Nurse Education Today最新文献

{"title":"Exploring the development of non-technical skills in pre-registration nursing students: A qualitative descriptive study","authors":"Ying Sun","doi":"10.1016/j.nedt.2025.106969","DOIUrl":"10.1016/j.nedt.2025.106969","url":null,"abstract":"<div><h3>Background</h3><div>Non-technical skills, such as communication, teamwork, empathy, and emotional intelligence are critical for safe and effective nursing practice. While current nursing education tends to emphasize technical skills, the nuanced development of non-technical skills—particularly how they are shaped by personal experiences, low-fidelity simulation, and their interplay with technical skills—remains underexplored.</div></div><div><h3>Aim</h3><div>To explore pre-registration nursing students' experiences in developing and applying non-technical skills within clinical and educational contexts.</div></div><div><h3>Design</h3><div>A qualitative descriptive study.</div></div><div><h3>Setting</h3><div>A large Australian university offering pre-registration nursing programmes.</div></div><div><h3>Participants</h3><div>Eight pre-registration nursing students (Bachelor and Master levels) with clinical placement experience.</div></div><div><h3>Methodology</h3><div>Data were collected through two focus groups (one face-to-face, one virtual) using a semi-structured interview guide. Reflexive thematic analysis was applied to identify patterns in non-technical skills development.</div></div><div><h3>Results</h3><div>Three key insights emerged: (1) Personal life experiences—including prior healthcare roles, volunteering, and non-clinical work—significantly shape how students understand and apply non-technical skills, suggesting a valuable but underrecognized learning pathway; (2) Low-fidelity simulations, while accessible, provide limited opportunities for developing the emotional and interpersonal dimensions of non-technical skills, raising concerns about their educational efficacy; (3) non-technical skills are not separate from technical skills but actively support their application, with strong communication and emotional regulation skills enhancing the effectiveness and safety of technical procedures.</div></div><div><h3>Conclusion</h3><div>Nursing education should intentionally integrate students' lived experiences into the development of NTS, explicitly teach emotional intelligence as a core component of non-technical competency, and design simulations that foster emotional realism. Recognising the interdependence between NTS and TS will better prepare students for the emotional and relational complexity of real-world nursing practice, ultimately enhancing resilience, adaptability, and humanistic care.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106969"},"PeriodicalIF":4.2,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936417","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":"Reclaiming nursing theory in the global south: Toward a contextually relevant framework","authors":"Tania de Villiers,&nbsp;Una Kyriacos","doi":"10.1016/j.nedt.2025.106970","DOIUrl":"10.1016/j.nedt.2025.106970","url":null,"abstract":"<div><h3>Background</h3><div>This paper extends the North–South dialogue on nursing theory, not by lamenting its underdevelopment in the South but by interrogating the dominance of Eurocentric nursing theory in the Global South. Nurse theorists in the Global North (Euro-North America) espouse the link between nursing theory, professionalization and scholarship as foundational to advancing practice, education, and research. From a Global South perspective, these ideations are context reliant and should be viewed through a multicultural lens. The importation of Eurocentric nursing theories that are not aligned to local cultural and nursing values raises ethical issues about patients' right to acceptable care. Despite critique of Eurocentric theories, there is a notable absence in most Global South countries of locally developed alternatives grounded in indigenous knowledge systems and cultural contexts.</div></div><div><h3>Problem</h3><div>The dearth of publications about the use of nursing theories in four selected countries in the Global South implies that nursing in these regions is largely atheoretical. Atheoretical nursing practice is not guided by a specific conceptual framework and may therefore be considered to be lacking in professionalization and scholarship. This characterization of nursing limits a cohesive, evidence-based team approach to measuring patient outcomes which has implications for patient safety and quality of care.</div></div><div><h3>Aim</h3><div>This paper interrogates the dominance of Eurocentric nursing theories in the Global South and examines how culturally grounded frameworks can reclaim nursing science through locally meaningful models such as <em>Ubuntu</em> Nursology. Using four emerging economies (China, Brazil, India and South Africa) as case examples, we highlight disparities in theory development and propose that Advanced Practice Nurses (APNs) can catalyze contextually relevant theorizing in education, research, and practice.