Nurse Education Today最新文献

{"title":"Enhancing the perceived clinical leadership competence of nursing undergraduates through service-learning unit led by students: A quasi-experimental study","authors":"Alberto Gallart ,&nbsp;Encarna Rodríguez-Higueras ,&nbsp;Pilar Fuster-Linares ,&nbsp;Maria Luisa Martin-Ferreres ,&nbsp;Eira Bejarano ,&nbsp;Lorena Moya ,&nbsp;Patricia Martinez-Jaimez ,&nbsp;Maria Angeles De Juan-Pardo","doi":"10.1016/j.nedt.2026.106989","DOIUrl":"10.1016/j.nedt.2026.106989","url":null,"abstract":"<div><h3>Background</h3><div>Clinical leadership by nurses is crucial to the provision of safe and high-quality care. Service-learning activities led by students (often referred to more broadly as community based learning or a form of experiential learning) can offer nursing undergraduates the opportunity to begin developing their leadership skills.</div></div><div><h3>Purpose</h3><div>To assess the impact of a service-learning led by students intervention on the perceived leadership competence of nursing undergraduates.</div></div><div><h3>Methods</h3><div>Quasi-experimental study conducted across four academic years (2017–2021) and involving 224 nursing undergraduates. In the context of their clinical placements, students in the intervention group participated in a service-learning program led by students, while controls were assigned to a standard primary care placement. Perceived leadership competence was assessed at the beginning and end of placements using the Self-Assessment Leadership Instrument (SALI), which provides a total score and four dimension scores (strategic thinking, emotional intelligence, impact and influence, and teamwork skills) and has been validated and proven reliable for use with nursing students in the Spanish population.</div></div><div><h3>Results</h3><div>Overall ratings of perceived leadership competence were 6% higher among students who participated in the service learning intervention than among controls (<em>p</em> &lt; .001), with a moderate effect (Cohen's d: 0.53; 95% CI [0.27 to 0.80]. Dimension-specific analyses indicated a moderate effect for Impact and Influence and Teamwork Skills, and a small effect for Emotional Intelligence and Strategic Thinking. No significant changes in perceived leadership competence were reported by controls.</div></div><div><h3>Conclusion</h3><div>Participation in service-learning unit led by students appears to enhance perceived leadership competence among nursing undergraduates. Further research is needed to assess their long-term impact and alignment between self-perceptions and objectively measured leadership behaviors.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106989"},"PeriodicalIF":4.2,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980959","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":"Academics' perspectives on climate change in nursing and midwifery education: A mixed-methods study","authors":"Seda Güney ,&nbsp;Seda Sarıköse ,&nbsp;Tuba Sengul ,&nbsp;Nurten Kaya","doi":"10.1016/j.nedt.2026.106986","DOIUrl":"10.1016/j.nedt.2026.106986","url":null,"abstract":"<div><h3>Background</h3><div>Climate change poses major, escalating health risks and demands curricular responses in nursing and midwifery education. However, academics' awareness, concerns, and approaches to climate change integration into the nursing/midwifery programs remain limited.</div></div><div><h3>Aim</h3><div>To examine academics' awareness, and levels of concern regarding climate change and explore their perspectives on integrating climate-related content into nursing and midwifery curricula.</div></div><div><h3>Design</h3><div>Convergent parallel mixed-methods design was used and guided by the Sustainability in Global Nursing Framework.</div></div><div><h3>Settings</h3><div>Universities with nursing and/or midwifery programs.</div></div><div><h3>Participants</h3><div>For the quantitative strand, 160 faculty members were recruited through a voluntary online survey shared via university listings and professional/social media channels. For the qualitative strand, purposeful maximum variation sampling was used to select 12 participants representing diverse academic titles, specialties, and years of experience.</div></div><div><h3>Methods</h3><div>Quantitative data were collected online using the Climate Change Awareness Scale, Climate Change Worry Scale, self-ratings, and curricular practice items. Analyses included descriptive statistics, group comparisons, and correlations. Qualitative data were thematically analyzed through a framework-informed, inductive–deductive approach with double coding and consensus. Findings were integrated into joint display tables.