JMIR nursing最新文献

{"title":"Exploring Nursing Students' Experiences in a Brief Virtual Reality-Enhanced Workshop: Cross-Sectional Exploratory Study.","authors":"Niklas Ferdinand Carlsson, Leonie Klompstra, Mats Westas","doi":"10.2196/85780","DOIUrl":"10.2196/85780","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence on how brief, optional virtual reality (VR) experiences can be used with first-semester nursing students as experiential learning strategies to support understanding of foundational nursing concepts, outside of mandatory coursework or full-scale simulations. Additionally, little is known about students' and teachers' perceptions of VR as a low-stakes, supplemental learning strategy introduced early in nursing education. Examining these experiences can provide insight into the pedagogical value and scalability of VR-enhanced learning within the formal nursing curriculum.</p><p><strong>Objective: </strong>This study explored students' and teachers' experiences of a brief, optional, VR-enhanced workshop offered outside mandatory coursework in first-semester nursing education and described students' perceptions of cognitive, social, and teaching presence.</p><p><strong>Methods: </strong>This was a cross-sectional evaluation at a Swedish public university. A single-session workshop, co-designed by nursing teachers and the university library makerspace (implementation context), combined brief headset exposures (sympathetic arousal via a short roller coaster experience and parasympathetic engagement via a short guided meditation), peer vital-sign practice (instructional aid), small-group synthesis, and a guided debrief aligned with the community of inquiry (CoI) framework. Immediately after the session, students completed a demographics questionnaire, a 7-item workshop-specific VR-perception set, and the 34-item CoI instrument, plus 2 open-ended items; teachers provided short reflections. Analyses were descriptive for quantitative data and summative content analysis of open-ended responses. Participants included 11.9% (16/134) of the invited first-semester students (mean age 25 years, SD 5.1; 15/16, 93.8% women; 6/16, 37.5% with prior VR exposure) and 3 teachers.</p><p><strong>Results: </strong>Most students agreed or strongly agreed that VR enhanced analysis and observation (12/16, 75%), exploration of phenomena (14/16, 87.5%), conceptual understanding and engagement (13/16, 81.3%), teacher support (13/16, 81.3%), and relevance to the session (14/16, 87.5%). CoI ratings indicated moderately positive perceptions (total mean 3.36, SD 0.44 on a 5-point scale), with cognitive presence rated the highest (mean 3.48, SD 0.41) and exploration being the top subdomain (mean 4.48, SD 0.49); design and organization and facilitation were similar (mean 3.42, SD 0.55 each), whereas direct instruction was rated lower (mean 2.88, SD 0.92). Open-ended remarks described links between theory and embodied experience and noted practical challenges.</p><p><strong>Conclusions: </strong>This study used an early, optional format; the results showed that brief, contrastive VR exposures paired with scaffolded inquiry and a guided debrief were perceived as pedagogically valuable for exploring foundational physiological conc","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e85780"},"PeriodicalIF":5.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Concept to Practice: Lessons from the BNuT Balanced Nursing Teams Decision-Support System-A Viewpoint Paper.","authors":"Senne Vleminckx, Peter Van Bogaert, Wim De Keyser, Filip Haegdorens","doi":"10.2196/92417","DOIUrl":"https://doi.org/10.2196/92417","url":null,"abstract":"<p><strong>Unstructured: </strong>The global nursing workforce crisis demands a shift from reactive staffing to strategic workforce optimization through data-driven decision-support systems. This viewpoint paper reflects on the development and attempted implementation of the Balanced Nursing Teams (BNuT) system-a decision-support tool integrating approximately 250 data points - of which roughly 150 are extracted from existing organizational systems (HR, scheduling, EHR, quality registries) through flexible import mechanisms, and the remainder collected through a built-in 360-degree staff survey with automated analysis - across ten domains to evaluate nursing team balance between capacity, performance and outcomes. Following crowdfunding by 18 Belgian healthcare organizations, BNuT was implemented across eight diverse settings (home healthcare, general hospitals, academic centers) between 2019 and 2023. Using the Human-Organization-Technology fit (HOT-fit) framework, we analyze why evidence-informed, organization-endorsed digital innovations struggle to achieve adoption. Our analysis reveals three interdependent barrier categories: technological fragmentation (vendor lock-in, legacy systems, prohibitive integration costs), organizational siloing (Chief Nursing Officers lacking budgetary authority, nursing framed as peripheral to strategic priorities), and managerial hesitance (fear of punitive data use, cognitive overload from staffing crises). These barriers were worsened by the substantial data-integration burden that the system's breadth imposed on organizations with limited digital maturity. Critically, only one site (i.e., a nurse-led home healthcare organization where leadership held both strategic authority and resource control) achieved sustained implementation. This contrast demonstrates that workforce optimization through data depends not on software maturity alone but on achieving simultaneous fit across human, organizational, and technological domains. We argue that the persistent marginalization of nursing leadership within hospital governance structures represents the fundamental barrier to digital transformation in nursing workforce management. The urgency paradox is striking: while nursing represents healthcare organizations' largest operational cost and most direct patient interface, workforce optimization tools are consistently deprioritized in favor of regulatory compliance systems and billing infrastructure. Bridging this gap requires systemic investment in nursing leadership authority, data interoperability standards, and recognition that data-driven workforce decisions are strategic imperatives rather than operational luxuries.