Nurse Education in Practice最新文献

{"title":"Generative AI and intelligent tutoring systems in nursing education: A systematic review of impacts on higher-order thinking skills and clinical competency","authors":"Hafizs Nasirun ,&nbsp;Sigit Mulyono ,&nbsp;Ayu Widowati Dwi Hapsari ,&nbsp;Hendri Hardi Wiradinata ,&nbsp;Mustika Ratu","doi":"10.1016/j.nepr.2026.104847","DOIUrl":"10.1016/j.nepr.2026.104847","url":null,"abstract":"<div><h3>Aims</h3><div>This review synthesizes the impact of Artificial Intelligence (AI) on nursing students' clinical competency, Higher-Order Thinking Skills (HOTS) and educational outcomes to differentiate between procedural efficiency and deep cognitive retention.</div></div><div><h3>Background</h3><div>Generative AI and Intelligent Tutoring Systems (ITS) offer personalized scaffolding. However, their comparative efficacy against conventional pedagogical approaches, such as face-to-face lectures and standard non-AI simulations, remains controversial, particularly regarding the potential trade-off between skill acquisition and cognitive depth.</div></div><div><h3>Design</h3><div>A systematic literature review guided by PRISMA 2020 guidelines.</div></div><div><h3>Methods</h3><div>A comprehensive search across seven databases (PubMed, EBSCOhost, Scopus, ScienceDirect, ProQuest, IEEE Xplore, JSTOR) from 2015 to 2025 identified 14 eligible studies (7 RCTs, 7 Quasi-experiments) which were synthesized across East Asia, Europe and Africa. Quality was appraised using JBI tools, with the protocol registered in PROSPERO.</div></div><div><h3>Results</h3><div>Synthesis of 14 studies (n = 1107) reveals a critical divergence. AI interventions significantly improved psychomotor application, procedural skills and communication mechanics compared with traditional instructor-led teaching methods. However, findings on HOTS and retention were mixed; while GenAI enhanced inquiry-based problem solving, it occasionally compromised critical reflection and long-term knowledge retention compared with human-led instruction. Furthermore, a \"gap in algorithmic empathy\" was evident, with AI failing to effectively enhance cultural awareness.</div></div><div><h3>Conclusion</h3><div>AI functions as a robust \"pedagogical scaffold\" for procedural simulation but risks inducing \"cognitive offloading\" if used passively. Educators must adopt a Hybrid-Scaffolded Model: leveraging AI for iterative drills while prioritizing human facilitation for deep cognitive consolidation, ethics and cultural safety.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104847"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing two different simulation methods to train nursing students in stoma care skills: A randomized controlled study","authors":"Ezgi Arslan,&nbsp;Havva Yönem Amaç,&nbsp;Sultan Özkan","doi":"10.1016/j.nepr.2026.104843","DOIUrl":"10.1016/j.nepr.2026.104843","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to compare the effects of education using hybrid simulation (HS) and medium fidelity simulation (MFS) on nursing students’ care skills and simulation experience satisfaction.</div></div><div><h3>Background</h3><div>Technological advances have expanded the use of simulation-based approaches in nursing skills education. However, evidence remains limited regarding how different simulation modalities support structured stoma care skills.</div></div><div><h3>Design</h3><div>This is a two-arm parallel-group randomized-controlled trial.</div></div><div><h3>Methods</h3><div>The study was conducted between April and November 2025 with nursing students (<em>n</em> = 98). The study outcomes were evaluated using the Descriptive Form, the Basic Information Form, the Stoma Care Skill Rubric and the Simulation Experience Satisfaction Scale. The participants were divided into two groups of 49 students each: hybrid simulation (HS) and medium fidelity simulation (MFS). Students in the HS group received simulation training with a standard patient wearing a wearable ostomy model developed for this research; those in the MFS group trained with an inanimate mannequin with a stoma.</div></div><div><h3>Results</h3><div>There was no significant difference in simulation experience satisfaction level between the HS (4.57 ± 0.40) and the MFS (4.59 ± 0.38) groups. However, the stoma care skill of the students in the HS group (40.24 ± 3.80) was higher than that of the MFS group (35.78 ± 5.53).</div></div><div><h3>Conclusion</h3><div>Both simulation-based teaching methods examined had no significant effect on nursing students’ satisfaction levels; however, the HS group demonstrated higher care skills than the MFS group. HS using wearable models could serve as a cost-effective alternative in educational scenarios.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104843"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student midwives’ lived experiences of clinical practice during pre-registration education","authors":"Jo Killingley ,&nbsp;Liang Q. Liu,&nbsp;Betsy Thom","doi":"10.1016/j.nepr.2026.104848","DOIUrl":"10.1016/j.nepr.2026.104848","url":null,"abstract":"<div><h3>Aim</h3><div>This study explored student midwives in their transition into clinical practice during their programme, aiming to identify key enablers and barriers influencing their development into confident and competent practitioners.