10.1016/j.nedt.2026.107014","DOIUrl":"10.1016/j.nedt.2026.107014","url":null,"abstract":"<div><h3>Background</h3><div>The increasing integration of artificial intelligence (AI) into healthcare has generated interest in its potential role within nursing practice, particularly in relation to clinical decision-making and care delivery processes.</div></div><div><h3>Objectives</h3><div>This study aimed to examine the relationship between nurses' attitudes toward AI and their clinical decision-making tendencies.</div></div><div><h3>Design</h3><div>This was a cross-sectional and descriptive study.</div></div><div><h3>Methods</h3><div>Data were collected from 323 nurses working in various clinical units of a training and research hospital in Turkey. The Artificial Intelligence Attitude Scale for Nurses and the Nursing Decision-making Instrument were used. Data were analyzed using descriptive statistics, correlation, and regression analyses.</div></div><div><h3>Results</h3><div>The mean score for nurses' attitudes toward AI was 107.19 ± 24.43, indicating a generally positive attitude. For clinical decision-making, the mean score was 67.17 ± 7.12, indicating an analytical decision-making tendency. A strong and significant negative correlation was found between attitudes toward AI and decision-making scores (<em>r</em> = −0.662, <em>p</em> < 0.001). Consistent with the instrument's scoring, these lower scores reflect an analytical decision-making tendency. Simple linear regression analysis demonstrated that attitudes toward AI significantly predicted decision-making scores, explaining 43.8% of the total variance. Additionally, marital status, educational level, professional experience, and clinical unit were significantly associated with both AI attitudes and decision-making tendencies (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>The findings indicate that nurses generally report positive attitudes toward AI, and that these attitudes are associated with analytical tendencies in clinical decision-making. AI technologies may function as supportive tools in clinical practice and may be associated with patient safety and care quality. Integrating AI-related competencies into nursing education may support evidence-based and systematic clinical decision-making.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 107014"},"PeriodicalIF":4.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-28DOI: 10.1016/j.nedt.2026.107011
Ayman Mohamed El-Ashry, Alaa Hamza Hermis, Sadiq Salam H Al-Salih, Mohammed Musaed Al-Jabri, Nashwa Ahmed Hussein Abdel Karim, Hamdya Ahmed Ali Mohamed, Sameer A Alkubati, Nora Ghalib AlOtaibi, Mohammed Jameel Wahab, Abbas Abdul-Hussein Hassan, Hawraa Ali Mukhlif, Walaa Eid Zaki Ahmed, Ahmed Farghaly Tawfik, Farida Habib, Eslam Reda Machaly
Background: AI tools are increasingly visible in nursing education and practice, yet student exposure and acceptance vary across settings. Limited digital literacy and technology anxiety may contribute to impostor syndrome (IS) in academic and clinical environments.
Objective: To assess and compare attitudes toward AI and the prevalence of IS among nursing students in five countries (Iraq, Egypt, Saudi Arabia, Jordan, and the UAE) and to examine their association.
Methods: Cross-sectional, descriptive-correlational survey of 1772 undergraduate nursing students from Iraq, Egypt, Saudi Arabia, Jordan, and the UAE (convenience sampling). Instruments were the General Attitudes toward AI Scale (20 items, Positive/Negative subscales) and the Clance Impostor Phenomenon Scale (CIPS; 20 items), plus demographics and technology-related variables (AI information sources, application type, prior training, and AI confidence). Group differences used t-tests/ANOVA with post-hoc tests; associations used Pearson correlations and multivariable linear regression with country fixed effects and robust SEs.
Results: Attitudes toward AI and IS differed by country, academic level, work status, information source, application used, and AI confidence (all p < .001). Iraqi students reported the most favorable AI attitudes; Egyptian and Iraqi students showed higher CIPS scores in bivariate analyses. First-year and younger students had higher IS. AI attitudes correlated negatively with IS (r = -0.206, p < .001). In regression, greater AI confidence and academic level predicted higher AI attitudes, whereas higher AI attitudes, upper academic levels, and AI training predicted lower IS.
