Nursing students' informal use of generative artificial intelligence in relation to workplace violence during clinical placement: A qualitative exploratory study.
Jul 2026· Nurse Education in Practice· Vol 95, pp.
104936
· 0 citations· 24 references
Medicine
TL;DR
Nursing students' use of generative artificial intelligence in relation to workplace violence should not be interpreted as a substitute for human or organisational support, and the need for responsible artificial intelligence literacy is highlighted.
Abstract
Aim
To explore how nursing students described and interpreted their use of generative artificial intelligence in relation to workplace violence during clinical placement.
Background
Workplace violence during clinical placement can affect students' learning, confidence and sense of safety. Although generative artificial intelligence is increasingly accessible in nursing education, little is known about how students use it when responding to distressing or uncertain clinical encounters.
Design
A qualitative exploratory study.
Methods
The study was underpinned by an interpretivist paradigm and a constructivist epistemological orientation. Participants were 24 final-year undergraduate nursing students in Indonesia who had experienced or witnessed workplace violence and used generative artificial intelligence in relation to those experiences. Data were collected through semi-structured interviews conducted in Bahasa Indonesia and analysed using reflexive thematic analysis.
Findings
Three themes were developed: generative artificial intelligence as a discreet coping resource in constrained clinical environments; as a practical guide for navigating difficult clinical encounters; and as an interpretive resource for rights, reporting and future planning. Participants used artificial intelligence to disclose distress privately, rehearse respectful but protective communication, interpret volatile situations and consider reporting and future options.
Conclusion
Nursing students' use of generative artificial intelligence in relation to workplace violence should not be interpreted as a substitute for human or organisational support. These findings highlight the need for responsible artificial intelligence literacy, including guidance on privacy, verification and appropriate escalation, alongside stronger clinical placement preparation, post-incident debriefing and reporting support.
ABSTRACT Workplace violence in clinical learning environments is increasingly recognised as a threat to nursing education and workforce sustainability, yet it is often understood as a series of isolated incidents rather than as a condition shaped by broader cultural and organisational forces. This study explored how workplace violence was experienced by nursing students, clinical nurses and clinical instructors in Indonesian hospital placements. Drawing on descriptive phenomenological accounts, the analysis shows how hierarchical relations, patient authority, collectivist expectations and gendered professional identities normalised endurance, constrained speaking up and blurred the boundaries between learning, care and vulnerability. Participants described pervasive verbal abuse alongside bullying, dehumanisation, sexual harassment and episodic physical aggression, with cumulative emotional, psychological and professional consequences that eroded safety, dignity and engagement in learning and practice. Coping responses reflected tensions between professional expectations, personal safety and relational harmony, with ambivalent reporting due to limited organisational follow‐through. These findings address an important gap in understanding how workplace violence may become culturally and organisationally sustained within clinical education, rather than merely occurring as isolated interpersonal events. By conceptualising workplace violence as a sustained cultural–organisational climate rather than a set of discrete events, this paper contributes to critical nursing inquiry and highlights the need to examine education and practice settings together when addressing safety, supervision and justice in clinical learning environments.
G. Rantung, I. Wulandari, J. Sihotang et al.· Nursing Inquiry· 0 citations
Obstetric and gynaecologic clinical practice may expose nursing students to emotionally demanding situations and complex care interactions that shape emerging professional identity and confidence.
The aim of this study was to explore nursing students’ care experiences during their obstetric and gynaecologic clinical practice.
A qualitative descriptive design was used. All eligible third-year nursing students who had participated in obstetric and gynaecologic clinical practice for the first time were recruited for the study. Data were collected through written reflective care stories at the end of the rotation. Narratives from 35 students were analysed using qualitative content analysis, following Graneheim and Lundman.
Four main themes emerged from the students’ narratives: (1) Professional identity questioning and humanistic care orientation, (2) Self-discovery and understanding nursing beyond tasks, (3) Struggles and barriers in providing emotional support, and (4) Satisfaction with the care offered and perceived self-efficacy. Students described reflecting on the kind of nurse they aspired to become, recognizing the importance of emotional presence alongside technical care, experiencing uncertainty in highly sensitive situations and reporting satisfaction with the care they offered and a sense of perceived self-efficacy when they addressed patient needs through education, problem-solving, and supportive presence.
Clinical learning environments and role modelling may influence students’ professional socialization in obstetrics and gynaecologic settings. The findings may inform educational approaches involving communication skills training, supervised reflective learning, and guidance for emotionally challenging encounters, which may support students’ perceived confidence in providing compassionate, person-centred and holistic care.
Gender-based discrimination remains a persistent structural challenge in health professions education and may shape students’ access to learning opportunities, sense of belonging, and professional identity formation. Psychological safety is essential for participation in clinical learning; however, little is known about how gendered experiences are perceived to influence psychological safety, professional identity, and resilience among nursing, midwifery, and medical students.
This qualitative study explored how nursing, midwifery, and medical students experience gender-based discrimination in educational and clinical learning settings and how they perceive these experiences as relating to psychological safety, professional identity development, and resilience. Guided by critical social theory, the study adopted an IPA-informed interpretative qualitative design. Seven FGDs were conducted with nursing, midwifery, and medical students (
n
= 56). Data were analysed using an iterative, interpretative process supported by MAXQDA. Reporting followed the COREQ guidelines.
