The impact of transitioning from a traditional to an AI-aware rubric in a Health and Medicine course is evaluated, examining how this shift influenced educators’ grading practices, instructional strategies, and perceptions of student engagement.
Abstract
Assessment strongly shapes student learning and engagement. Traditional assessment rubrics in health and medicine education often fail to account for emerging challenges posed by artificial intelligence. The use of AI tools risks encouraging surface-level learning and undermining academic integrity if not addressed through purposeful assessment design. This study evaluates the impact of transitioning from a traditional to an AI-aware rubric in a Health and Medicine course, examining how this shift influenced educators’ grading practices, instructional strategies, and perceptions of student engagement.
A qualitative research design employed semi-structured interviews with three educators who had taught the course using both original and revised rubrics. As the complete teaching team, their perspectives captured the experience of every educator who taught the course. Interview data were analysed using thematic analysis, with themes cross-referenced against the Twelve Tips for Designing AI-Resilient Assessments framework.
Analysis revealed five overarching themes: perceived transformation in student learning and critical thinking; refinement of assessment practices and expectations; expansion of teaching strategies and curriculum design; implementation challenges and assessment authenticity; and institutional readiness and professional development. Educators perceived that the revised rubric supported deeper student engagement with AI, increased their grading confidence, and prompted shifts in instructional approaches.
AI-aware rubric design can meaningfully reshape both teaching and assessment practices. However, sustainable implementation requires institutional support, structured professional development, and clearer policy guidance on acceptable AI use. The study also refines the Twelve Tips framework, positioning it as a flexible design heuristic rather than a prescriptive checklist. These findings are particularly relevant for undergraduate health professions programs navigating rapid educational and technological change.
BACKGROUND
The rapid integration of generative artificial intelligence (GenAI) into nursing education presents both opportunities and challenges, yet empirical evidence on students' critical engagement with AI-generated content within assessment contexts remains limited.
AIM
To examine undergraduate nursing students' reflections when comparing their own evidence-based summaries with AI-generated outputs in response to the same clinical research questions.
METHODS
A qualitative descriptive design was employed using retrospective analysis of 497 assessment submissions from an undergraduate nursing cohort at an Australian university. Students formulated a research question, synthesised peer-reviewed evidence, submitted the same question to an AI tool, and critically reflected on the comparison. Data were analysed using qualitative content analysis and thematic analysis.
RESULTS
Four themes were identified: 1. Credibility, quality of evidence and academic rigour. Students identified fabricated references, outdated information, and absence of peer-reviewed sourcing as key limitations. Additionally, students reflected on algorithmic limitations and the challenge of verifying AI outputs without prior topic knowledge; 2. Critical thinking, depth of analysis, and human intelligence. AI was perceived as unable to replicate contextual reasoning or multi-source synthesis; 3. Efficiency, accessibility, and practical utility. AI's speed and clarity were valued for brainstorming and initial scoping; and 4. Student identity, learning, and professional development were shaped by the view that engaging in manual, hands-on research was integral to forming a safe, evidence-informed nursing identity.
CONCLUSION
This study suggests that structured AI-comparison tasks offer the opportunity to develop AI and digital health literacy in nursing students. Students are neither naively accepting of AI nor reflexively dismissive but are actively working to understand its place within the ethical frameworks of nursing education. These findings contribute to AI integration in nursing education and offer practical guidance for educators seeking to support graduates to be AI-critical and well-equipped to leverage the efficiencies of these tools.
Embedding structural changes within assessment design, rather than relying on rule enforcement, will ensure nursing and midwifery graduates are prepared to thrive in an AI-enabled world.
Y. Salamonson, Pauletta Irwin, R. Kornhaber et al.· Journal of Clinical Nursing· 0 citations
INTRODUCTION
Workplace-based assessments (WBAs) are central to evaluating clinical performance in clerkships, yet their design and implementation remain challenging. One major challenge is that WBAs inevitably rely on subjective human judgement. However, little is known about how undergraduate students perceive subjectivity in assessment and what they consider trustworthy assessment practices. We therefore explored undergraduate medical students' perceptions of WBAs during clerkships, using a strengths-based approach to envision an ideal WBA system.
METHODS
We organised six focus groups (N = 24) guided by Appreciative Inquiry. Focus group discussions focused on memorable assessment experiences, underlying values, desired changes and visions of an ideal system. We used Reflexive Thematic Analysis within a constructionist paradigm through iterative coding, thematic mapping, analytic memos and team discussions to ensure rigour and reflexivity.
RESULTS
Three themes represent foundational conditions for an ideal WBA system: (1) Being seen, acknowledging students as individuals through personalised feedback; (2) Growth, conceptualising WBAs as a longitudinal process supporting learning and career exploration; and (3) Feeling safe, emphasising a meaningful dialogue and a culture of trust. A fourth theme, Balancing ideals, captured the inherent tensions between competing ideals. Importantly, students perceived assessment as trustworthy not when subjectivity was eliminated but when it was considered accountable and conducive to fair outcomes.
DISCUSSION
Our findings suggest that trustworthy WBA systems are best understood as sets of deliberate compromises, negotiated in ongoing dialogue with students and assessors, rather than one-size-fits-all frameworks. By adopting a strengths-based approach, this study reframes familiar assessment concepts as conditions for enabling trust, rather than as solutions to deficits. These findings advance our understanding of how to embed subjectivity into WBAs in a trustworthy manner and offer a student-informed approach for strengthening WBAs design in undergraduate medical education.