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Perceptions of the Role of Nursing in Substance Use Disorder Treatment Programs: Qualitative Study.","authors":"Clara Lucas Guerra, Marina Gómez de Quero Córdoba, Bruno García Tardón, Guadalupe González Naranjo, Noemí Mayoral Gonzalo","doi":"10.2196/82401","DOIUrl":"10.2196/82401","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders are chronic conditions with significant personal and social consequences. Nursing care plays a key role in outpatient and community-based rehabilitation programs, yet patients' perspectives on this role remain underexplored.</p><p><strong>Objective: </strong>This study aimed to explore how patients with substance use disorders perceive and interpret nursing care in community addiction treatment centers operated by the Spanish Red Cross in Madrid, Spain. Specifically, it sought to describe the organizational and care-related roles attributed to community addiction treatment centers and analyze patients' perceptions of nurses' technical and relational functions.</p><p><strong>Methods: </strong>A phenomenological qualitative design was used. Fourteen in-depth, semistructured interviews were conducted with patients undergoing treatment at Red Cross centers. Participants were selected through purposive sampling to ensure diversity in age, gender, substance use, and treatment experiences. The data were analyzed using systematic text condensation and supported by the ATLAS.ti software.</p><p><strong>Results: </strong>The center is perceived as a significant space not only for offering healthy leisure activities outside the context of substance use but also as a supportive environment that fosters a sense of belonging to a community. Patients valued the emotional support, empathy, and relational care provided by nurses, often highlighting their role in building trust and offering personalized attention. However, there was limited awareness of nurses' technical competencies.</p><p><strong>Conclusions: </strong>These findings underscore the importance of holistic, patient-centered care and the need to enhance the visibility and recognition of nursing roles in addiction treatment settings.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e82401"},"PeriodicalIF":5.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Enhanced Wound Care to Improve Access, Efficacy, and Equity in Wound Care for Older Adults in Rural and Remote Regions of Canada.","authors":"Courtney Genge, Basnama Ayaz, Shannon Freeman, Heba Tallah Mohammed, Robert D J Fraser, Ibukun-Oluwa Omolade Abejirinde, Deirdre O'Sullivan-Drombolis, Rebecca Brookham","doi":"10.2196/85644","DOIUrl":"10.2196/85644","url":null,"abstract":"<p><strong>Unlabelled: </strong>Wound care is an increasing global challenge, with older adults among those most affected. As populations age, the demand for effective and efficient wound care increases. Over the years, various wound assessment and care techniques have been developed, including digital wound care technology (DWCT), which uses innovative artificial intelligence (AI). Many older adults, especially those living in rural and remote areas, face significant barriers in obtaining timely and effective wound care, leading to poorer health outcomes and increased health care costs related to wound care. These challenges underscore the urgent need to implement wound care models that equitably improve access to care and enhance clinical outcomes, particularly for older adults, to promote healthy aging and age-in-place. Based on evidence from the literature and the initial implementation of a DWCT in 2 community health systems in Ontario, this viewpoint paper encourages clinicians and health care leaders to embrace and expand the implementation of an AI-driven DWCT to address inequities in access to high-quality, timely care. The experiences from these implementations indicate that the use of AI can support clinical decision-making and extend access to care for individuals in rural and remote communities in Canada. By leveraging DWCT powered by AI, health care providers can enhance the accuracy and consistency of wound assessments, improve communication, streamline care processes, and more effectively allocate resources, ultimately aiming to reduce disparities in wound care outcomes. .</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e85644"},"PeriodicalIF":5.