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106970"},"PeriodicalIF":4.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980957","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":"Clinical ethics observation embedded in nursing ethics education: Nursing students' experiences","authors":"Wei Liang ,&nbsp;Chenhui Zhu ,&nbsp;Ka Ming Chow ,&nbsp;Yetunde Oluwafunmilayo Tola ,&nbsp;Yong Li ,&nbsp;Qin Xu ,&nbsp;Yan Ji ,&nbsp;Yuanpeng Ren","doi":"10.1016/j.nedt.2025.106967","DOIUrl":"10.1016/j.nedt.2025.106967","url":null,"abstract":"<div><h3>Background</h3><div>Nursing ethics is foundational to the provision of quality nursing care. Teaching methods such as in-class case analysis and standardised patient interactions may fail to fully replicate the complexity and dynamic nature of real-world clinical practice. Clinical ethics observation engages students in real-world clinical settings to reflect on nursing ethics through guided observation. Given that understanding student perspectives is crucial for quality assessment and enhancement in higher education, qualitative research is necessary to evaluate this teaching method.</div></div><div><h3>Objective</h3><div>This study aimed to explore the experiences and perspectives of baccalaureate nursing students who participated in a clinical ethics observation module embedded in a nursing ethics course.</div></div><div><h3>Design</h3><div>A qualitative descriptive design was used, involving five focus groups conducted in December 2024.</div></div><div><h3>Setting</h3><div>Participants were recruited from the second-year cohort of an undergraduate nursing programme at a medical university in China.</div></div><div><h3>Participants</h3><div>Twenty-nine second-year baccalaureate nursing students (mean age: 19.34 years) participated.</div></div><div><h3>Methods</h3><div>The clinical ethics observation module consisted of three phases: preparatory, observation, and reflection. The 90-min observation phase was conducted in the patient wards of a tertiary care teaching hospital. Focus groups were conducted by two moderators using a semi-structured interview guide. Data were analysed using latent content analysis with an inductive approach.</div></div><div><h3>Results</h3><div>The qualitative analysis revealed four key themes: (1) reflecting on the gap between ‘ideal’ ethical decisions and ‘real’ ethical behaviours, (2) impact on knowledge application and competence building, (3) inspiring future self-improvement in nursing professionalism, and (4) suggestions for future improvement.</div></div><div><h3>Conclusions</h3><div>This study is among the first to report findings on the use of clinical ethics observation in nursing ethics education. The module facilitated students' knowledge application and competence building and motivated them to pursue professional growth. Students' suggestions provided valuable insights for refining and implementing this teaching method in future curricula.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106967"},"PeriodicalIF":4.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939766","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 “From student to RN: Newly graduated nurses' understanding and experience of discrimination in nursing education” [Nurse Educ. Today, 155, December 2025, 106859]","authors":"Deema Mahasneh ,&nbsp;Noordeen Shoqirat ,&nbsp;Charleen Singh ,&nbsp;Tuba Sengul ,&nbsp;Zyrene Marsh ,&nbsp;Joanne “Jody” Minnick","doi":"10.1016/j.nedt.2025.106966","DOIUrl":"10.1016/j.nedt.2025.106966","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106966"},"PeriodicalIF":4.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885834","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":"Impact of asynchronous online cancer education for nurses on practice outcomes: A systematic review using the kirkpatrick evaluation model","authors":"Helen Cope,&nbsp;Karen Campbell","doi":"10.1016/j.nedt.2025.106964","DOIUrl":"10.1016/j.nedt.2025.106964","url":null,"abstract":"<div><h3>Background</h3><div>Continuing education is critical for oncology nurses to enable the delivery of safe, efficient, specialist care based on current evidence-based guidelines. Accessing training opportunities can be challenging in the face of work and staffing pressures. Asynchronous online education can circumvent this barrier but despite growth in popularity, evidence of its effectiveness on practice outcomes is weak.</div></div><div><h3>Aim</h3><div>To evaluate and synthesise evidence for the impact of asynchronous online cancer education for nurses on practice outcomes.</div></div><div><h3>Methods</h3><div>A systematic approach was used to identify primary studies in the following databases: CINAHL, MEDLINE, APA, PsychInfo, ERIC, EMBASE, PubMed and Web of Science. Critical appraisal was guided by the Medical Education Research Quality Instrument (MERSQI) and Effective Public Health Practice Project (EPHPP) tools for quantitative studies, and the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies. The Kirkpatrick Four Level Model of training evaluation and a modified effect direct plot were used to facilitate synthesis of the evidence.