</div></div><div><h3>Background</h3><div>While educational programmes focus on developing clinical competence, less attention has been given to the nuances of student midwives transition. These factors are increasingly recognised as central to student well-being, learning and workforce retention.</div></div><div><h3>Design</h3><div>A hermeneutic phenomenological approach was adopted within a mixed-methods design to capture both the depth and breadth of student experience.</div></div><div><h3>Methods</h3><div>Data were collected from student midwives at one UK university using an online survey, focus groups and semi-structured interviews. Methodological triangulation enabled exploration of shared patterns while preserving individual lived experience. Reflexive thematic analysis was used to interpret the data within a strong conceptual framework, allowing themes to emerge beyond surface-level descriptions.</div></div><div><h3>Results</h3><div>Findings revealed strong intrinsic motivation rooted in vocational commitment and care, yet frequently challenged by emotionally demanding placements, inconsistent supervision, fragmented support structures and performance-driven clinical culture. Where students experienced emotionally intelligent supervision, continuity and peer support, they reported enhanced confidence, psychological safety and professional identity development.</div></div><div><h3>Conclusions</h3><div>Supervision should be reframed as a relational and reflective practice rather than a procedural requirement. Greater investment in protected supervisory roles, including Professional Midwifery Advocates (PMAs) and Clinical Practice Facilitators (CPFs), is essential. Embedding structured emotional support and reflective opportunities within clinical placements may enhance learning, well-being and long-term retention in the midwifery workforce.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104848"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing end-of-life communication in Chinese first-year nursing students: A mixed-methods study of a culturally tailored experiential course grounded in Kolb’s experiential learning theory","authors":"Jingcheng Wang ,&nbsp;Jinyang Geng ,&nbsp;Chengcheng Pei ,&nbsp;Hongyu Zhao ,&nbsp;Keyuan Peng ,&nbsp;Chenglei Hu ,&nbsp;Josephine Hegarty ,&nbsp;Pingting Zhu","doi":"10.1016/j.nepr.2026.104842","DOIUrl":"10.1016/j.nepr.2026.104842","url":null,"abstract":"<div><h3>Aim</h3><div>To develop and evaluate a culturally sensitive end-of-life communication course for first-year nursing students, grounded in Kolb’s experiential learning theory.</div></div><div><h3>Background</h3><div>Global ageing and multimorbidity have intensified the need for effective end-of-life communication, but in China, cultural taboos and limited training hinder its development.</div></div><div><h3>Design</h3><div>A quasi-experimental, cluster-randomized mixed-methods study was conducted.</div></div><div><h3>Methods</h3><div>A total of 114 first-year nursing students across four classes were cluster-randomized into an intervention (n = 59; EOLC course) or control group (n = 55; traditional lectures). Pre- and post-tests and between-group comparisons were used to assess learning outcomes. Reflective writings from the intervention group were analysed qualitatively using content analysis.</div></div><div><h3>Results</h3><div>Post test comparisons showed significant improvements in communication knowledge (MD = 4.36, <em>p</em> = 0.003) and skills (MD = 4.34, <em>p</em> = 0.001). Compared with the control group, the intervention group showed significantly greater improvements in end-of-life care attitudes (<em>β</em> = 7.29, <em>p</em> = 0.028) and positive attitude toward communication skills learning (<em>β</em> = 3.43, <em>p</em> = 0.012). However, the intervention group’s attitude toward caring for the dying person’s family significantly decreased after the program (MD = - 1.19, <em>p</em> &lt; 0.05). Qualitative analysis complemented the quantitative findings, revealing five themes that reflected students’ evolving understanding and professional development.</div></div><div><h3>Conclusions</h3><div>Within the context of this study, an experiential, culturally tailored end-of-life communication course was associated with enhanced nursing student competencies and attitudes. These findings suggest that introducing such programmes earlier in training may better equip students to provide effective end‑of‑life care in the future.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104842"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing students’ experiences of narrative pedagogy in psychiatric nursing education: A phenomenological study","authors":"Ling Shen ,&nbsp;Huijun Huang ,&nbsp;Fangping Guan","doi":"10.1016/j.nepr.2026.104845","DOIUrl":"10.1016/j.nepr.2026.104845","url":null,"abstract":"<div><h3>Aim</h3><div>This phenomenological study aimed to explore the experiences of undergraduate nursing students in psychiatric nursing education using narrative pedagogy informed by Perry’s cognitive development theory.