</div></div><div><h3>Results</h3><div>Participants reported high self-rated knowledge of climate causes and health effects, and moderately high practice awareness, while climate-related concern was moderate. Three qualitative themes emerged: (1) knowledge and perceived importance, (2) educational integration and partnerships, and (3) anticipated positive, sustained outcomes. Integrated findings indicated higher concern among academics but highlighted fragmented, elective-heavy content and credit constraints, revealing a persistent gap between motivation and institutional capacity.</div></div><div><h3>Conclusions</h3><div>Climate change content should be integrated into the core of nursing and midwifery education rather than treated as peripheral. Higher concern among faculty in state universities suggests educator motivation surpasses institutional support, highlighting an awareness–implementation gap. Strengthening credit allocation, accreditation expectations, and targeted resources is essential for consistent and sustainable integration.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106986"},"PeriodicalIF":4.2,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020464","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":"Effect of flipped classroom and screen-based simulation on nursing students' clinical judgment: A quasi-experimental study","authors":"Rachid Gouifrane ,&nbsp;Halima Lajane ,&nbsp;Mounir Arai ,&nbsp;Omar Abidi ,&nbsp;Ghizlane Chemsi ,&nbsp;Mohamed Radid","doi":"10.1016/j.nedt.2026.106983","DOIUrl":"10.1016/j.nedt.2026.106983","url":null,"abstract":"<div><h3>Background</h3><div>Clinical judgment is essential in nursing education, especially in emergency care. However, several studies report that nursing students face persistent challenges in developing this competency. Traditional teaching methods and limited instructional time in nursing curricula often fail to provide the necessary conditions for fostering these skills. This quasi-experimental study investigated the effect of a flipped classroom combined with screen-based simulation on clinical judgment development.</div></div><div><h3>Method</h3><div>Seventy-nine second-year nursing students enrolled in an emergency care course were stratified by gender, academic performance, and baseline knowledge, then randomly assigned to one of three groups: (1) traditional lecture (control), (2) flipped classroom, or (3) flipped classroom combined with screen-based simulation (FC + SBS). Clinical judgment was assessed using a Key Features exam (five scenarios, 30 items), developed in accordance with the NCSBN Clinical Judgment Measurement Model and the Lasater Clinical Judgment Rubric, and administered at both immediate and six-week delayed post-tests.</div></div><div><h3>Results</h3><div>Experimental groups demonstrated significantly higher clinical judgment scores than the control group (<em>p</em> &lt; .001). At six weeks, the FC + SBS group showed the highest retention (M = 75.2%, SD = 5.7) compared to the flipped classroom group (M = 69.1%, SD = 6.5) and the control group (M = 61.4%, SD = 8.2; p &lt; .001). While the trend favored the FC + SBS group over the flipped classroom group, post-hoc analysis did not reach statistical significance (<em>p</em> = .08). More students in the experimental groups reached the “Accomplished” level on the Lasater Clinical Judgment Rubric, consistent with the quantitative findings.</div></div><div><h3>Conclusion</h3><div>Integrating screen-based simulation into flipped classrooms appears to be effective in supporting clinical judgment development and promoting retention of decision-making skills in nursing education. Further studies are needed to confirm long-term effects and clarify the impact of flipped classroom and screen-based simulation in real patient care settings.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106983"},"PeriodicalIF":4.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980956","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":"Challenging the narrative to reimagine health disparities research and education: Perspectives from international scholars","authors":"Soo Hyun Kim ,&nbsp;Celeste Chavez ,&nbsp;Thomas Hinneh ,&nbsp;Erh-Chi Hsu ,&nbsp;Getachew Kassa ,&nbsp;Sarah Won ,&nbsp;Samuel Byiringiro","doi":"10.1016/j.nedt.2025.106971","DOIUrl":"10.1016/j.nedt.2025.106971","url":null,"abstract":"<div><div>This paper, drawing on the experiences of international and US-based nursing scholars, critically reflects on health disparities research and education in the US. We call for the need to expand health disparities discourse beyond race and ethnicity to include other axes of disparity, such as gender and sexuality, socioeconomic conditions, rural-urban divides, and displacement due to conflict. Examples from