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Nurse-Patient Communication Through Health Technologies and Nursing Practices to Recognize and Support Limited Digital Health Literacy: Qualitative Study.","authors":"Eline Mariosé Dijkman, Jobke Wentzel, David Edvardsson, Carine Doggen, Constance Helène Christine Drossaert","doi":"10.2196/82272","DOIUrl":"10.2196/82272","url":null,"abstract":"<p><strong>Background: </strong>In the past decade, the use of health technologies, such as telemonitoring, video consultations, and patient portals, has increased. However, it remains unclear how these technologies have influenced nurse-patient communication. Additionally, little is known about the role nurses play in recognizing and supporting limited (digital) health literacy patients.</p><p><strong>Objective: </strong>This study aimed to explore which health technologies are currently being used in a hospital context and how nurse-patient communication has changed as a result. Furthermore, we sought to identify the practices nurses use and the barriers they experience in recognizing and supporting patients with limited digital health literacy.</p><p><strong>Methods: </strong>This is a qualitative descriptive study that used semistructured interviews with nurses working in a hospital (n=21). The interview guide was partly based on the 6-function model of medical communication by de Haes and Bensing. All interview transcripts were analyzed by 2 independent coders using a combination of deductive and inductive approaches.</p><p><strong>Results: </strong>According to the nurses, health technologies have impacted all 6 functions of nurse-patient communication. They noted improvements in gathering information, providing information, enabling disease and treatment management, and responding to patients' emotions. In contrast, technology made fostering the relationship more difficult, and technologies were seldom used in shared decision-making. Nurses identified limited digital health literacy through intuition, observation of verbal and nonverbal cues, and direct questioning. To support patients with limited digital health literacy, nurses relied on building trust, involving the social network, tailoring communication, and offering additional support. High workload and limited knowledge were the main barriers to applying these practices.</p><p><strong>Conclusions: </strong>Our findings show that health technologies have significantly influenced nurse-patient communication in the hospital setting. The results highlight the need for tailored training programs to strengthen nurses' competencies in identifying and supporting patients with limited digital health literacy. This is essential to ensure more comprehensible and accessible care and promote equitable patient engagement with health technologies.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e82272"},"PeriodicalIF":5.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Nursing Pilot in the Inpatient Setting: Qualitative Evaluation.","authors":"Ksenia Gorbenko, Maria Bailon, Jordan Randall, James Viskochil, Clara Cualing, Patrick Healy, Madhu Mazumdar, Robert Freeman","doi":"10.2196/76994","DOIUrl":"10.2196/76994","url":null,"abstract":"<p><strong>Background: </strong>Global nursing shortages require innovative care delivery models. Virtual nursing is a cutting-edge model being explored.</p><p><strong>Objective: </strong>This study aimed to examine the perspectives of clinical and administrative staff involved in a virtual nursing pilot on a medical-surgical unit and to identify best practices for future adoption.</p><p><strong>Methods: </strong>We conducted a qualitative evaluation using individual semistructured interviews with virtual and bedside nurses, nurse executives, and IT project managers implementing a virtual nursing pilot program at a medical-surgical unit with 35 private and semiprivate beds at the Mount Sinai Hospital, a 1110-bed acute care hospital in New York, NY. Interviews took place in the spring of 2024 and were completed via phone or Zoom, audio recorded, and professionally transcribed. Participants were selected using purposive sampling. The authors applied an iterative thematic analysis to transcripts using Dedoose. Claude.ai was used to generate code summaries for select codes.</p><p><strong>Results: </strong>Of 33 individuals approached, 16 (48.5%) consented to participate. Nine participants were clinical staff (virtual and bedside nurses and nurse managers), and 7 were executive leaders or managers in nursing and informatics. Our analysis identified the following themes: (1) staff attitudes toward virtual nursing shifted from resistance to acceptance over time, (2) direct communication channels between virtual and bedside nurses were critical for efficient care coordination and model adoption, (3) admission and discharge processes evolved throughout the pilot implementation, and (4) adaptable staffing allocations were necessary to accommodate fluctuating patient census and unit demands.</p><p><strong>Conclusions: </strong>The main beneficiaries of this intervention, bedside nurses, found their virtual counterparts helpful following a few adjustments. Participants reported a perceived reduction in administrative burden, uninterrupted completion of clinical tasks, and they felt their overtime was reduced, which all increased their buy-in for this care model. There are several opportunities for improvement, such as real-time communication, unit-specific virtual nurse training, and flexible staffing for high-volume units. Our findings suggest that virtual nursing can address staffing challenges. Calculating the true return on investment for virtual nursing programs will require comprehensive mixed methods evaluations of such outcomes as care team and patient satisfaction, length of stay, readmission prevention, completion of nursing tasks, and reduction in overtime.