</div></div><div><h3>Background</h3><div>Psychiatric nursing education entails complex cognitive and emotional demands that traditional lecture-based approaches may insufficiently address. Though narrative pedagogy has been increasingly used in nursing education, its application, informed by educational theory, remains limited.</div></div><div><h3>Design</h3><div>A qualitative phenomenological study.</div></div><div><h3>Methods</h3><div>Narrative pedagogy informed by Perry’s cognitive development theory was implemented throughout the psychiatric nursing course. After completing the course, 18 undergraduate nursing students were purposively sampled and invited to participate in semi-structured interviews to explore their experiences. Data were analysed using Colaizzi’s seven-step phenomenological method.</div></div><div><h3>Results</h3><div>Five themes were identified: (1) from knowledge understanding to cognitive construction; (2) from emotional connection to empathic understanding; (3) from experiencing enjoyment to engaging in learning; (4) from professional empowerment to career reorientation; and (5) experiencing cognitive load and participation challenges. Students described a deepening ability to absorb and construct knowledge, enhanced emotional connection and empathy development, increased engagement in learning and growing interest in psychiatric nursing. Meanwhile, concerns were raised regarding instructional time allocation and limited participation.</div></div><div><h3>Conclusions</h3><div>Narrative pedagogy facilitated both cognitive and emotional learning in psychiatric nursing education. Addressing concerns related to time allocation and participation may further enhance learning experiences. Meanwhile, the long-term impact of narrative pedagogy should be monitored. The integration of emerging technologies, such as virtual reality, may offer additional opportunities to enrich narrative-based teaching.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104845"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of mindfulness-based interventions on stress, anxiety and depression among nursing students: A systematic review and meta-analysis","authors":"Bin Shen ,&nbsp;Jianjiang Liu ,&nbsp;Qiaoxia Lv","doi":"10.1016/j.nepr.2026.104841","DOIUrl":"10.1016/j.nepr.2026.104841","url":null,"abstract":"<div><h3>Aim</h3><div>This updated systematic review and meta-analysis aimed to evaluate the effectiveness of mindfulness-based interventions (MBIs) in reducing stress, anxiety, depression and improving mindfulness among nursing students.</div></div><div><h3>Background</h3><div>Nursing students often experience significant psychological distress due to the demanding academic and clinical environments of nursing education. MBIs have been increasingly used to reduce distress and enhance well-being. However, the strength and certainty of the available evidence remain variable, warranting an updated synthesis.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, five databases were searched up to September 2025 for randomized controlled trials (RCTs) on MBIs in nursing students. Two reviewers independently extracted data and assessed risk of bias using RoB2. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using Stata 17.0 software. Subgroup, sensitivity and meta-regression analyses explored heterogeneity. Evidence certainty was assessed using the GRADE approach.</div></div><div><h3>Results</h3><div>Eighteen RCTs were included. MBIs were associated with reductions in anxiety (SMD = −0.49), depression (SMD = −0.43), stress (SMD = −0.54) and with an improvement in mindfulness (SMD = 0.40). Subgroup analyses showed no significant differences between face-to-face and online delivery modes across outcomes. A significant stage-based difference was observed for stress, with larger pooled effects in clinical-phase students.</div></div><div><h3>Conclusions</h3><div>This meta-analysis provides moderate certainty evidence suggesting that MBIs are associated with improvements in psychological well-being among nursing students. However, given methodological limitations, further well-designed RCTs with longer follow-up are needed to strengthen the evidence base.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104841"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of crossword puzzle on nursing students’ willingness to work with older adults and gerontological nursing competence: A waiting list randomized controlled trial","authors":"Zühal Erdoğan,&nbsp;Sultan Ayaz-Alkaya","doi":"10.1016/j.nepr.2026.104844","DOIUrl":"10.1016/j.nepr.2026.104844","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the effect of crossword puzzle activities on nursing students’ willingness to work with older adults and their competence in gerontological nursing.</div></div><div><h3>Background</h3><div>Although crossword puzzles are widely used learning tools, their effects in these areas have not been sufficiently investigated.</div></div><div><h3>Design</h3><div>A parallel-design randomized controlled trial with a waiting list.