Dr. Dorothy Miller Watches Daughter Graduate from Nursing Program She Created

Dr. Dorothy Miller Watches Daughter Graduate from Nursing Program She Created

As a once impoverished teen mom in rural North Carolina, Dr. Dorothy Miller watched with great pride as her eldest daughter graduated 13 years to the day she received her nursing degree from a nursing program she created at St. Andrews University in Laurinburg, North Carolina.

Dr. Miller, the St. Andrews University Department Chair of Health Services, credits her mom, Ruby Bandy, for prioritizing education. At 15 years old, Dr. Miller, then a student, gave birth to her first daughter on a Friday, and her mom insisted that the North Carolina high school freshman was back at school on Monday. 

“My mother had to stop going to school when she was in the third grade because she had to go work on the farms,” says Dr. Miller, 56. “She knew that education would be the vehicle that would take me to a better future.”

Dr. Miller says she wanted to become a nurse growing up, but her high school counselor told her she would never become a nurse because of her poor grades in math and science.

“As my high school counselor mentioned, the odds were definitely against me,” Dr. Miller says. “Fortunately, I was born with tenacity and the unmitigated audacity to refuse to give up.”

And she knew education was a ticket out of poverty for her and her baby.

Daily Nurse is proud to recognize Dr. Dorothy Miller as our Nurse of the Week, honoring her tenacity and perseverance to defy the odds and dedication to education to become a nurse educator.

Dr. Miller went on to get her associate’s degree, bachelor’s degree, master’s, PhD, and another master’s. She also served in the U.S. Army from 1995 to 2001.

Now Dr. Miller, who is currently running for a seat on the North Carolina Board of Nursing, went on to work as a nurse for seven years before switching to an academic career in healthcare.

Dr. Miller launched the first nursing school at St. Andrews in 2021. Not only was her daughter Bandy in the first graduating class, but her name was also the first one called during the May ceremony.

It’s rewarding for Dr. Miller to see her child follow in her footsteps after being the driving force behind her successful career.

“I think if I hadn’t been given the opportunity to have that child, I wouldn’t have accomplished what I did,” Dr. Miller says. “By having her, it pushed me to something outside of me that I could have a better future for her.”

Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.

National League for Nursing to Induct 2023 Class of Fellows into the Academy of Nursing Education

National League for Nursing to Induct 2023 Class of Fellows into the Academy of Nursing Education

Twenty-three distinguished nurse educators, including a former National League for Nursing president, have been selected for induction as the 17th class of fellows in the prestigious Academy of Nursing Education . Dr. Elaine Tagliareni, who joined the Academy with this class, served as League president from 2007 to 2009. The Academy was launched in March 2007 while Dr. Tagliareni served as president-elect.

With the addition of the 17th class, academy membership totals 379 leading nurse educators who teach in various programs across the spectrum of higher education. They are affiliated with top-ranked teaching hospitals, academic institutions, and other organizations committed to advancing healthcare quality in the U.S. and globally.

Following tradition, the induction ceremony takes place at the Honors Convocation before the closing Gala at this year’s NLN Education Summit on Saturday, September 30.

In a competitive application process, the Academy of Nursing Education Review Panel has a great deal to consider before recommending fellowship candidates to the NLN Board of Governors, the oversight body for the Academy. Evaluations consider applicants’ contributions to innovative teaching and learning strategies; nursing education research; faculty development activities; academic leadership; promotion of public policy initiatives that advance nursing education; and collaborative educational, practice, or community partnerships.

NLN Chair Kathleen Poindexter, PhD, RN, CNE, ANEF, assistant dean of undergraduate programs at Michigan State University in Lansing, congratulated the 2023 fellows on behalf of the Board, saying, “This cohort of Academy of Nursing Education fellows, like the classes before them, reflect the extraordinary leadership, fortitude, creativity, and compassion required to tackle the enormous challenges facing today’s health care and higher educational environments. They have demonstrated important success in preparing and motivating students to increase access and inclusion in delivering outstanding, culturally humble health care.”

NLN President and CEO Beverly Malone, PhD, RN, FAAN says, “With threats to global health ever-present, not least the existential effects of climate change, and social determinants of health creating greater obstacles to health care equity, we applaud these leading nurse educator-scholars for their role in supporting and facilitating excellence in nursing education and serving as role models to their students and peers alike.”