</div></div><div><h3>Findings</h3><div>Thirty studies of varying research design were included in the review. Vast heterogeneity was apparent in research designs, participants, intervention design and duration, and outcome measures. Due to this heterogeneity, it was difficult to establish that one design of education was more effective than another. Patient outcomes were not measured in any of the thirty studies reviewed. Behavioural change was objectively measured in two (7 %) studies, evaluating screening rates and pain assessments, and self-reported in eleven (37 %) studies regarding changes such as adapting to patients' language needs, cytotoxic drug handling, and discussing reproductive health. At least one educational outcome (nurses' knowledge, skills, attitudes, beliefs, confidence or self-efficacy) was measured in all thirty papers, however, improvements in these did not necessarily translate to evidence of changing practice outcomes. The overall quality of evidence was weak, particularly with respect to research design and validity of outcome measures.</div></div><div><h3>Conclusion</h3><div>The need for more rigorous research in this field continues as there were limited evidence available to evaluate the direct impact of online cancer education on practice outcomes. Practice outcome evaluation could be enhanced by using measurements that are less subject to bias.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106964"},"PeriodicalIF":4.2,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936394","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":"Interdisciplinary education between nursing and engineering: A scoping review","authors":"Can Liu (刘灿) ,&nbsp;Chong Tian (田翀) ,&nbsp;Furong Wang (王芙蓉)","doi":"10.1016/j.nedt.2025.106963","DOIUrl":"10.1016/j.nedt.2025.106963","url":null,"abstract":"<div><h3>Introduction</h3><div>Nursing engineering has gained increasing attention and has developed at different levels of nursing education globally. Interdisciplinary education combining nursing and engineering is essential for equipping graduates to address complex healthcare challenges and to navigate the modern healthcare landscape. However, the implementation of such interdisciplinary education in academic institutions remains underexplored.</div></div><div><h3>Aim</h3><div>This review aimed to examine the scope of the literature on interdisciplinary education in nursing and engineering in an academic setting.</div></div><div><h3>Design</h3><div>This scoping review was designed and conducted in accordance with the PRISMA-ScR checklist.</div></div><div><h3>Data sources</h3><div>Five databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) were searched from inception to August 6, 2024, for studies on nursing-engineering interdisciplinary education within academic settings.</div></div><div><h3>Review methods</h3><div>Two independent reviewers screened the papers, and data extraction was carried out systematically to ensure accuracy and consistency. The data were analyzed using content analysis.</div></div><div><h3>Results</h3><div>A total of 29 articles were included and categorized into four thematic groups: (a) types of the interdisciplinary education intervention, (b) development of educational programs, (c) effectiveness of educational program, and (d) Barriers to and facilitators for the implementation of interdisciplinary education.</div></div><div><h3>Conclusions</h3><div>The results indicate a growing global interest in nursing engineering education, which holds promise for enhancing students' knowledge, skills, and competencies. Moreover, the findings suggest the importance of interdisciplinary collaboration and learning when conducting nursing engineering education, but also reveal two critical limitations in the current delivery of education. First, the interdisciplinary education model for nursing and engineering is currently in the early stages of exploration and development, and secondly, there is an imbalance in the level of disciplinary crossover. Future work needs to be done to explore a more systematic and academic model of education and a more diverse mix of disciplines.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106963"},"PeriodicalIF":4.2,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879437","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":"Exploring the relationship between intergroup contact and mental illness stigma among Chinese nursing students: Based on the dual attitudes model","authors":"Sheng Wang ,&nbsp;Yila Ren ,&nbsp;Yuhe Liu ,&nbsp;Jiaqi Xu ,&nbsp;Siqi Chen ,&nbsp;Jinyan Xu ,&nbsp;Xiuxiu Shi","doi":"10.1016/j.nedt.2025.106965","DOIUrl":"10.1016/j.nedt.2025.106965","url":null,"abstract":"<div><h3>Background</h3><div>Intergroup contact may influence mental illness stigma. However, only a few studies have differentiated between implicit and explicit forms of stigma.