Conclusions: More favorable attitudes toward AI were associated with lower impostor feelings. Context-appropriate AI education (paired with ethics/academic-integrity guidance) and targeted psychological support may foster technological readiness and mitigate impostor experiences.
Implications: Integrate structured AI literacy (where permitted), ensure equitable digital access, and provide mentorship and mental-health support-especially for early-year students.
{"title":"Attitudes toward artificial intelligence and impostor phenomenon among nursing students: A five-country cross-sectional study.","authors":"Ayman Mohamed El-Ashry, Alaa Hamza Hermis, Sadiq Salam H Al-Salih, Mohammed Musaed Al-Jabri, Nashwa Ahmed Hussein Abdel Karim, Hamdya Ahmed Ali Mohamed, Sameer A Alkubati, Nora Ghalib AlOtaibi, Mohammed Jameel Wahab, Abbas Abdul-Hussein Hassan, Hawraa Ali Mukhlif, Walaa Eid Zaki Ahmed, Ahmed Farghaly Tawfik, Farida Habib, Eslam Reda Machaly","doi":"10.1016/j.nedt.2026.107011","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107011","url":null,"abstract":"<p><strong>Background: </strong>AI tools are increasingly visible in nursing education and practice, yet student exposure and acceptance vary across settings. Limited digital literacy and technology anxiety may contribute to impostor syndrome (IS) in academic and clinical environments.</p><p><strong>Objective: </strong>To assess and compare attitudes toward AI and the prevalence of IS among nursing students in five countries (Iraq, Egypt, Saudi Arabia, Jordan, and the UAE) and to examine their association.</p><p><strong>Methods: </strong>Cross-sectional, descriptive-correlational survey of 1772 undergraduate nursing students from Iraq, Egypt, Saudi Arabia, Jordan, and the UAE (convenience sampling). Instruments were the General Attitudes toward AI Scale (20 items, Positive/Negative subscales) and the Clance Impostor Phenomenon Scale (CIPS; 20 items), plus demographics and technology-related variables (AI information sources, application type, prior training, and AI confidence). Group differences used t-tests/ANOVA with post-hoc tests; associations used Pearson correlations and multivariable linear regression with country fixed effects and robust SEs.</p><p><strong>Results: </strong>Attitudes toward AI and IS differed by country, academic level, work status, information source, application used, and AI confidence (all p < .001). Iraqi students reported the most favorable AI attitudes; Egyptian and Iraqi students showed higher CIPS scores in bivariate analyses. First-year and younger students had higher IS. AI attitudes correlated negatively with IS (r = -0.206, p < .001). In regression, greater AI confidence and academic level predicted higher AI attitudes, whereas higher AI attitudes, upper academic levels, and AI training predicted lower IS.</p><p><strong>Conclusions: </strong>More favorable attitudes toward AI were associated with lower impostor feelings. Context-appropriate AI education (paired with ethics/academic-integrity guidance) and targeted psychological support may foster technological readiness and mitigate impostor experiences.</p><p><strong>Implications: </strong>Integrate structured AI literacy (where permitted), ensure equitable digital access, and provide mentorship and mental-health support-especially for early-year students.</p>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"161 ","pages":"107011"},"PeriodicalIF":4.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-28DOI: 10.1016/j.nedt.2026.107013
Evelina Alūzaitė, Olga Riklikienė, Snieguolė Kaselienė, Laima Karosas
Aim: The aim of this study was to examine the general and professional values of two cohorts of undergraduate nursing students over a ten-year period to identify emerging trends or changes.
Background: Nursing students and early-career nurses face complex ethical situations that require alignment of personal values with professional ethics to ensure safe and compassionate care. Although values in nursing have traditionally been viewed as stable, research shows they evolve over time and are influenced by education, cultural context, and professional experience.
Design: Cross-sectional survey design was used in this study.
Methods: The study was conducted between October 2020 and January 2021 across nine higher education institutions offering nursing programs in Lithuania. A total of 370 third- and fourth-year nursing students participated. The questionnaire included 37 general and 20 professional values.