Ethiopia, Ghana, South Korea, Taiwan, and Rwanda illustrate how geopolitical factors, infrastructure, and local cultural contexts shape health disparities. We also critique the practice of binary and hierarchical racial comparisons, aggregation of racial and ethnic categories, and use of a single explanatory framework, all of which obscure important nuances and limit the scope of nursing research and education. We advocate culturally respectful approaches that apply intersectional lenses to each local context of health disparities. This process requires collaboration across multiple sectors, including researchers, clinicians, and community partners from diverse settings, in reciprocal learning environments. Our reflections offer actionable strategies and modalities for rethinking health disparities education. Globally nuanced perspectives, the ones examining multiple axes of disparities through collaboration of diverse sectors and backgrounds, can enrich nursing education, deepen understanding of how social determinants of health intersect in each context, and better equip future nursing researchers and practitioners to design and implement equitable healthcare interventions tailored to the needs of diverse populations.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106971"},"PeriodicalIF":4.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980899","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":"Efficacy of the Socialization, Externalization, Combination, and Internalization model in clinical nursing education: A systematic review and meta-analysis","authors":"Kaihan Yang ,&nbsp;Ke Zhou ,&nbsp;Yujie Xie ,&nbsp;Yile Li ,&nbsp;Guifeng Wang ,&nbsp;Sijia Ye ,&nbsp;Dan Luo ,&nbsp;Zhuyue Li","doi":"10.1016/j.nedt.2026.106984","DOIUrl":"10.1016/j.nedt.2026.106984","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In recent years, the Socialization, Externalization, Combination, and Internalization (SECI) model has gained widespread application in clinical nursing courses across China. Despite its prevalence, a comprehensive and quantitative evaluation of its outcomes remains unaddressed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To systematically assess the efficacy of the SECI model in Chinese clinical nursing education.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A stepwise method was used by searching four databases (China National Knowledge Infrastructure [CNKI], Wanfang Database, Chinese Scientific Journals Database [VIP], and SinoMed) to retrieve published papers in Chinese examining the application of the SECI model in clinical nursing education. The time frame for the searches included all literature before March 31, 2025. The investigators independently completed study selection, data extraction, quality assessment and analysis of all included studies. Review Manager (RevMan, version 5.4) was used to analyze the data. The methodological quality of the included studies was evaluated using the Cochrane Risk of Bias 2 (Cochrane RoB 2) tool. The risk of bias assessment, meta-analysis, and heterogeneity testing were conducted using RevMan version 5.4 software. The 95% Prediction Intervals (&lt;em&gt;PIs&lt;/em&gt;) were calculated with R software (version 4.3.1). The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of five randomized controlled trials conducted in China were included in the systematic review and meta-analysis, consisting of 340 participants (163 in the SECI model group and 177 in the control group). The meta-analysis revealed that the theoretical knowledge scores (&lt;em&gt;SMD&lt;/em&gt; = 1.44, 95% &lt;em&gt;CI&lt;/em&gt;: 0.80–2.08, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; 95% &lt;em&gt;PI&lt;/em&gt;: −0.02 − 2.90), skill scores (&lt;em&gt;SMD&lt;/em&gt; = 2.88, 95% &lt;em&gt;CI&lt;/em&gt;: 1.08–4.68, &lt;em&gt;P&lt;/em&gt; = 0.002; 95% &lt;em&gt;PI&lt;/em&gt;: −0.67 − 6.43), overall competence (&lt;em&gt;SMD&lt;/em&gt; = 0.87, 95% &lt;em&gt;CI&lt;/em&gt;: 0.63–1.12, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; 95% &lt;em&gt;PI&lt;/em&gt;: 0.41–1.34), professional commitment (&lt;em&gt;SMD&lt;/em&gt; = 0.77, 95% &lt;em&gt;CI&lt;/em&gt;: 0.40–1.13, &lt;em&gt;P&lt;/em&gt; &lt; 0.001), and teaching satisfaction (&lt;em&gt;SMD&lt;/em&gt; = 2.61, 95% &lt;em&gt;CI&lt;/em&gt;: 1.81–3.42, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) were significantly higher in the SECI model group than in the control group. Sensitivity analysis confirmed the results of our meta-analysis were reliable. The evidence grades of the results regarding theoretical knowledge scores and overall competence were rated as low, while those for skill scores, professional commitment, and teaching satisfaction were rated as very low.