</div></div><div><h3>Aim</h3><div>To determine the relationship between intergroup contact and mental illness stigma among nursing students, guided by the Dual Attitude Model (DAM).</div></div><div><h3>Design</h3><div>Cross-sectional study design.</div></div><div><h3>Methods</h3><div>A total of 96 nursing students from Hangzhou, China, were recruited through convenience and snowball sampling methods from December 2024 to January 2025. Explicit stigma was assessed using the Intergroup Contact Scale and Semantic Differential Scale, while implicit stigma was evaluated through three Single Category Implicit Association Tests (SC-IATs). Statistical analyses were conducted using SPSS 26.0.</div></div><div><h3>Results</h3><div>Overall attitudes toward mental illness were predominantly negative. Mental illness stigma differed significantly by gender, educational level, and whether participants had family members or friends diagnosed with mental illness. Intergroup contact was positively correlated with explicit stigma but had no significant association with implicit stigma. Additionally, explicit and implicit stigma were found to be unrelated.</div></div><div><h3>Conclusions</h3><div>The results indicated that both explicit and implicit stigma toward mental illness exist among Chinese nursing students, excluding explicit behavioral tendencies. Intergroup contact was found to be significantly associated with explicit stigma only, and explicit and implicit stigma are independent constructs. Future research should focus on how intergroup contact influences explicit stigma and explore which factors moderate implicit stigma to develop more effective anti-stigma interventions.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106965"},"PeriodicalIF":4.2,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879495","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":"Network of job demands-resources and depressive symptoms in clinical nursing interns: A cross-sectional study","authors":"Li Chen ,&nbsp;Yuanzi Chen ,&nbsp;Qiaoyan Wu ,&nbsp;Haiyan Wang ,&nbsp;Yunjian Qu ,&nbsp;Zhangyi Wang","doi":"10.1016/j.nedt.2025.106962","DOIUrl":"10.1016/j.nedt.2025.106962","url":null,"abstract":"<div><h3>Background</h3><div>Clinical nursing interns often face high stress from heavy workloads, interpersonal challenges, and role conflicts, which can lead to depressive symptoms. Understanding how job demands and resources affect their mental health is crucial.</div></div><div><h3>Objectives</h3><div>To explore the relationships between job demands-resources and depressive symptoms among clinical nursing interns.</div></div><div><h3>Design</h3><div>A cross-sectional design was applied.</div></div><div><h3>Methods</h3><div>A total of 813 participants were included in this study. Data were collected via questionnaires including the SNS-14-CHI, Career Self-efficacy Questionnaire, and PHQ-9. Network analysis and structural equation modeling were applied for data analysis.</div></div><div><h3>Results</h3><div>In this study, network analysis results showed that among depressive symptoms, “Sad mood” had the highest expected influence, followed by “Appetite” and “Concentration”. Meanwhile, in terms of job demands-resources and personal resources, the node with the highest expected influence was “Number of work days per week”, followed by “Being prepared” and “Problem-solving ability”. Three bridging variables were identified: “Placement workload”, “Staffing levels”, and “Number of work days per week”. The final structural equation model generally supported the results of the network analysis, with acceptable model fit.</div></div><div><h3>Conclusions</h3><div>The study confirms significant associations between job demands-resources and depressive symptoms in clinical nursing interns. “Sad mood,” “Appetite,” and “Concentration” are core depressive symptoms, while “Number of work days per week,” “Staffing levels,” “Being prepared,” and “Problem-solving ability” are key factors in job demands-resources and personal resources. Among these, “Number of work days per week” stands out as a feasible intervention target. Optimizing scheduling is associated with potential reductions in depressive symptoms, safeguard interns' mental health, and ultimately contribute to a stable healthcare workforce.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106962"},"PeriodicalIF":4.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842640","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":"Understanding student preceptorship across healthcare disciplines: The experience of preceptors","authors":"Erin Marchio ,&nbsp;Tracy Hoot ,&nbsp;Tracy M. Christianson","doi":"10.1016/j.nedt.2025.106960","DOIUrl":"10.1016/j.nedt.2025.106960","url":null,"abstract":"<div><h3>Background</h3><div>Clinical preceptorships can help ease the transition of novice nurses into practice in the clinical setting and are considered an essential component of nursing education. Unfortunately, current challenges are hindering the effectiveness of preceptorships. These include a shortage of experienced nurse preceptors willing to take on this role, limited educational opportunities and supportive practices for preceptors, and unsupportive clinical learning environments. While much research has explored the perceptions and experiences of clinical nurse preceptees and preceptors, less attention has focused on multidisciplinary preceptorship models and the similarities and differences among them.