Results: Study II respondents showed stronger general values than those in Study I, while Study I participants demonstrated stronger professional values. No significant differences were found between the studies based on age, sex, or year of study. Both general and professional Honesty values were stronger in Study II, whereas Religiousness, Self-control, and Authority were stronger professional values in Study I. Study II respondents also scored higher on general values such as Intellectualism, Independence, and Altruism, indicating a shift toward a more scientific and less religiously influenced approach, with a growing interest in the science of nursing.
Conclusion: This study revealed notable shifts in nursing students' values over a ten-year period, with Religiousness, Self-control, and Authority giving way to Intellectualism, Independence, and Altruism - highlighting an increased emphasis on scientific thinking and caring for others.
{"title":"Changes in general and professional values of nursing students over a decade.","authors":"Evelina Alūzaitė, Olga Riklikienė, Snieguolė Kaselienė, Laima Karosas","doi":"10.1016/j.nedt.2026.107013","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107013","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine the general and professional values of two cohorts of undergraduate nursing students over a ten-year period to identify emerging trends or changes.</p><p><strong>Background: </strong>Nursing students and early-career nurses face complex ethical situations that require alignment of personal values with professional ethics to ensure safe and compassionate care. Although values in nursing have traditionally been viewed as stable, research shows they evolve over time and are influenced by education, cultural context, and professional experience.</p><p><strong>Design: </strong>Cross-sectional survey design was used in this study.</p><p><strong>Methods: </strong>The study was conducted between October 2020 and January 2021 across nine higher education institutions offering nursing programs in Lithuania. A total of 370 third- and fourth-year nursing students participated. The questionnaire included 37 general and 20 professional values.</p><p><strong>Results: </strong>Study II respondents showed stronger general values than those in Study I, while Study I participants demonstrated stronger professional values. No significant differences were found between the studies based on age, sex, or year of study. Both general and professional Honesty values were stronger in Study II, whereas Religiousness, Self-control, and Authority were stronger professional values in Study I. Study II respondents also scored higher on general values such as Intellectualism, Independence, and Altruism, indicating a shift toward a more scientific and less religiously influenced approach, with a growing interest in the science of nursing.</p><p><strong>Conclusion: </strong>This study revealed notable shifts in nursing students' values over a ten-year period, with Religiousness, Self-control, and Authority giving way to Intellectualism, Independence, and Altruism - highlighting an increased emphasis on scientific thinking and caring for others.</p>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"107013"},"PeriodicalIF":4.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-24DOI: 10.1016/j.nedt.2026.107008
Miaoli Wang, Lin Xiao, Jingjing Jiao, Mei Sun, Zhao Ni, Jinnan Xiao, Minghui Tan, Haojie Zhang, Wei Liu, Jinfeng Ding
Aims: (i) To summarize the application scenarios and teaching models of AI and VR in healthcare education. (ii) To compare teaching outcomes between AI, VR, and traditional methods. (iii) To identify the relative advantages of AI and VR in different outcomes.
Design: A network meta-analysis.
Data sources: We systematically searched ten databases, including PubMed, Embase, Web of Science, Cochrane Library, IEEE Xplore, CINAHL, Association for Computing Machinery, China National Knowledge Infrastructure, WanFang, and China Computer Federation, to identify randomized controlled trials and quasi-experimental studies.
Methods: Educational effects of various teaching methods were compared through network meta-analysis by estimating standardized mean differences (SMD) with 95% confidence intervals (CIs). Study quality was evaluated using the Joanna Briggs Institute Critical Appraisal Tool.