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Based on low- to very-low-certainty evidence, the SECI model may improve students' theoretical knowledge scores, skill scores, overall competence, professional commitment, and teaching satisfaction compared with contro","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106984"},"PeriodicalIF":4.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024073","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":"The use of digital gamification, extended reality, artificial intelligence, and integrated digital learning tools in palliative care education of undergraduate nurses: A systematic review","authors":"Adam Graham ,&nbsp;Minna Hökkä ,&nbsp;Sari Pramila-Savukoski ,&nbsp;Miina-Liisa Flinkkilä ,&nbsp;Marco Tomietto ,&nbsp;Kristina Mikkonen","doi":"10.1016/j.nedt.2026.106982","DOIUrl":"10.1016/j.nedt.2026.106982","url":null,"abstract":"<div><h3>Background</h3><div>Nurses are at the forefront of providing palliative care, playing a critical role in ensuring high-quality support for patients and their families. Emerging digital and immersive technologies offer new opportunities to simulate complex palliative care scenarios, bridging the gap of limited clinical experiences and developing palliative care competence.</div></div><div><h3>Objectives</h3><div>To explore and analyse what type of interventions have been implemented within palliative care education of undergraduate nursing students using digital and immersive technologies. Secondary aims were exploring the experiences and effect on palliative care competence.</div></div><div><h3>Design</h3><div>A systematic review of mixed-methods interventional studies, based on Joanna Briggs Institute guidelines.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across Ovid Medline, CINAHL, Scopus, Web of Science, Cochrane Library, and ERIC in March 2025. Eligible studies included empirical research on undergraduate nursing students using digital and immersive technologies to deliver palliative care education. Quality assessment followed JBI critical appraisal tools. Quantitative studies were analysed by Cohen d effect sizes and qualitative studies with content analysis.</div></div><div><h3>Results</h3><div>Six studies met the inclusion criteria and were published in 2023 or 2024. Interventions varied between use of immersive simulation and screen-based simulation. Quantitative findings indicated statistically significant improvements in palliative care attitudes, abilities and readiness for practice with effect size ranging from 0.40 (<em>p</em> = .01) to 1.13 (<em>p</em> &lt; .001). Qualitative content analysis identified two main themes: clinical experience and digital learning experience.</div></div><div><h3>Conclusions</h3><div>Digital and immersive simulation holds significant promise in addressing gaps in undergraduate nursing palliative care competences. Research in this field is highly limited, with no use of artificial intelligence within simulations used in the reviewed research. Further high-quality, standardised, and longitudinal studies are essential to determine sustained impact and generalisability.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106982"},"PeriodicalIF":4.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980898","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":"The impact of clinical learning environment on nursing interns' professional identity: The mediating role of belongingness","authors":"Qian Yao ,&nbsp;Jian Luo ,&nbsp;Yu Ni ,&nbsp;Chunxia He ,&nbsp;Chuanying Huang ,&nbsp;Ting Xu ,&nbsp;Xiuchuan Li ,&nbsp;Jimei Zhang","doi":"10.1016/j.nedt.2026.106974","DOIUrl":"10.1016/j.nedt.2026.106974","url":null,"abstract":"<div><h3>Background</h3><div>According to social identity theory, nursing interns' professional identity is shaped by their belongingness, and the clinical learning environment significantly contributes to its development. However, the specific relationship among the clinical learning environment, belongingness, and professional identity remains unclear.</div></div><div><h3>Objectives</h3><div>This study aimed to explore the mediating role of belongingness in the relationship between the clinical learning environment and professional identity. Additionally, it provides a reference for nursing managers to refine and improve nursing interns' educational strategies.</div></div><div><h3>Methods</h3><div>A total of 304 nursing interns from three hospitals in Chengdu, Sichuan Province, were recruited between January and February 2025 through convenience sampling. Data were collected using a demographic and sociological questionnaire, the Clinical Learning Environment Scale, the Belongingness Scale, and the Professional Identity Scale. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Statistics (version 27.0) with independent-samples <em>t</em>-tests, one-way analysis of variance, and Pearson correlations. The mediating effect of belongingness was analyzed using the SPSS Process macro (Model 4).</div></div><div><h3>Results</h3><div>The clinical learning environment was positively correlated with belongingness (r = 0.590, <em>P</em> &lt; 0.001) and with professional identity (r = 0.537, <em>P</em> &lt; 0.001). Additionally, the belongingness exhibited a positive correlation with professional identity (r = 0.779, <em>P</em> &lt; 0.001). Bootstrap analysis confirmed that belongingness mediated the relationship between the clinical learning environment and professional identity among nursing interns (95 % CI = 0.177, 0.283), with an indirect effect value of 0.228 and a mediating effect accounting for 79.72 %.</div></div><div><h3>Conclusion</h3><div>The clinical learning environment significantly impacts the nursing interns' professional identity. The belongingness mediates the relationship between the clinical learning environment and professional identity. Therefore, nursing administrators and educators should prioritize optimizing the clinical learning environment, providing nursing interns with high-quality learning and teaching resources, and fostering a positive work atmosphere to effectively strengthen their belongingness and professional identity.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106974"},"PeriodicalIF":4.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980958","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":"How do undergraduate nursing students choose to reflect? A descriptive online survey comparing preferences towards diverse methods of reflection","authors":"Caroline Browne ,&nbsp;Helen Dugmore","doi":"10.1016/j.nedt.2026.106973","DOIUrl":"10.1016/j.nedt.2026.106973","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to explore how final semester undergraduate nursing students engage with reflective practice, by comparing their preferences towards digital storytelling or written reflections.</div></div><div><h3>Background</h3><div>Reflective practice is an essential component of professional nursing practice. Reflection is embedded as both a learning and an assessment tool in undergraduate nursing curriculum, however it may not come easily to some students. Digital storytelling was integrated into the final semester of a Bachelor of Nursing program, as an innovative way to engage students in reflective practice.</div></div><div><h3>Design</h3><div>A descriptive survey design was used in this study.</div></div><div><h3>Methods</h3><div>An online survey was used to explore nursing student experiences using both digital storytelling and written forms of reflection. Descriptive statistics were used to analyse student preferences, and content analysis was used to analyse open ended responses.</div></div><div><h3>Results</h3><div>A total of 147 responses were received across two cohorts (response rate of 24 %). Preferences were mixed between the two methods. Digital Storytelling provided an opportunity for students to share their stories with their peers leading to reflective learning, whilst written reflection provided an avenue to enhance clinical confidence and identify areas for development. Both methods had challenges including the timing of reflective activities within their units, expressing and sharing emotion, and working with technology and assessment restrictions to complete reflections.</div></div><div><h3>Conclusion</h3><div>Students need to be introduced to different methods of reflection throughout their undergraduate studies, so they can engage in reflective practices that work for them. Nursing educators need to recognise the importance of students sharing their stories to derive meaning from their experiences and transform their learning.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106973"},"PeriodicalIF":4.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980897","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":"AI-enhanced virtual reality simulation for nursing students' empathy: Automated scoring and inter-rater reliability in a randomised controlled study","authors":"Pao-Ju Chen","doi":"10.1016/j.nedt.2025.106968","DOIUrl":"10.1016/j.nedt.2025.106968","url":null,"abstract":"<div><h3>Background</h3><div>Empathy is a fundamental nursing competence that supports effective communication and high-quality care. In obstetric settings, the emotional intensity and unpredictability of childbirth place heightened demands on advanced empathic communication. Yet conventional teaching methods often lack immersion and interactivity, limiting students' capacity to respond empathically in high-pressure clinical situations.