2023 Academy of Nursing Education Fellows

  • Lora Claywell, PhD, MSN, RN, CNE
  • Jennifer Coleman, PhD, RN, CNE, COI
  • Kelley Connor, PhD, RN, CHSE
  • Audria Denker, DNP, RN, FAADN
  • Michael Joseph Dino, PhD, MAN, RN, LPT, FAAN, FFNMRCSI
  • Selena Gilles, DNP ANP-BC, CNEcl, FNYAM
  • Susan Hendricks, EdD, MSN, RN, CNE
  • Desiree Hensel, PhD, RN, PCSN-BC, CNE, CHSE
  • Mary Ann Jessee, PhD, RN
  • Brandon “Kyle” Johnson, PhD, RN, CHSE
  • Megan Lippe, PhD, RN
  • Rachel Onello, PhD, RN, CHSE, CNE, CNL
  • Steven Palazzo, PhD, MN, RN, CNE
  • Elizabeth Richards, PhD, RN, CHES
  • Leland Rockstraw, PhD, RN, FNAP
  • Jennifer Ross, PhD, RN, CNE
  • Zepure Samawi, PhD, MSN, BSN, RN
  • Elizabeth Seldomridge, PhD, RN, CNE
  • Linda Silvestri, PhD, RN, FAAN
  • Beth Ann Swan, PhD, RN, FAAN
  • M. Elaine Tagliareni, EdD, RN, CNE, FAAN
  • Beth Vottero, PhD, RN, CNE
  • Penni Watts, PhD, RN, CHSE-A, FSSH, FAAN

Application for admission to the Academy in 2024 opens this November. Eligibility criteria and other details may be found online at NLN.org. For more information about the 2023 NLN Education Summit, including online registration, visit Summit.NLN.org.

Building the Nursing Pipeline by Addressing Social Determinants of Learning

Building the Nursing Pipeline by Addressing Social Determinants of Learning

The U.S. nursing shortage is projected to hit the hundreds of thousands, and the ability to educate and train nurses is more vital than ever. Yet, prospective caregivers still encounter barriers within nursing education that can limit their degree completion. And this disproportionately includes college applicants from diverse communities.

The nursing leadership team at Adtalem Global Education  helps nursing schools better meet the needs of their students through the Social Determinants of Learning (SDOL). Principles that emphasize access over exclusivity and put students at the center, and ultimately, help decrease the nursing shortage. If adopted more widely, the framework can help nursing schools better meet the needs of their students and, ultimately, help reduce the nursing shortage.

Among the core principles are:

  • Student Admissions: The process evaluates factors beyond standardized test scores and GPA.
  • Student Success: Personalized learning approaches encourage strong student outcomes.
  • Mindfulness: An 8-week program integrated into a pre-licensure BSN program helps manage the stress that can hinder student progress.

Daily Nurse spoke with Karen Cox, PhD, RN, FACHE, FAAN, president of Chamberlain University and member of the leadership team at Adtalem Global Education, who helped create and implement a learning framework to adjust for those factors. She’s committed to assisting students to overcome all barriers, including past academic performance. As a healthcare executive and a former clinical nurse specializing in pediatric intensive care, burn care, and infectious diseases, she leads the largest school of nursing in the U.S. with nearly 38,000 students across 23 campuses and online programs. As a result, Chamberlain University is the leading grantor of bachelor of science in nursing degrees to underrepresented minority students in the U.S.

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Karen Cox, president of Chamberlain University, talks about how the Social Determinants of Learning can help schools build a nursing pipeline

Prospective nursing students encounter barriers within nursing education that limit their degree completion, and this disproportionately includes college applicants from diverse communities. What can nursing schools do to adjust those factors?

First, nursing programs don’t tend to look at students as a whole. Their gold standard is the GPA. And that gets them the students with the most privilege and advantage. Those will be students that are usually independent or dependent, do not have to work full time, are very likely to be highly successful and pass the boards at a high rate.

As long as the profession generally does that, diversity in general, and I’m talking about ethnic and socio-economic diversity, diversity won’t be accomplished because people are more than their GPA. And so our approach is what nursing and other parts of higher ed talk about holistic admissions. And that’s where you look at the person, their life experiences, and their GPA, but you also try to understand what was behind that GPA if it was lower. And figure out if they will likely succeed, knowing they need more support.

And that’s where the Social Determinants of Learning framework comes in. We did a study at Chamberlain that shows only 30% of success or progress is related to people’s academic abilities. Seventy percent is related to psychosocial factors. So we have students that are independent, work full time, and if they lose a job, or if their car breaks down on the way to one of their clinicals, they can’t figure out what to do to get there. Those are nuisances to many people, but it could be the difference between success and failure to our students. So you have to look at supporting people. I will tell you I saw a school admitting students before they accepted your application. You have to take a test that you have reliable transportation, which is code for lots of things. But number one, if you say yes, and then you don’t, they won’t have to work with you on it. And what I find so interesting is that nursing is the most caring profession. And we’re not caring for students, and then we wonder why they’re not as caring for patients and families as we’d like them to be.