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e76994"},"PeriodicalIF":5.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Cross-Device Platform for Robotic Systems in Nursing Care: Mixed Methods Feasibility Study.","authors":"Pascal Müller, Ruven Veit, Sebastian Hofstetter, Patrick Jahn","doi":"10.2196/84118","DOIUrl":"10.2196/84118","url":null,"abstract":"<p><strong>Background: </strong>Aging populations and rising chronic illness prevalences are increasing demands for nursing care, while staff shortages threaten care quality. Robotics offer potential support, yet usability, workflow integration, and user acceptance remain major barriers.</p><p><strong>Objective: </strong>This study aims to develop and evaluate the feasibility, usability, and acceptance of a cross-device platform for controlling robotics in nursing using a participatory, user-centered approach.</p><p><strong>Methods: </strong>A convergent mixed methods feasibility study was conducted across 4 iterative workshops with 13 nurses from 2 German health care facilities. Quantitative measures included the System Usability Scale (SUS), Technology Usage Inventory (TUI), and Technology-based Experience of Need Satisfaction (TENS-Interface). Qualitative data were collected via think-aloud protocols and focus groups. Data integration supported iterative platform refinement and assessment of usability, acceptance, and satisfaction of psychological needs.</p><p><strong>Results: </strong>Participants exhibited high curiosity, perceived usefulness, and strong intention to use robotics, with low skepticism. SUS scores indicated acceptable usability. TENS-Interface scores showed increased autonomy and competence following workflow simplification and stepwise interaction logic. Qualitative findings emphasized intuitive control, personalized interventions, centralized management of multiple technologies, integration with documentation systems, and structured training. Triangulation of quantitative and qualitative data confirmed that iterative, user-centered refinements enhanced usability, acceptance, and platform effectiveness.</p><p><strong>Conclusions: </strong>Cross-device platforms integrating robotics can be successfully developed through participatory, user-centered methods. Technical usability, personalization, workflow integration, and structured training are key for adoption. The study demonstrates that technological barriers, rather than human resistance, are primary constraints to integrating robotics into nursing practice and can be mitigated through iterative co-creation aligned with real-world care contexts.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e84118"},"PeriodicalIF":5.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Enablers for Sustaining Nurse-Led Use of Clinical Decision Support Tools for Antibiotic Stewardship: Qualitative Study.","authors":"Victoria L Tiase, Aurie D Tovar, Natalie Henning, Mariana Braga, Keelin McHugh, Lynn Xu, Haddy Bah, Alice Yuroff, Rachel Hess, Devin M Mann, David Feldstein, Elizabeth R Stevens","doi":"10.2196/83567","DOIUrl":"10.2196/83567","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision support (CDS) tools embedded in electronic health records in the form of integrated clinical prediction rules provide a potentially effective intervention to reduce inappropriate antibiotic prescribing for acute respiratory infections. However, their effectiveness has been limited by workflow barriers and low adoption by health care providers. Nurses are well positioned to implement evidence-based protocols using CDS tools. In a multicenter randomized controlled trial, a nurse-led implementation strategy for acute respiratory infection integrated clinical prediction rules was evaluated for use in primary care and urgent care settings.</p><p><strong>Objective: </strong>This study aimed to examine nurse and nurse leader perspectives on the sustainability of an electronic health record-integrated CDS tool for antibiotic stewardship and explored factors influencing its potential long-term integration into ambulatory nursing practice beyond the clinical trial.</p><p><strong>Methods: </strong>We interviewed 22 nurses and nurse leaders from 37 clinics across 3 academic medical centers that participated in the clinical trial. Two semistructured interview guides, one for nurses and one for nursing leadership, were developed to understand the barriers and facilitators to implementing a decision aid tool for nurses and to elicit challenges specific to nursing interactions with the CDS tool. Interviews were recorded and transcribed. Using thematic content analysis and iterative coding, our team collaboratively identified emerging themes related to sustainability and refined the results with consensus.</p><p><strong>Results: </strong>Five themes emerged: (1) importance of staffing stability and capacity, (2) impact of dedicated clinic resource availability, (3) variable nurse readiness with CDS-guided clinical care, (4) influence of openness to change and a nurse-supportive clinic culture, and (5) ongoing need for training and support. Specific recommendations for future actions were also noted.</p><p><strong>Conclusions: </strong>Our findings revealed specific barriers and facilitators to the sustainability of a CDS tool from the nursing perspective that can inform further implementation of nurse-led delegation protocols in the ambulatory setting. Future solutions should consider mapping physical workflows, scheduling specific to nurse visits, continuing education, and treating cough and sore throat as 2 distinct processes.