</div></div><div><h3>Methods</h3><div>Participants included 102 s-year nursing students with 51 assigned to the experimental group and 51 to the control group. Data were collected using Willingness to Work with Elderly People Scale and the Gerontological Nursing Competence Scale. The experimental group completed a crossword puzzle activity once a week for three weeks following standard lectures. The data were analyzed using independent and paired samples t-tests.</div></div><div><h3>Results</h3><div>The gerontological competence post-test mean scores in the experimental group were significantly higher than those in the control group (p = 0.031), with a medium effect size (d = 0.43). Gerontological nursing competence (p = 0.033) and willingness to work with older adults (p = 0.004) significantly increased from pre- to post-test in the experimental group. However, no significant group difference in willingness to work with older adults was found after the intervention (p = 0.654).</div></div><div><h3>Conclusion</h3><div>The present study concluded that the crossword puzzle activity was associated with promotion in enhancing gerontological nursing competence among nursing students. However, no significant effect was observed on willingness to work with older adults. Crossword puzzle activities could be integrated into nursing education programs to strengthen competence in gerontological care.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"93 ","pages":"Article 104844"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to \"Undergraduate nursing student and preceptors' experiences of clinical placement through an innovative clinical school supervision model\" [Nurse Educ. Pract. (2021) 102986].","authors":"Carmel McLeod, Yangama Jokwiro, Yuhua Gong, Susan Irvine, Kristina Edvardsson","doi":"10.1016/j.nepr.2026.104836","DOIUrl":"https://doi.org/10.1016/j.nepr.2026.104836","url":null,"abstract":"","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":" ","pages":"104836"},"PeriodicalIF":4.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core elements of functionally bilingual nursing education-A descriptive qualitative study.","authors":"Hanna Repo Jamal, Minna Elomaa-Krapu, Jaana-Maija Koivisto","doi":"10.1016/j.nepr.2026.104849","DOIUrl":"https://doi.org/10.1016/j.nepr.2026.104849","url":null,"abstract":"<p><strong>Aim: </strong>To describe functionally bilingual nursing education.</p><p><strong>Background: </strong>Functionally bilingual nursing education, where students simultaneously complete a nursing degree and acquire the local language, has been developed to alleviate the global issue of nurse shortages. Qualitative research exploring how language-integrated nursing education is implemented in practice is limited.</p><p><strong>Design: </strong>A descriptive qualitative study.</p><p><strong>Methods: </strong>Data were collected through individual thematic interviews with teachers (n = 13) and analysed using inductive content analysis.</p><p><strong>Results: </strong>Functionally bilingual nursing education consists of three core elements: 1) linguistically aware teaching and guidance, 2) integration of the local language and 3) linguistically supported clinical practice. The collaboration between nursing and language teachers, whose complementary expertise ensures both discipline-specific rigour and language-aware pedagogy, is central. Functionality operates as both a theoretical foundation and a pedagogical choice: flipped learning, authentic learning environments and active student participation place the local language at the core of classroom. In clinical practice, language-matched placements and language agreements support students, supervisors and work communities in adopting language-aware practices.</p><p><strong>Conclusions: </strong>Functionally bilingual nursing education responds to staff shortages and increases linguistic and cultural diversity. By emphasising functional language learning pedagogy, language is positioned not as a separate prerequisite but as an integral part of professional competence. This approach supports equitable learning, sustainable workforce integration and ethically grounded pathways for international students into European labour markets and is relevant beyond nursing. Further research should assess effectiveness using mixed methods and experimental designs, incorporate various stakeholders' perspectives and examine feasibility and impact in other professional fields.</p>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"94 ","pages":"104849"},"PeriodicalIF":4.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The era of agentic AI: Should nurses and midwives learn about vibe coding and AI agents for better health and care?","authors":"Siobhan O'Connor, Mengying Zhang, Vivian Hui, Lu-Yen Anny Chen, Janet Delgado, Charlene H Chu, Charlene E Ronquillo, Lucija Gosak, Dan Wicks, Peter White, Helen Caton-Peters, Nathan Blake","doi":"10.1016/j.nepr.2026.104837","DOIUrl":"https://doi.org/10.1016/j.nepr.2026.104837","url":null,"abstract":"","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":" ","pages":"104837"},"PeriodicalIF":4.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}