So we role model that level of care. And nurses have to accept people in all situations, all walks of life. And if nursing faculty can’t accommodate that, it doesn’t send the right message. Some schools say, “We want more diverse students, but we can’t get them.” And it’s not just that some diverse individuals haven’t had privileges. So you’re setting up another factor that could cause structural racism. You build the procedures that are the advantage—the majority group.

As a leadership team member at Adtalem Global Education, what are you doing to create and implement a learning framework to adjust for those factors?

A couple of different things. As mentioned in the admissions piece, we look at the faculty role differently. Faculty teach a class for three hours once a week or twice a week. And go home. Faculty are coaches and mentors, and guides and help us identify resources that students need. And then, we ensure we have the requisite resources that we need on-site or connections. We recently identified an organization that can help people who find themselves without a home and how to navigate that system and find them housing. We can’t provide all these things for people, but we can help them identify what that looks like in a crisis.

Food insecurity is an issue for many of our students, and we’re working to make sure we have either food available, or a pantry available on campus, but also, if we can’t, for whatever reason, have a connection and a seamless way to work with community services. So it’s paying attention not just to their learning but the things that get in the way of their learning. The other piece we’re doing at Chamberlain is that our students have to work full-time. But we don’t want them to work in retail, not because it is bad, but because it’s a couple of things. Retail work isn’t as flexible in considering the schedule of nursing clinicals and courses. But the bigger issue is if they can work in a hospital or healthcare setting, that’s one more experiential option where they see healthcare in action. And they get some hands-on experience. And they get to know an employer. It’s called “Earn to Learn” because the next step is that so many state boards now allow students to do some of their clinical work in an organization while getting paid not all but some hours for each specialty. And again, they’re not with faculty in the same way as they are typically, so they get yet another look at the day in the life of nurses. The nurse has extra pair of hands. And so we feel like it’s important. And if we had had something like this setup before COVID started, we’d have over 13,000 pre-licensure students nationwide. We could have been a force to support the workforce in a very seamless, organized ready-to-go way.

How has Chamberlain University become the leading grantor of bachelor of science in nursing degrees to underrepresented minority students in the U.S.? 

So right now, getting into nursing school takes work. And I’m not saying it should be easy. But a 3.8 or 3.9 gets you looked at for nursing admission. What we do is look, again, we have students with a 3.2, who turn out to be extraordinary nurses with a high level of resilience and a high level of passion and excitement about being in the nursing profession. And so it’s about feeling that belonging. And if you walk onto one of our campuses, you will immediately see the diversity. It’s not in pockets. It’s prominent. And we’re so proud of it because of our scale. We can have an outsized impact on sending diverse nurses into the workplace. And the bigger we get, the more outsized that impact is.

So nursing graduates match what it’s like out there in the real world?

Exactly. Health equity has a chance. And we feel very strongly about that. I can’t tell you the disappointment when you read about well-educated Black women who died in childbirth. I tell people we see that disparity because it’s not normal, and you shouldn’t ever die at birth. But if two people get colon cancer, colon cancer is bad no matter what. So it’s hard to measure when you look at outcomes, but it’s harder and takes longer. But when you’re talking about something that’s supposed to be a normal part of life, yeah. It’s just stark.

Some of it comes down to not listening to or believing people. And if somebody says, I don’t feel right, and this is going on, I always tell students and new nurses, if a patient says or a parent says, this is not right, then something’s wrong. You stop in your tracks. And you investigate, and you get a colleague to look at it. The worst that can happen is everything’s okay. But often, patients know their kids, especially when you work with children and their families. And so what I think the piece about structural racism, there are lots of factors in healthcare. But the fundamental thing of listening and trusting someone and not just making assumptions or the notion of biases that have no basis effect.

How can the framework – the Social Determinants of Learning help other nursing schools better meet the needs of their students and, ultimately, help decrease the nursing shortage?

Education overall is about elitism, it’s about the best of the best going to the best schools. And the best, you know, promulgating that notion that it’s for the people with the highest abilities, the money to go to school. And so, we published that framework in 2021. And we’ve had a lot of interest. I would say the interest has been more at the faculty level than the leadership level. We plan to speak about it at a few conferences, but it’s a fairly new kind of name that we put on and developed this framework. I think that if people are honest, they know that your chances of diversifying go down dramatically if you don’t have a holistic admissions process. Still, we’re going to struggle with this because this was developed and discussed ten years ago at a national level how important the holistic admissions process is, and it’s just simply not there to the degree it needs to be.

When you sat down and created the SDOL framework, what did you envision as the desired outcome for nursing schools and the nursing profession?