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of the Virtual Reality Integrated Artificial Intelligence Empathic Communication Simulation (VR-AI-ECS) in enhancing nursing students' empathic communication, and to examine the concordance between AI-generated and educator ratings.</div></div><div><h3>Methods</h3><div>A randomised controlled mixed-methods design assigned students to an experimental group (VR-AI-ECS, <em>n</em> = 40) or a control group (360° video with standardised patient interaction, <em>n</em> = 40). The experimental group experienced first-person simulations incorporating AI-guided dialogue and real-time feedback. Empathic communication was measured at T0, T1, and T2 using the Empathic Communication Performance Rating Scale, evaluated by both AI and educators. Quantitative data were analysed using generalised estimating equations and intraclass correlation coefficients (ICC), and qualitative insights were gathered from focus groups.</div></div><div><h3>Results</h3><div>The experimental group demonstrated significantly higher empathic communication scores at T1 (p &lt; .001, <em>Cohen's d</em> = 0.96) and T2 (p = .010, <em>Cohen's d</em> = 0.60). AI and educator ratings were strongly correlated (ICC = 0.81). Students reported that dual perspectives and AI feedback enhanced their awareness and communication.</div></div><div><h3>Conclusions</h3><div>The VR-AI-ECS effectively enhances empathic communication and self-reflection among nursing students. AI-generated scoring shows strong alignment with expert judgement, supporting its application in scalable, standardised, and personalised empathy training.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"159 ","pages":"Article 106968"},"PeriodicalIF":4.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919177","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 to thrive in transcultural nursing education: A Constructivist Grounded Theory approach","authors":"Lijie Xu ,&nbsp;Shuqin Xiao ,&nbsp;Jane Haines Alice ,&nbsp;June Liu ,&nbsp;Meihua Ji ,&nbsp;Weiwen Wang","doi":"10.1016/j.nedt.2025.106972","DOIUrl":"10.1016/j.nedt.2025.106972","url":null,"abstract":"<div><h3>Background</h3><div>Global nursing education increasingly emphasizes cross-cultural competence development through international exchanges. While existing research highlights that cross-cultural training enhances nursing students' language proficiency, clinical skills, and cultural awareness in the short term, less is known about their long-term professional and personal growth.</div></div><div><h3>Objective</h3><div>This study explored the growth trajectory of Chinese nursing students in Sino-U.S. exchange program, focusing on their experiences and transitions.</div></div><div><h3>Design</h3><div>A constructivist grounded theory approach was employed.</div></div><div><h3>Setting</h3><div>This study examined Chinese nursing students who completed a one-year, three-semester program at a U.S. nursing school during their junior year.</div></div><div><h3>Participants</h3><div>From October to December 2024, 15 Chinese nursing students were recruited using purposive and theoretical sampling methods. Eligible participants had completed a one-year Sino-U.S. nursing exchange program during their junior year (program period: 2015–2024), with the length of time since program completion ranging from 1 to 8 years (mean ± standard deviation: 5.47 ± 2.23 years).</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted via Zoom, exploring participants' growth trajectories. Data analysis followed constructivist grounded theory, using constant comparison to progress from initial to theoretical coding, identifying core concepts.</div></div><div><h3>Results</h3><div>Fifteen participants were included in the study. Analysis of the interview data generated four theoretical codes: (1) Self-Awaking, (2) Self-Responsibility, (3) Self-Empowerment, and (4) Self-Expansion—along with ten focused codes. These codes collectively formed the 4S Spiral Growth Model (4S-SGM) within the context of transcultural nursing education.</div></div><div><h3>Conclusion</h3><div>This study employed Constructivist Grounded Theory to examine nursing students' personal growth after studying abroad. It introduces a novel model illustrating the impact of international exchange on their development. The findings offer practical insights for improving exchange programs and provide empirical support for fostering globally competent nursing professionals.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"160 ","pages":"Article 106972"},"PeriodicalIF":4.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915310","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}