Results: This study included 54 studies. The network meta-analysis results showed that in nursing education, VR, compared to traditional teaching, improved students' satisfaction (SMD = 0.93, 95% CI: 0.07 to 1.80), knowledge (SMD = 0.60, 95% CI: 0.30 to 0.90), and practical skills (SMD = 1.06, 95% CI: 0.57 to 1.55), while AI only enhanced knowledge (SMD = 1.11, 95% CI: 0.60 to 1.62). There was no significant difference in the indirect comparison between AI and VR. In clinical medicine, both VR and AI improved knowledge (VR: SMD = 0.75, 95% CI: 0.32 to 1.19; AI: SMD = 0.81, 95% CI: 0.10 to 1.51) and practical skills (VR: SMD = 1.14, 95% CI: 0.65 to 1.63; AI: SMD = 0.91, 95% CI: 0.16 to 1.66) compared to traditional teaching, but no significant difference was found in the indirect comparison between AI and VR.
Conclusions: Future research should focus on direct comparisons between AI and VR, assess their long-term educational effects, and design integrated teaching models that harness the strengths of both technologies to inform evidence-based improvements in instructional practice.
{"title":"Effectiveness of AI- and VR-based simulation with traditional teaching in healthcare education: A network meta-analysis.","authors":"Miaoli Wang, Lin Xiao, Jingjing Jiao, Mei Sun, Zhao Ni, Jinnan Xiao, Minghui Tan, Haojie Zhang, Wei Liu, Jinfeng Ding","doi":"10.1016/j.nedt.2026.107008","DOIUrl":"https://doi.org/10.1016/j.nedt.2026.107008","url":null,"abstract":"<p><strong>Aims: </strong>(i) To summarize the application scenarios and teaching models of AI and VR in healthcare education. (ii) To compare teaching outcomes between AI, VR, and traditional methods. (iii) To identify the relative advantages of AI and VR in different outcomes.</p><p><strong>Design: </strong>A network meta-analysis.</p><p><strong>Data sources: </strong>We systematically searched ten databases, including PubMed, Embase, Web of Science, Cochrane Library, IEEE Xplore, CINAHL, Association for Computing Machinery, China National Knowledge Infrastructure, WanFang, and China Computer Federation, to identify randomized controlled trials and quasi-experimental studies.</p><p><strong>Methods: </strong>Educational effects of various teaching methods were compared through network meta-analysis by estimating standardized mean differences (SMD) with 95% confidence intervals (CIs). Study quality was evaluated using the Joanna Briggs Institute Critical Appraisal Tool.</p><p><strong>Results: </strong>This study included 54 studies. The network meta-analysis results showed that in nursing education, VR, compared to traditional teaching, improved students' satisfaction (SMD = 0.93, 95% CI: 0.07 to 1.80), knowledge (SMD = 0.60, 95% CI: 0.30 to 0.90), and practical skills (SMD = 1.06, 95% CI: 0.57 to 1.55), while AI only enhanced knowledge (SMD = 1.11, 95% CI: 0.60 to 1.62). There was no significant difference in the indirect comparison between AI and VR. In clinical medicine, both VR and AI improved knowledge (VR: SMD = 0.75, 95% CI: 0.32 to 1.19; AI: SMD = 0.81, 95% CI: 0.10 to 1.51) and practical skills (VR: SMD = 1.14, 95% CI: 0.65 to 1.63; AI: SMD = 0.91, 95% CI: 0.16 to 1.66) compared to traditional teaching, but no significant difference was found in the indirect comparison between AI and VR.</p><p><strong>Conclusions: </strong>Future research should focus on direct comparisons between AI and VR, assess their long-term educational effects, and design integrated teaching models that harness the strengths of both technologies to inform evidence-based improvements in instructional practice.</p><p><strong>Registration: </strong>(PROSPERO): CRD42024605827.</p>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"107008"},"PeriodicalIF":4.2,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Absenteeism among nursing students in classroom and clinical settings presents ongoing challenges to academic performance, clinical competency, and program completion. Understanding its causes, impacts and mitigation strategies is critical for improving student outcomes.
Aim
To map the existing literature on absenteeism among undergraduate nursing students. The objectives were (1) to identify the factors contributing to absenteeism; (2) to examine the academic, clinical, and professional impacts of absenteeism; and (3) to explore strategies used to address this issue.
Design
Scoping review.