It was to scale it, share it, and disseminate and hopefully get the attention of people who go to it who say to themselves, “Oh, yeah, I can now see that I know the social determinants of health because I teach that.” Now I can see how you brought that out to somebody in education. And, of course, this has applicability past nursing for any education situation looking at people’s barriers. And what can you do about those barriers? If you want to do something, there are a lot of people who still like the survival of the fittest. You met ten people, and two aren’t making it, and that’s okay. That’s not Chamberlain. We take it personally when we lose a student we went with and invested in. And that could be a real asset to the profession.

When creating this framework, you anticipated there would be pushback. What are your thoughts about selling the idea and having it makes sense?

The narrative is that everybody should have a level playing field and be at a certain place. And we’re not talking about not having the same outcomes. We’re talking about coming into a program. The other pieces, it takes more people, more work, different structures, different ways of organizing classes. Some schools will say they don’t have the dollars to do it. Or they don’t see the need. And that’s why I think that, at some point, the accrediting bodies will have to talk about being more holistic. But they don’t. They’re going about their business. They’ve got a busy school. They got plenty of applicants. They have twice as many applicant slots. In their mind it doesn’t make a difference, but it sure does nationally.

Chamberlain can influence, and as we grow with purpose and quality in mind, the more that we have, the more have to listen to us. We aren’t just going to sit over here. We’re in a category of one in terms of our mission, scale, and national presence. And so we’ve been more about just making sure that we have that impact and that people know about it and see it and the people who see it or the health system leaders locally hiring our graduates

Anything else to add?

There is a study that came out recently that talked about how many lost years and lost dollars occur in this country because of health inequities. And when we say the cost of healthcare in the U.S. is unsustainable, and I believe it is, one big component is addressing health disparities. And if we got busy and worked on that, we could work together across sectors. We could make an impact.

Potential for ChatGPT-Assisted Learning in Nursing Education

Potential for ChatGPT-Assisted Learning in Nursing Education

“ChatGPT-assisted learning has the potential to revolutionize nursing education, providing opportunities for enhancing the learning experience and outcomes for nursing students,” says Michael LeTang, MS, RN-BC, CCRN-K, vice president, chief nursing informatics officer for the risk management department at Healthcare Risk Advisors (HRA), a part of TDC Group, and an adjunct professor at New York University in the graduate nursing informatics program.

Daily Nurse spoke with LeTang about the potential for ChatGPT-assisted learning in nursing education.

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Michael LeTang, MS, RN-BC, CCRN-K, vice president, chief nursing informatics officer for the risk management department at Healthcare Risk Advisors (HRA), a part of TDC Group

How will AI-powered tools impact nursing education?

Personalized learning is one of AI’s most significant predicted influences on nursing education. ChatGPT could provide students with customized feedback, resources, and learning experiences, ensuring optimal learning outcomes. Additionally, AI-powered tools like ChatGPT could support nursing students in developing their clinical decision-making skills by providing real-time information, evidence-based recommendations, and assistance with clinical scenarios. This can be especially beneficial in developing critical thinking and decision-making skills, which are crucial for success in nursing practice.

AI technology is also predicted to enhance virtual simulation and immersive learning experiences, providing students with practical experience and developing clinical skills in safe, controlled environments. Although not a direct feature of ChatGPT, AI-driven tools could enable the development of virtual simulations and immersive learning experiences, allowing nursing students to gain practical experience.

However, it is important to note that the role of educators remains vital in guiding students to connect course content with real-life situations and ensuring they can effectively apply their knowledge and skills in the context of patient care. Therefore, a balanced approach integrating ChatGPT-assisted learning with traditional teaching methods can enhance nursing education, prepare students for an ever-changing professional landscape, and ultimately improve patient outcomes.

What are the potential misuses of ChatGPT in nursing education?

While ChatGPT can serve as a valuable supplementary resource in nursing education, potential misuses, such as overreliance on AI-generated information, inadvertent neglect of human interaction, fostering complacency, or misinterpreting knowledge, could hinder nursing students’ learning process and professional development.

Nursing education emphasizes theoretical and practical knowledge, so students must apply AI resources like ChatGPT responsibly and cautiously.