Analysis generated three interrelated themes with nine sub-themes. Theme 1, Gendered Professional Identity: Professional Role, Competence, and Status, comprised gender-based labelling of professional roles, gender-coded task allocation framed through “sensitivity versus physical strength,” and glass-ceiling perceptions in career pathways. Theme 2, Inequity in Clinical Learning Opportunities and Psychological Safety, included restricted access to learning, gendered recognition and discrimination, and psychological safety and withdrawal. Theme 3, Resilience Through the Lens of Gender, encompassed competence-based identity construction, supportive academic and institutional ecosystems, and collective voice through professional solidarity and advocacy.
The findings suggest that gender-responsive and psychologically safe clinical learning environments may be important across nursing, midwifery, and medical education. Educators, supervisors, and clinical staff should consider addressing gendered role labelling, inequitable task allocation, and hidden curricula as potential structural barriers to learning and participation. Transparent and auditable learning objectives, gender-responsive supervision, monitoring of task and feedback allocation, and accessible reporting pathways may help reduce perceived inequities and support students’ willingness to speak up. The findings also indicate that moving beyond an exclusive reliance on individual resilience may better support equitable professional identity development, sustainable workforce preparation, and safe patient care. However, these interpretations should be understood within the specific educational, clinical, and sociocultural context of the study.
Tuba Sengul, Seda Sarıköse, Betül Uncu et al.· BMC Medical Education· 0 citations
This study aimed to evaluate the effectiveness of interventions involving a dual contact pedagogical intervention on nursing students' attitudes toward mental illness, and to further explore their learning experiences and perspectives. A mixed methods approach using an explanatory sequential design was applied with a single group quasi-experimental design, and a qualitative deductive approach guided by Kolb's experiential learning theory. The dual-contact intervention involving both inpatients and individuals in recovery was integrated into the psychiatric nursing curriculum. Forty-four nursing students enrolled in a five-year junior college in southern Taiwan participated in the intervention group, including 13 who took part in three focus groups. Quantitative data from three self-report scales assessing attitudes, perceived stigma and social distance were analysed using repeated one-way analysis of variance, while qualitative data from focus group interviews conducted after students completed their psychiatric nursing practicum were analysed using content analysis. There were significant differences in attitudes and social distance, particularly after contact with the individuals in recovery. Qualitative data analysis identified that the Dual Learning Strategies with Meaningful Contacts category was associated with these changes, which encompassed three subcategories: (1) Reflective learning experiences, (2) Transforming experiential insights into clinical practice and (3) Debriefing of contacts across phases of psychiatric care. Both contact-based interventions improved attitudes. Notably, engaging with individuals in recovery significantly reduced perceived stigma and social distance. Interaction with inpatients reinforced theoretical knowledge integrating clinical contexts, while engaging with individuals in recovery cultivated empathy and caregiving competencies. Both contact-based interventions provided complementary learning benefits.
Yen-Hua Shih, Mei-Yu Yeh, L. Chuang· International Journal of Men...· 0 citations
BackgroundThis study explored nursing students' lived experiences and perceptions of caregiving practices and the distribution of caregiving responsibilities in clinical settings within the context of holistic nursing.MethodsA qualitative study using an interpretive phenomenological approach was conducted. Data were collected between March and June 2026 through semi-structured interviews with 24 nursing students with clinical experience. Interviews were audio-recorded, transcribed verbatim, and analyzed using interpretive phenomenological analysis.ResultsCaregiving was often deprioritized, fragmented, and delegated to students. Clinical environments were described as task-oriented and constrained by workload and bureaucratic demands, limiting holistic and relational care. Students perceived caregiving primarily as an individual moral responsibility rather than a structured professional obligation. Limited role modeling and supervision reinforced this pattern.ConclusionA gap exists between holistic care values in education and clinical practice. The marginalization of caregiving threatens the relational and humanistic foundations of nursing. Strengthening care-focused environments, role modeling, and support for holistic care is essential to sustain core nursing values.
Şadiye Özcan, Fusun Afsar· Journal of Holistic Nursing· 0 citations
OBJECTIVES
To explore oncology nurses' experiences of using expressive relational practices to support emotional processing among older adults with cancer and to develop a practice-oriented conceptual model intended to inform clinical practice and nursing education.
METHODS
A qualitative interpretive descriptive study was conducted in two tertiary cancer services in Saudi Arabia. Eighteen oncology nurses with direct experience in geriatric cancer care participated in semi-structured interviews. Of 41 eligible nurses approached, 18 were enrolled. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Two researchers independently coded the first five transcripts and iteratively refined a shared codebook; remaining coding and theme development were discussed in regular analytic meetings. Rigor was enhanced through member reflection, peer debriefing, and reflexive journaling.
RESULTS
Four interconnected themes emerged: (1) creating space for what cannot be said, reflecting nurses' attunement to silence and indirect distress; (2) expression beyond clinical dialogue, including storytelling, life review, and symbolic or sensory pathways; (3) holding emotional weight, capturing emotional containment and professional vulnerability; and (4) negotiating boundaries in expressive care, shaped by cultural mediation and institutional constraints. These findings informed an integrative model conceptualizing expressive care as a cyclical process of relational attunement, facilitated expression, emotional containment, and contextual negotiation.
CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE
In this culturally specific setting, expressive relational care appears to function as an integral, rather than adjunct, dimension of person-centered geriatric oncology nursing. Structured expressive communication training, culturally responsive practice guidelines, and institutional recognition of emotional labor may enhance patient dignity and nurse resilience; patient- and family-focused research is needed to test the transferability of these findings.
S. Ali, Mostafa Shaban· Seminars in Oncology Nursing· 0 citations