</div></div><div><h3>Aim</h3><div>The aim of this study was to explore multidisciplinary student preceptorship models from the experience and perceptions of clinical preceptors.</div></div><div><h3>Methodology</h3><div>This research project used a qualitative, phenomenological approach to explore multidisciplinary student preceptorship models.</div></div><div><h3>Methods</h3><div>Data collection took place at a hospital in British Columbia and included preceptors from multiple disciplines. The multidisciplinary departments included in this study were nursing, physiotherapy, respiratory therapy, medical imaging, and dieticians. One participant from each multidisciplinary department was selected, resulting in a purposeful sample of five preceptors. Data were collected through a pre-questionnaire designed to gather background information about participants' experience as preceptors followed by individual in-person interviews.</div></div><div><h3>Results</h3><div>All participants shared the importance of maintaining 1:1 ratios between preceptors and student preceptees during preceptorship placements. However, the duration of these preceptorship placements varied across disciplines. Staffing shortages across healthcare disciplines posed significant challenges to sustaining 1:1 ratios and hindered a preceptors' ability to attend preceptorship educational workshops.</div></div><div><h3>Conclusion</h3><div>The findings of this study can be shared and applied across disciplines to enhance student preceptorship models and retain the future generation of healthcare professionals.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106960"},"PeriodicalIF":4.2,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866675","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":"Learning with AI, not from AI: Ethical and pedagogical implications of ChatGPT in undergraduate education","authors":"Dianne Stratton-Maher ,&nbsp;Jennifer Kelly","doi":"10.1016/j.nedt.2025.106961","DOIUrl":"10.1016/j.nedt.2025.106961","url":null,"abstract":"<div><h3>Aim</h3><div>To explore how first-year nursing students engaged with ChatGPT during an assessment task, and to understand the experiences, challenges, and perceptions they reported regarding its use in academic work.</div></div><div><h3>Background</h3><div>As artificial intelligence (AI) tools like ChatGPT reshape higher education, new opportunities and ethical tensions emerge in how students learn. Rather than simply adopting AI as a shortcut, there is an urgent need to guide students toward learning with AI critically, ethically, and creatively within assessment practices. Despite the growing use of AI, limited research has examined how structured integration into undergraduate education influences learning outcomes, digital literacy, and academic integrity.</div></div><div><h3>Design</h3><div>A qualitative descriptive study investigated the ethical and pedagogical implications of integrating ChatGPT into a first-year undergraduate nursing assessment.</div></div><div><h3>Method</h3><div>Focus groups were conducted with 48 first-year nursing students following their use of ChatGPT in an assessment task. Semi-structured questions explored students' experiences, challenges, and perceptions of ChatGPT's role in their academic development. Data were analysed using Braun and Clarke's reflexive thematic analysis, supported by the AI tool CoPilot for coding rigour.</div></div><div><h3>Results</h3><div>The analysis identified six themes: initial confusion, developing skills, evaluating reliability, negotiating academic integrity, recognising future benefits, and valuing support. Students initially experienced uncertainty, particularly around ethical use and institutional messaging. Many developed critical engagement skills, using ChatGPT to improve writing clarity, language proficiency, and idea generation. However, tensions remained between the benefits of AI support and concerns about dependency, misinformation, and digital inequities.</div></div><div><h3>Conclusions</h3><div>Structured, ethical engagement with ChatGPT can foster critical literacy, digital fluency, and deeper learning outcomes in undergraduate education. To fully realise AI's potential, institutions must develop coherent policies, embed AI literacy into curriculum design, and provide targeted support for educators and students. Learning with AI, rather than passively relying on it, is essential for preparing graduates to thrive in an AI-integrated future.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"158 ","pages":"Article 106961"},"PeriodicalIF":4.2,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790244","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}