A few potential misuses and their possible consequences:

  1. Overreliance on AI-generated information: Students may excessively depend on ChatGPT to answer questions or provide insights without cross-referencing the information with other reliable sources. This could lead to misconceptions, misinformation, and poor decision-making, potentially harming patient care in the long run.
  2. Inadvertent neglect of human interaction: The convenience and immediacy of ChatGPT may inadvertently lead to students favoring digital interactions over human connections. This could impact their interpersonal skills and empathy, essential in nursing. Maintaining a balance between AI assistance and personal communication with educators, mentors, and peers is crucial.
  3. Fostering complacency: The ease with which students can obtain answers from ChatGPT might foster a sense of complacency, reducing the motivation to delve deeper into complex subjects or develop critical thinking skills. Students should always be encouraged to explore beyond the information provided by AI and strive for comprehensive understanding.
  4. Misinterpreting knowledge: AI-generated information may occasionally be ambiguous or misleading, resulting in students misinterpreting the content. Students should be taught to critically evaluate the information they receive from AI sources and cross-check with authoritative references to ensure accuracy.
  5. Ethical concerns: Using AI tools, such as ChatGPT, in nursing education raises ethical concerns around data privacy and security. Students should be aware of these concerns and adhere to guidelines and best practices when using AI technology.

How can educators maximize ChatGPT in nursing education?

To maximize the benefits of ChatGPT in nursing education, educators must guide students on how to responsibly utilize AI as a supplementary tool while emphasizing the importance of critical thinking. This will ensure that future nurses are well-equipped to provide high-quality patient care while responsibly embracing AI technologies.

ChatGPT and Its Potential in Nursing Education

ChatGPT and Its Potential in Nursing Education

Artificial intelligence (AI) offers incredible potential to improve health on a global scale, and ChatGPT, an artificial intelligence chatbot developed by OpenAI, shows great promise as a convenient and accessible way for nursing students to access information and practice their clinical skills using ChatGPT-assisted learning in nursing education.

Cara Lunsford , RN, CPHON, is the vice president of community at Nurse.com, where she fosters a community where nurses can find peer support, allies, professional opportunities, resources, and education. Lunsford has 16 years of experience in acute care, home health, and home infusion settings. 

Daily Nurse 
spoke with Lunsford about using ChatGPT in nursing education, the role of nursing educators in an AI world, and lessening the digital divide to make technological advancements accessible for all.

What follows is our interview, edited for length and clarity.

How has AI integration become more prevalent with technological advancements in the healthcare field?  

AI supports simulations to give students and clinicians more practice in safer environments before they begin working with human beings. AI also can bring a broader range of knowledge together more quickly for potential further exploration of the best course of action. Additionally, as ChatGPT becomes more accurate and reliable, students can use it on their own time and in a private setting. They’ll likely feel more comfortable asking questions without fear of judgment from instructors or other students.

How can AI be used to improve health on a global scale?

The demand for healthcare will only continue to increase across the globe as the population ages. However, with challenges related to staffing for both nurses and physicians, AI presents opportunities to reduce costs for organizations and limit exposure to contagious diseases, especially in underserved areas of the world.

Patient populations are also becoming more complex, and we will continue to face increasing global health challenges, such as COVID-19. People will continue to travel more than before. Viruses will spread more quickly than we can keep up with. However, we can provide global health equity with immediate access to evidence-based best practices that will eventually be available through AI. As a result, we can save hundreds of thousands of lives.

Does ChatGPT provide students a convenient and accessible way to access information and practice their clinical skills?   

As ChatGPT becomes more reliable, it will allow nursing students to build clinical and interpersonal skills in a more controlled setting. Whether simulating patient interactions or explaining a clinical procedure, ChatGPT has the potential to be an excellent resource for basic information that nursing students can use as a starting point and then expand their knowledge. 

Talk about the potential for ChatGPT-assisted learning in nursing education. 

ChatGPT could create scenarios or personas for students as they think through the best course of action in providing care for an AI-simulated patient or communicating with a simulated family member. Additionally, ChatGPT can help summarize complex topics in courses nurses often find challenging, such as chemistry or pharmacology. Having a non-textbook take can help break learnings down into digestible pieces.

What are the potential misuses of ChatGPT in nursing education?

Using the current iteration of ChatGPT to diagnose or provide care plans would be dangerous. The information provided by AI can be a valuable time saver; however, the results of queries can contain outright errors. While ChatGPT has numerous advantages, you can run into ethical issues in nursing education, such as plagiarism or cheating. ChatGPT can create unique pieces that include scientific data depending on your prompt. However, it removes the essential components of completing your research, compiling your data, and formulating your thoughts. It can be a slippery slope. On another note, when ChatGPT creates each text, it may be missing critical elements like tone, which makes writing more authentic and personal. ChatGPT lacks empathy – something all nursing students need. 

What are some of the potential limitations and fallacies in the use of ChatGPT? 

As noted, the current iteration of ChatGPT sometimes contains errors in answers to queries. Also, the software cannot currently provide citations for the source of the information in its responses. In nursing education, this has a dangerous potential for students to act on erroneous information. Student nurses will continue to need guidance from educators with years of experience who have well-developed judgment and hands-on knowledge of nursing protocols and pitfalls. ChatGPT cannot also pull recent data. Students seeking information on recent clinical trials or new protocols for patient care might receive responses needing more current data.