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e83567"},"PeriodicalIF":5.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Intentions of Nursing Students Regarding Digital Health: Cross-Sectional Study.","authors":"Alexandre Castonguay, Sandrine Hegg-Deloye, Guy Paré, Faustin Armel Etindele Sosso","doi":"10.2196/77051","DOIUrl":"10.2196/77051","url":null,"abstract":"<p><strong>Background: </strong>The integration of digital health technologies (DHTs) in clinical practice is accelerating, creating a need for nursing students to develop digital competencies aligned with professional expectations. In Quebec, curricular reforms aim to enhance digital health literacy, but data are limited on students' preparedness.</p><p><strong>Objective: </strong>This study aimed to assess nursing students' perceptions, self-reported competencies, and willingness to engage with DHTs across different academic years.</p><p><strong>Methods: </strong>A cross-sectional descriptive survey assessing self-reported digital health competencies, attitudes, perceived training coverage, and intentions was conducted using an online questionnaire administered through Qualtrics. Participants (N=136) were recruited from 3 cohorts: first-year (group 1; n=58, 42.6%), second-year (group 2; n=55, 40.4%), and third-year (group 3; n=23, 16.9%) nursing students. Data were analyzed using descriptive statistics and ANOVAs, with post hoc analyses performed via SPSS.</p><p><strong>Results: </strong>Significant differences were observed among cohorts concerning digital competencies and access to digital tools. Compared with first-year students (group 1), third-year students (group 3) showed higher proficiency with electronic medical records (group 3: mean 3.29, SD 1.31; group 1: mean 2.59, SD 1.32; P=.01), virtual reality (group 3: mean 4.53, SD 1.11; group 1: mean 2.90, SD 1.44; P<.001), and clinical databases (group 3: mean 4.59, SD 1.00; group 1: mean 3.21, SD 1.55; P<.001). Despite positive attitudes toward DHTs across all groups, training coverage for most digital tools was perceived as low, with the highest levels reported for clinical databases (mean 2.97, SD 1.1). This underscored a substantial gap between institutional expectations and actual digital training across all cohorts.</p><p><strong>Conclusions: </strong>This study highlights critical gaps in digital health training among nursing students, emphasizing the need for targeted curricular reforms such as the one currently underway at the Université de Montréal. These efforts represent a promising opportunity to better align educational content with the evolving demands of health care systems. Today, preparing students in digital competencies is no longer just advantageous but may soon become essential for the next generation of nurses to navigate and lead within technology-driven care environments.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e77051"},"PeriodicalIF":5.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Large Language Models in the Japanese Public Health Nurse National Examination: Comparative Cross-Sectional Study.","authors":"Yutaro Takahashi, Ryota Kumakura, Rie Okamoto, Shizuko Omote","doi":"10.2196/82842","DOIUrl":"10.2196/82842","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) have shown promising results on Japanese national medical and nursing examinations. However, no study has evaluated LLM performance on the Japanese Public Health Nurse National Examination, which requires specialized knowledge in community health and public health nursing practice.</p><p><strong>Objective: </strong>This study aimed to compare the performance of multiple LLMs on the Japanese Public Health Nurse National Examination and evaluate their potential utility in public health nursing education.</p><p><strong>Methods: </strong>Three LLMs were evaluated: GPT-4o, Claude Opus 4, and Gemini 2.5 Pro. All 110 questions from the 111th Public Health Nurse National Examination were administered using standardized prompts. Questions were classified by format (text vs figure or calculation), content (general vs situational), and selection type (single vs multiple choice). Accuracy rates and 95% CIs were calculated, with statistical comparisons performed using chi-square tests.</p><p><strong>Results: </strong>All LLMs exceeded the passing criterion (60%). The accuracy rates were as follows: 85.5% (94/110) for GPT-4o (95% CI 77.5%-91.5%), 91.8% (101/110) for Claude Opus 4 (95% CI 85.0%-96.2%), and 92.7% (102/110) for Gemini 2.5 Pro (95% CI 86.2%-96.8%). No significant differences were found among the LLMs (P>.99). However, all models showed lower accuracy on multiple-choice questions than on single-choice questions, with significant intramodel differences observed for GPT-4o (10/16, 62.5% vs 82/92, 89.1%; P=.01) and Claude Opus 4 (12/16, 75% vs 87/92, 94.6%; P=.03).</p><p><strong>Conclusions: </strong>LLMs demonstrated high performance on a public health nursing examination but showed limitations in complex reasoning requiring multiple-choice selection. These findings suggest the potential for LLM use as educational support tools while highlighting the need for cautious implementation in specialized nursing education.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"9 ","pages":"e82842"},"PeriodicalIF":5.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}