Methods
A comprehensive literature search was conducted in four major databases, including MEDLINE (Ovid), CINAHL (EBSCO), EMBASE, PsycINFO (Ovid) and also in Google Scholar. Keywords included “nursing students,” “absenteeism,” “classroom attendance,” and “clinical placement”. Studies published in English between 2000 and 2024 were included. Titles, abstracts, and full texts were screened, and relevant studies were analysed using content analysis, consistent with JBI guidance for scoping reviews. Findings were subsequently mapped and categorised into three overarching domains: contributing factors, impacts, and strategies to address absenteeism.
Results
Twenty-six studies were included. Absenteeism in classroom and clinical settings reflected four broad factors: teaching and academic factors, personal and health factors, logistical and institutional factors, and social and cultural factors. Impacts of absenteeism included reduced academic performance, delayed progression, and diminished clinical competency and skill development. Strategies to mitigate absenteeism were categorised into five domains: academic and curriculum support, student engagement and motivation, student wellbeing and support services, governance and policy enforcement, and community, clinical, and collaborative engagement.
Conclusion
Absenteeism in nursing education is multifaceted and has an adverse impact on both academic and clinical outcomes. Addressing this issue requires a holistic, multi-level approach that combines academic support, student engagement, institutional governance, and collaborative partnerships. Further research is needed to evaluate the effectiveness of these strategies.
{"title":"Absenteeism among undergraduate nursing students: a scoping review","authors":"Eleni Kata , Seema Reddy , Rukshana Nisha , Julie Reis , Komal Kant , Michelle Stubbs , Ana Conikeli , Atelaite Kateni , Laisa Yavita , Lavenia Raiwalui , Luse Sivo , Matelita Drokaasaqa Ravai , Mereseini Kamunaga , Natasha Ali , Nikhat Shagufta Naaz , Radhika Sami , Rajesh Chandra , Shobhna Mala , Suraki Tavaita , Vilimaina Takayawa , Ritin Fernandez","doi":"10.1016/j.nedt.2026.107006","DOIUrl":"10.1016/j.nedt.2026.107006","url":null,"abstract":"<div><h3>Background</h3><div>Absenteeism among nursing students in classroom and clinical settings presents ongoing challenges to academic performance, clinical competency, and program completion. Understanding its causes, impacts and mitigation strategies is critical for improving student outcomes.</div></div><div><h3>Aim</h3><div>To map the existing literature on absenteeism among undergraduate nursing students. The objectives were (1) to identify the factors contributing to absenteeism; (2) to examine the academic, clinical, and professional impacts of absenteeism; and (3) to explore strategies used to address this issue.</div></div><div><h3>Design</h3><div>Scoping review.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in four major databases, including MEDLINE (Ovid), CINAHL (EBSCO), EMBASE, PsycINFO (Ovid) and also in Google Scholar. Keywords included “nursing students,” “absenteeism,” “classroom attendance,” and “clinical placement”. Studies published in English between 2000 and 2024 were included. Titles, abstracts, and full texts were screened, and relevant studies were analysed using content analysis, consistent with JBI guidance for scoping reviews. Findings were subsequently mapped and categorised into three overarching domains: contributing factors, impacts, and strategies to address absenteeism.</div></div><div><h3>Results</h3><div>Twenty-six studies were included. Absenteeism in classroom and clinical settings reflected four broad factors: teaching and academic factors, personal and health factors, logistical and institutional factors, and social and cultural factors. Impacts of absenteeism included reduced academic performance, delayed progression, and diminished clinical competency and skill development. Strategies to mitigate absenteeism were categorised into five domains: academic and curriculum support, student engagement and motivation, student wellbeing and support services, governance and policy enforcement, and community, clinical, and collaborative engagement.</div></div><div><h3>Conclusion</h3><div>Absenteeism in nursing education is multifaceted and has an adverse impact on both academic and clinical outcomes. Addressing this issue requires a holistic, multi-level approach that combines academic support, student engagement, institutional governance, and collaborative partnerships. Further research is needed to evaluate the effectiveness of these strategies.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 107006"},"PeriodicalIF":4.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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