As AI continues to develop, will it replace educators in the future?

While AI has advanced rapidly, it’s unlikely it will completely replace human educators in the near future. Educators provide more than just information; they’re mentors, counselors, and more, to their students. Human educators can also empathize with students, bringing creativity and critical thinking to the learning process, which isn’t what AI is known for. Education is a social process, and human interaction, especially in medicine, is essential for effective learning. While AI has its growing list of uses and benefits in the educational realm, it can’t fully replace in-person interaction between educators and their peers, educators and their students, or the human perspective. Right now, AI can serve as a tool to augment the work of educators, providing personalized and adaptive learning experiences and automating routine tasks. This gives educators time to focus on providing their students mentorship, support, and guidance.

Additionally, nursing education is all about hands-on clinical experience. Student nurses stand to absorb more information and build more confidence through hands-on clinical experiences with nurse educators at the helm. While ChatGPT is a helpful piece of technology and can aid in giving students further academic support, it can’t replace the one-on-one guidance they receive from their nurse educators during their most formative years in nursing.

If acquiring knowledge becomes increasingly accessible, what will be the role of higher education in an AI world?

Making knowledge more readily accessible is a good thing. You might ask an AI tool: Give me three options for providing care to this person in this simulated scenario. Compiling knowledge and ideas more quickly can aid life-saving actions. But it can also empower life-threatening actions if misused. Nurses must have supervised early experiences to build their expertise. They need sounding boards and critical feedback as they develop their nursing skills. When a nurse returns to school for an advanced degree, it validates employers and peers that this person has gained access to a certain degree of information that will help them advance in their career. A BSN, MSN, or PhD will still stand as a confirmation that a nurse has not only received the higher education but that they were able to apply it to their practice and demonstrate an understanding of that information. Higher education is vital to developing good nurses we can trust to do the best for their patients.

Does this mean that training critical thinking, rather than delivering the content of the class materials, becomes more important than ever?

Critical thinking and gut instinct have always been vital for nurses, which is necessary for good problem-solving. Student nurses must be aware of anything that rings alarm bells, just as it is for experienced nurses. As general content becomes more available through AI, it will be imperative that nursing educators use their time to help students hone their critical thinking skills and instincts. If something seems off, asking a more knowledgeable nurse, or getting a second opinion, is a good course of action. However, nurses must think quickly and act based on their knowledge and experience. Using AI for information gathering and suggesting solutions can be a time saver, but relying on AI for clinical decision-making could have tragic outcomes.

How should we evaluate students’ competency in acquiring knowledge in the classroom? For example, should we start implementing traditional paper and pencil formats for exams? 

At every level, we have to trust nurses to make ethical decisions. For student nurses, knowing how to find reliable sources and remember evidence-based practices is crucial to their future careers and the safety of their patients. So, digital exams are still valuable. Requiring students to cite their answers’ sources can ensure they know how to find the information they need to succeed in nursing.  

The best kind of competency evaluation for nurses still resides in clinical practice and access to simulations. Instead of going back to paper and pencil, we should look at ways of harnessing technology so we can place student nurses in virtually realistic situations so they can make real patient care decisions. 

While we are making concerted efforts to address health disparities and promote equity globally, do you see the advancement of technology further widening the digital divide across populations with various socio-demographic characteristics (e.g., age, socioeconomic status, and geographic locations)?

Like every tool and skill, that depends on how we put the technology into practice. Technology can help spread the word about differences in populations and individuals more quickly. For instance, it can help us recognize disease trends in certain populations. It can help more people around the world be aware of cultural resistance or preferences for communicating, being approached by caregivers, and receiving care. In the past, some research findings used male populations and extrapolated those results to females. With technology, we can share broader and specific knowledge more quickly and widely. That, in turn, allows critical and sometimes opposing views to be shared more quickly, adding to critical thinking and sparking further research. While there will always be those that embrace or resist new technology, it also raises the question, is it accessible? Creators of technology, like ChatGPT, place themselves in unique positions to deliver information and services more quickly. However, it’s essential to recognize what must be done to make technological advancements accessible for all. For example, internet access is still not as widely available in certain geographic areas, creating limitations for populations living there. As a result, healthcare resources such as telehealth services become more limited and inaccessible for those populations. I believe steps have been taken to make healthcare resources and services through technology more equitable to these populations, but more work needs to be done to lessen this divide.

The Promise and Peril of ChatGPT in Geriatric Nursing Education 

The Promise and Peril of ChatGPT in Geriatric Nursing Education 

Artificial intelligence (AI) integration in healthcare has become more prevalent through the advancements of ChatGPT, an OpenAI-developed AI language model based on deep learning that produces human-like text. 