Jelle W Meerstra, Lara M. van Peppen, I. Otto et al.· Medical Education· 0 citations
Background Humanities courses in medical training are increasingly recognized as essential for developing empathetic, reflective and socially responsive physicians. Although well-established globally, their integration into medical education in African contexts remains limited. In Kenya, humanities are often peripheral within curricula dominated by biomedical sciences and clinical medicine. Aga Khan University (AKU), Nairobi, has introduced a novel medical curriculum that embeds seven core humanities courses as central components of the initial phase of its MBChB program. This study explored students’ perceptions and lived experiences of these humanities courses. Methods A retrospective descriptive study using an embedded mixed-methods design was conducted among the first two cohorts of medical students. Of the 11 courses offered in the first two trimesters, seven were humanities courses, each routinely evaluated following delivery. Evaluation data comprised quantitative closed-ended Likert-scale items and qualitative open-ended responses capturing students’ perceptions of course relevance, delivery and assessment. Quantitative data were analyzed using descriptive statistics while qualitative data were analyzed thematically using Braun and Clarke’s six-phase framework to complement and provide explanatory context to the quantitative findings. Results Students reported overall positive perceptions of the humanities courses, with a mean score of 3.9 (range: 3.7–4.2) on a five-point scale. Mean scores were similar across trimesters 1 and 2. Overall, 70.1% (89/127) of students rated the courses favorably, agreeing or strongly agreeing with positive statements about their learning experiences. Courses perceived as more relevant to medical training and those that were better organized received higher ratings. Key areas for improvement identified by students included increasing opportunities for formative assessment and enhancing consistency and structure in instructional delivery. Conclusion Students at AKU reported positive experiences with humanities courses during the first two trimesters of their medical training. Longitudinal studies are needed to evaluate the impact of these courses on learning, professional identity formation and clinical practice in later stages of medical education.
C. Gathu, Marthaclaire Zammit, Urvi Saboo et al.· Journal of Medical Education...· 0 citations
Clinical placement logbooks are widely used to guide learning, document clinical exposure, and support student–tutor feedback. Despite their ubiquity, little is known about how logbooks shape medical students’ learning behaviours, particularly the tension between their reflective and administrative functions. This study explores how students and tutors experience logbooks and how these experiences influence engagement during clinical placements.
A qualitative study was conducted at a single university-affiliated teaching hospital. Six third-year medical students and two clinical tutors participated in one-to-one semi-structured interviews. Convenience sampling was used for students and purposive sampling for tutors. Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis, supported by NVivo. A reflexive, interpretivist approach underpinned the analysis, with iterative development of themes informed by an audit trail and researcher positionality.
Three themes were generated.
Logbooks as reflective tools versus administrative tasks
captured the tension between students’ desire for narrative reflection and the restrictive, checklist-driven format of logbooks.
The Goldilocks balance of structure
described how logbooks provided orientation early in placements yet later constrained learning by directing behaviour toward predefined tasks.
Logbooks as motivators for participation
illustrated how signatures and checklist completion prompted engagement, particularly among less confident students, but also fostered superficial documentation and extrinsic motivation, with meaningful feedback often limited by clinical workload.
Logbooks influence learning behaviours in complex and sometimes unintended ways. While they can support orientation and prompt participation, their administrative demands may constrain autonomy, limit meaningful reflection, and contribute to task-driven engagement. Redesigning logbooks to separate administrative tracking from reflective practice, supported by deliberate, structured feedback conversations, may better align their use with the realities of clinical learning and the needs of students.
Raymond S Piggott, Laura M. Piggott, J. Harbison et al.· BMC Medical Education· 0 citations
Limited Teaching Faculty (LTF) are often asked to teach occasional sessions without formal pedagogical training. To address this gap, we developed the Teaching Essentials Series (TES), a faculty development program tailored to help these educators become more effective teachers. We evaluated TES using a case study approach guided by the Kirkpatrick evaluation framework, utilizing quantitative and qualitative methods. Pre- and post-surveys assessed changes in participants’ knowledge and confidence. In addition, qualitative semi-structured interviews were conducted with program participants from 2023 to 2025. The Kirkpatrick model informed both the development of the interview guide and the interpretation of findings. Quantitative findings indicate that TES is a beneficial program that enhances participants’ knowledge and confidence. Qualitative interviews revealed four central themes: (1) the need for formal pedagogical training, (2) the value of practical learning, shared strategies, and peer connections, (3) enhanced confidence and educational profile, and (4) a shift in teaching perspective and mindset. Participants reported that TES helped them develop practical teaching skills that they could share with peers and leaders, with minimal time commitment. Aligned with the 4-Cs framework (Competence, Career, Context, and Community), the evaluation of the TES program suggests that TES represents a feasible, low-time-commitment model for supporting educators with substantial research and clinical responsibilities. Furthermore, participants noted that TES equipped them with tools they could share with colleagues and leaders, reinforcing the program’s broader impact.
A. Pajoohesh-Ganji, Kirsten A. Brown, Tayla Beckles et al.· The journal of the Internati...· 0 citations