ChatGPT has many questioning its role in healthcare, specifically its use in nursing education.

So Daily Nurse spoke with Bei Wu, PhD, FGSA, FAAN (Honorary), Vice Dean for Research, Dean’s Professor in Global Health, New York University, Rory Meyers College of Nursing , and Xiang Qi, BSN, RN, PhD candidate at New York University, Rory Meyers College of Nursing about ChatGPT’s potential use in geriatric nursing education.

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Bei Wu, PhD, FGSA, FAAN (Honorary), Vice Dean for Research, Dean’s Professor in Global Health, New York University, Rory Meyers College of Nursing, and Xiang Qi, BSN, RN, PhD candidate at New York University, Rory Meyers College of Nursing

What follows is our interview, edited for length and clarity.

How has AI integration become more prevalent with technological advancements in the healthcare field?

Xiang Qi: AI has become increasingly prevalent in the healthcare field due to several factors, including advancements in machine learning algorithms, increased computational power, and the availability of large datasets for training. These improvements have led to applications such as early disease detection, personalized medicine, patient monitoring, telehealth, and streamlining administrative tasks. For example, in geriatric nursing care, AI is used for monitoring patients with dementia, detecting falls, facilitating communication, and managing medications, enhancing the overall quality and efficiency of care for older adults.

Does ChatGPT provide students a convenient and accessible way to access information and practice their clinical skills?

Bei Wu: ChatGPT provides students a convenient and accessible way to access information and practice their clinical skills. As an AI language model, ChatGPT can offer instant feedback, answer questions, and engage in interactive conversations, making it a valuable resource for learning. However, it is important to note that ChatGPT should be used as a supplementary tool alongside traditional educational methods and guidance from qualified educators to ensure a comprehensive understanding of clinical skills and concepts.

Talk about the potential for ChatGPT-assisted learning in geriatric nursing education. 

Xiang Qi: ChatGPT-assisted learning has significant potential in geriatric nursing education. Key benefits include accessibility, personalized learning, scenario-based learning, and continuous updates. For example, ChatGPT allows students to access information and resources 24/7, accommodating diverse schedules and learning needs.

ChatGPT can simulate patient interactions, enabling students to practice communication, decision-making, and critical thinking skills in realistic geriatric care situations. In addition, AI can tailor the learning experience based on individual students’ needs, strengths, and weaknesses, ensuring effective learning outcomes. Furthermore, ChatGPT can integrate the latest research and best practices in geriatric care, keeping students current with evolving knowledge. However, it’s crucial to combine ChatGPT-assisted learning with guidance from experienced instructors and hands-on training to ensure the development of well-rounded geriatric nursing professionals.

What are the potential misuses of ChatGPT in geriatric nursing education?

Xiang Qi: Potential misuses of ChatGPT in geriatric nursing education include students’ overreliance, misinformation, limitations in empathy, and inadequate preparation. For instance, students may become overly dependent on ChatGPT, neglecting the need for hands-on experience, critical thinking, and guidance from a qualified educator. For the problem of misinformation, while ChatGPT is a powerful tool, it may occasionally provide inaccurate or outdated information, which could negatively impact students’ learning. As an AI, ChatGPT lacks genuine empathy, essential in geriatric nursing. Overemphasis on AI-based learning may hinder students’ interpersonal skills and compassion development. Furthermore, ChatGPT is now not well prepared for geriatric nursing education. It cannot replicate all aspects of real-world geriatric care, so students might not be fully prepared for the complexity and challenges of actual clinical situations.

What are some of the potential limitations and fallacies in the use of ChatGPT? 

Xiang Qi: Some potential limitations and fallacies in using ChatGPT include inaccurate information, ambiguity and context, verbose and overconfident answers, and dependence on user inputs. As noted in our article, ChatGPT may occasionally provide incorrect or outdated responses, as its knowledge is based on the data it was trained on and is limited to a specific cutoff date. We asked ChatGPT to provide literature on a particular topic, but all its outputs need to be more accurate, and all literature it provided is non-existent. ChatGPT may sometimes generate verbose responses or provide overly confident answers even when uncertain, which could mislead users. It should be mentioned that ChatGPT’s responses are guided by user input, which means that its effectiveness is partly dependent on the clarity and quality of the questions asked. ChatGPT may struggle with understanding ambiguous questions or context, potentially leading to irrelevant or unclear responses.

As AI continues to develop, will it replace educators in the future?

Bei Wu: While AI will likely play an increasingly significant role in education, it is unlikely to replace educators completely. Instead, AI will serve as a tool to complement and support our work. Faculty possess unique qualities, such as empathy, creativity, and adaptability, which are difficult for AI to replicate. The human element remains essential for fostering relationships, understanding individual needs, and providing tailored guidance. AI can, however, streamline administrative tasks, personalize learning experiences, and offer additional resources, allowing educators to focus on higher-level teaching and mentoring responsibilities.

If acquiring knowledge becomes increasingly accessible, what will the role of higher education become in an AI world?

Bei Wu: We may finally enter into an AI world. In an AI-driven world, higher education’s role will likely evolve to focus on skills development, interdisciplinary learning, ethical and social responsibility, and innovation. Higher education will emphasize the development of critical thinking, problem-solving, creativity, and emotional intelligence, which are difficult for AI to replicate and remain essential for professional success.

Higher education will encourage students to engage in interdisciplinary studies, fostering the ability to integrate knowledge from various fields and driving innovation and adaptability in a rapidly changing world. Furthermore, higher education will play a critical role in teaching students about ethical considerations, social responsibility, and the impact of AI on society, ensuring responsible AI development and application. By embracing these roles, higher education will maintain its relevance and importance in an AI-driven world, preparing students for a future that increasingly depends on human skills, adaptability, and ethical awareness.

What kind of education and training do we need to provide our students so they become highly qualified geriatric nursing professionals?

Bei Wu: Education should focus on theoretical knowledge, clinical skills, interprofessional collaboration, empathetic communication, ethical considerations, cultural competence, evidence-based practice, technological proficiency, and leadership development to train highly qualified geriatric nursing professionals. 

I emphasize cultural competence and leadership development as we now see a more diverse world than ever. Educators must equip students with the knowledge and skills to provide culturally sensitive care and respect students from diverse backgrounds with different cultural beliefs and values towards older adults. We also need to foster leadership skills and encourage students to advocate for the needs of older adults, both within the healthcare system and in the broader society. By combining these elements, educational programs can prepare students to become competent, compassionate, and well-rounded geriatric nursing professionals.

Does this mean that training critical thinking, rather than delivering the content of the class materials, becomes more important than ever?

Bei Wu: Yes, training critical thinking becomes increasingly important as it enables students to effectively analyze, interpret, and apply the content of class materials. This skill empowers them to adapt to new information, solve complex problems, and make informed decisions in their professional practice, which is essential in the dynamic field of geriatric nursing.

How should we evaluate students’ competency in acquiring knowledge in the classroom? For example, should we start implementing traditional paper and pencil formats for exams?

Bei Wu: Evaluating students’ competency in acquiring knowledge should involve various assessment methods to capture the breadth and depth of their understanding. While traditional paper-and-pencil exams can help assess theoretical knowledge, it is also essential to consider alternative methods, such as practical exams, which assess students’ clinical skills and abilities through simulations or hands-on clinical experiences; group projects to evaluate teamwork, collaboration, and problem-solving skills in real-life scenarios or case studies; presentations that allow students to demonstrate their understanding and communication skills by presenting on specific topics; and portfolios to track students’ progress and achievements over time with a collection of their work, including research papers, clinical evaluations, and other relevant documents. Educators can better evaluate students’ competency across various aspects of their geriatric nursing education by implementing a mix of assessment methods.

While we are making concerted efforts to address health disparities and promote equity globally, do you see the advancement of technology further widening the digital divide across populations with various socio-demographic characteristics (e.g., age, socioeconomic status, and geographic locations)?

Bei Wu: Advancements in AI technology do have the potential to widen the digital divide across populations with different socio-demographic characteristics. Some of the challenges include affordability, infrastructure, and digital literacy. For example, lower-income populations may need help to afford devices, internet connections, or services required to access digital health resources. Rural or underdeveloped areas may need more infrastructure for reliable internet connectivity or access to advanced healthcare technologies. Older adults or those with limited education may need help understanding and utilizing digital technologies effectively.

However, government, healthcare providers, technology companies, and researchers should make concerted efforts to minimize these disparities and promote digital equity. For example, investing in infrastructure to improve internet connectivity and access to digital resources in underserved areas, providing financial assistance or subsidized devices and services for low-income populations, and implementing digital literacy programs to enhance digital skills and understanding across all age groups and backgrounds. By addressing these challenges, the advancement of technology can be harnessed to promote health equity and reduce disparities across diverse populations.

Anything else to add?

Bei Wu: ChatGPT can transform practice and research in geriatric nursing and allied health. Its capabilities in generating natural language text, synthesizing vast data, and responding to specific inquiries render it a valuable asset for healthcare professionals. As geriatric nursing progresses, staying current with cutting-edge tools and methodologies, including AI, becomes crucial for healthcare practitioners.